Pelvic Floor Weakness - The Awkward Truth

This is not a topic that comes up often in day-day conversation. “Oh hey Marge, just wondering, do you wet your pants a bit when you sneeze?” or “Does anyone else find sex painful since giving birth?’ or “No thanks, I’m going to avoid skipping in today’s class, I’m not wearing my panty liners..”

MEN – come back here. This may freak you out to read about, but is just as important for you to understand what your partners are going through as it is for your partners to realise that this IS NOT ABNORMAL! In fact, pelvic floor problems occur in a large number of women and MEN too!

Let’s quickly review what (and where) the pelvic floor actually is:

The pelvic floor is a group of muscles and ligaments that support the bladder, womb (uterus) and bowel. It is incredibly important for

  • Bladder control

  • Keeping the contents of the uterus (such as bub) inside mum

  • Sexual function

Pelvic Floor Disorder results from two main issues:

  1. Overactivity of the pelvic floor (inability to relax. Common in athletes such as gymnasts or in mums who spend TOO much time doing their pelvic floor exercises without relaxing properly)

  2. Underactivity of the pelvic floor: generally from the pelvic floor being stretched during pregnancy or giving birth, in overweight people, in people who lift heavy weights consistently, in a change in hormones.

So what can we do about it?

First of all, don’t panic. TALK to your women’s health physiotherapist about the symptoms you get and the issues you may be dealing with. Remember, this is nothing to be embarrassed about – it is incredibly common and something physio’s deal with very regularly. Find out if your pelvic floor is underactive or overactive. (this can be done using Real Time Ultrasound (like when you had scans for your bub) or an internal examination by a qualified women’s health physio).

The royal Perth hospital website has some great advice for teaching you how to turn on your pelvic floor (if underactive):

Exercise 1

Step 1:

Sit, stand tall, lie on your back with your knees bent and legs comfortably apart or kneel on your hands and knees.

Step 2:

Close your eyes, imagine what muscles you would tighten to stop yourself from passing wind or to 'hold on' from passing urine. If you can’t feel a distinct tightening of these muscles, ask for some help from a women’s health physiotherapist. She will help you to get started.

Step 3:

Now that you can feel your pelvic floor muscles working, tighten them around your front passage, vagina and back passage as strongly as possible and hold for three to five seconds. By doing this, you should feel your pelvic floor muscles 'lift up' inside you and feel a definite 'let go' as the muscles relax. If you can hold longer (but no more than a maximum of eight seconds), then do so. Remember, the squeeze must stay strong and you should feel a definite 'let go'.

Repeat up to ten times or until you feel your pelvic floor muscles fatigue. Rest for a few seconds in between each squeeze.

Steps one to three count as one exercise set.

If you can, do three sets per day in different positions.

Do your pelvic floor exercises every day for the rest of your life.

Exercise 2 (quick squeeze for power)

Squeeze and lift your pelvic floor muscles as strongly and as quickly as possible. Do not try to hold on to the contraction, just squeeze and let go. Rest for a few seconds in between each squeeze. Repeat this 10 to 20 times or until you feel your pelvic floor muscles fatigue. If you can, do this exercise set one to three times per day.

During both exercises you should:

  • Feel your pelvic floor muscles 'lift up' inside you, rather than feel a downward movement

  • Relax your thighs and buttocks

  • Keep breathing normally

  • Stop exercising if your muscles fatigue.

Click here for further information/advice from the Royal Women’s hospital

It’s a bit trickier teaching your pelvic floor to relax if it’s overactive- so best to chat to your women's health physio about that. DON’T BE SHY! Call if you need to chat to someone and get on top of that poor functioning pelvic floor NOW (p.s men – you can call too!!)

Do you have a niggling ache or pain? Book in to see one of our physio's today - book online here or call us on (08) 9448 2994!

#physiotherapyperth #surfphysio #physio #runningphysio #physiotherapy #perthphysio #pelvicfloor

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