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The Ups and Downs of your pelvic floor

What is my pelvic floor?

The pelvic floor is a group of ‘U’ shaped muscles forming a sling in the base of the pelvis. They attach from the tailbone to the pubic bone, and between the sit bones.  This sling of muscles supports the pelvis, the pelvic organs and the low back, helping to create a stable base for your body to move from. 

Why is it important? 

The pelvic floor muscles play a significant role in offering support to the bladder, uterus and bowel. If weakened, they can contribute to poor bladder and bowel control, difficulty emptying, leakage, sexual dysfunction, pain and/or pelvic organ prolapse.

How do I know if my pelvic floor is weak? 

  • You may experience light bladder leakage when you cough, sneeze, laugh or exercise 
  • You may experience a sense of urgency to go to the toilet 
  • You may feel a heaviness or bulging due to lack of support of the pelvic organs 
  • You may find it difficult to control wind 

How do I strengthen my pelvic floor?

The pelvic  floor is the same as any other muscle in the body, in order to make it stronger, you need to do your strength exercises! Your Physiotherapist can guide you through a specific strengthening program, tailored to your individual needs and goals. Another great resource is the Pelvic Floor First App, which can be found at http://www.pelvicfloorfirst.org.au/pages/pelvic-floor-first-app.html

What weakens my pelvic floor? 

  • High impact exercises such as running, jumping, contact sports
  • Chronic constipation 
  • Chronic coughing 
  • Pregnancy, the weight of the baby, placenta and amniotic fluid over 9 months causes increased pressure on the pelvic floor 
  • Birth, more commonly a vaginal delivery 

Can my pelvic floor be too tight?

It is possible for your pelvic floor to become overactive or ‘tight’. This happens when the pelvic floor muscles are hypertonic (increased tone) as opposed to a hypotonic (decreased tone). An overactive pelvic floor can cause symptoms such as pelvic pain, dyspareunia (painful intercourse), constipation and urinary frequency. 

Do men have a pelvic floor? 

Yes!  Similarly to women, men have a pelvic floor too. While men do not go through pregnancy and birth, pelvic floor strength is still important. Many of the risk factors listed above also affect men. The pelvic floor also plays an important role in supporting the low back, reducing incontinence (particularly in older people) and supporting sexual function. 

What is the difference between pelvic floor and core? 

“Core’ is an umbrella term for several muscles making up your deep stabilising system. A simple way to understand this is by picturing a house. The abdominals (transverse abdominis, rectus abdominis and the obliques) form the front wall, while small spinal muscles called multifidus form the back wall. The diaphragm is the roof and the pelvic floor is funnily enough, the floor.  These muscles work together, along with your breathing centres, to form a deep stabilising system for your body. 

Is ‘light bladder leakage’ normal? 

Urinary incontinence or ‘light bladder leakage’ is a common experience affecting over 6 million Australians, regardless of gender, age or background.  Bladder leakage indicates an issue either with the bladder and/or the pelvic floor and is not something you should have to ‘put up with’. It may be as simple as doing a pelvic floor lift to support the bladder during times of increased abdominal pressure such as coughing, sneezing or laughing. 

How can Physiotherapy help? 

For a lot of women, pelvic floor dysfunction  is a sensitive issue, that often goes untreated. A Women’s Health consultation will evaluate the function of your pelvic floor muscles and assess your ability to contract and relax these muscles. You will then be guided through a pelvic floor retraining programme to help you gain control and restore your confidence. 

Jacinta Meharry 

-Physiotherapist 

-Clinical Pilates Instructor

-Special Interest in Women’s Health 

References:

Continence Foundation of Australia (2019). The Facts. Retrieved 8th July 2019 from https://www.continence.org.au/pages/the-facts.html

Continence Foundation of Australia (2019). Pelvic Floor Muscles. Retrieved 8th July 2019 from https://www.continence.org.au/pages/how-do-pelvic-floor-muscles-help.html

Hay-Smith J & Dumoulin C (2006) Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database of Systematic Reviews, Issue (1) (CD005654).

Hay-Smith J, Mørkved S, Fairbrother K & Herbison GP (2008) Pelvic floor muscle training for prevention and treatment of urinary and faecal incontinence in antenatal and postnatal women. Cochrane Database of Systematic Reviews, Issue (4) (CD007471)

Pelvic Floor First (2016). The Pelvic Floor. Retrieved 8th July 2019 from http://www.pelvicfloorfirst.org.au/pages/the-pelvic-floor.html

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