The pelvic floor is made up of two layers of muscle, the superficial pelvic floor and the deep pelvic floor. Collectively, they include 6 different muscles groups, as well as fascia and fibrous tissue. The pelvic floor supports the pelvic organs, which includes the bladder, bowel, uterus and vagina. The primary function of the pelvic floor is to keep all of our internal organs internal. However, there are also many other important functions of the pelvic floor in women including maintaining urinary continence, bowel continence and sexual function. During pregnancy the pelvic floor gets the extra challenge of supporting the weight of a growing baby and uterus over 9 months. For such an important muscle group it is amazing how overlooked it is in our day-to-day lives and how little we talk about it as a society. At school we are taught about how to eat a healthy diet, how to exercise, and about the anatomy of our major muscle groups, but the pelvic floor tends to be neglected, even in sexual health classes.
Pelvic floor dysfunction consists of problems relating to the pelvic floor muscles, which can include weakness, high tone (tightness) or stretched muscle fibers. Dysfunction also relates to shortening or stretching of the pelvic floor fascia or fibrous tissue. Plus, last but not least, prolapse of the bladder, bowel or uterus. Prolapse is when the uterus, bowel or bladder has slipped down, forward or backwards respectively into the vagina. Symptoms of dysfunction include leaking urine when you cough, laugh or jump, constipation, breaking wind uncontrollably, back ache, heaviness within the vagina and pain during intercourse.
Pelvic floor exercises can be used as part of a treatment program for various types of dysfunction. All women will benefit from completing regular pelvic floor exercise regardless of whether they have had children or not, or whether they plan to. Similar to every other muscle in the body, the pelvic floor can become weaker if it is not exercised. The beauty of exercising the pelvic floor is that you can do it anywhere and no one should know you are doing it, if you are doing it correctly! A common pelvic floor exercise problem I see is the recruitment of larger muscle groups when attempting a pelvic floor contraction, such as squeezing the buttocks and/or the thighs together. Another incorrect technique is breath holding and pushing down, rather than drawing up the pelvic floor muscles. These incorrect techniques are counterintuitive to achieving a strong pelvic floor. When activating the pelvic floor correctly there should be no other visible muscle contraction apart from a very gentle core contraction. Achieving a correct pelvic floor contraction really is an art and gaining feedback either in the form or a women’s health Physiotherapy assessment or by the use of biofeedback devices is a great place to start. Once you have the ability to achieve a correct pelvic floor contraction an exercise program specific to your strength and symptoms can be written. This can then be monitored and progressed by a Physiotherapist with women’s health experience.
If you are new to pelvic floor exercises or have concerns regarding your continence or any of the symptoms mentioned in this article, it is advisable to seek an assessment with a Physiotherapist practicing in women’s health. Please call to book an appointment with Jen at Kensington or Caulfield
