Welcome to the pelvic floor!

You might have heard the term pelvic floor thrown around but what is it?

The pelvic floor are a group of muscles that support your bladder, uterus and bowel. They prevent incontinence, prolapse and play an important role in sexual function for both sexes. The muscles are located between the tailbone and the pubic bone kind of like a sling, they contract and provide support.

They can get weakened by pregnancy, childbirth, constant coughing, low oestrogen post menopause, pelvic floor tension caused by periods and endometriosis, prostate cancer treatment, obesity and chronic constipation. Or they can also be overactive. This is known as pelvic floor dysfunction.

How do you know you have pelvic floor dysfunction?

Common symptoms can include:

• Leaking urine when coughing, sneezing, laughing or running.
• Not making the toilet in time, loss of bladder control.
• Passing wind from either the anus or vagina when bending or lifting.
• Reduced sensation in the area and during sex.
• Heaviness in back and pelvis
• Recurrent UTI’s and thrush.
• Pain during sex and inability to orgasm.

Special exercises can help you improve strength, some people may need to see a pelvic floor specialist who can do an internal exam to figure out if they are working too hard or not enough. (local recommendation below)

Muscles of the pelvic floor and what they do.

Levator Ani are the three muscles that contribute to the pelvic floor, they originate from the pectinate line of the pubic bone and stretch like a hammock to the coccyx and from side to side. They are called the Coccygeus, Iliococcygeus and Pubococcygeus.

These muscle work with your deep abdominal muscles, deep back muscles and diaphragm to support and stabilise your spine and visceral organs. They assist in controlling abdominal pressure.

So how do we make them stronger?

Studies show that performing 10 x 10 second reps of pelvic floor exercises three times a day is effective for increasing pelvic floor muscle strength and decreasing rates of pelvic floor dysfunction in pregnant women. To avoid fatiguing your pelvic floor we recommend starting more slowly and incorporating some relaxation exercises. Here’s our suggestions below. This is more tailored to women however men can often benefit from these sorts of exercises too.

1. Relaxation – take a deep breath in and out, on your next breath in imagine your vagina opening like a flower. Rest on the exhale and repeat again on the next inhale. Try 5 in a row. This is a good one to do throughout the day but particularly important to do before and after your pelvic floor workout.
2. Warm up – continue the exercise above but this time on the exhale add a pelvic floor lift. Lift as much as you can for the duration of your exhale and then feel it drop back down as you let it go for the inhale. Try 5 in a row.
3. Lift – continue on from the last exercise. This time on a slow 5 count exhale lift your pelvic floor more deliberately and slowly as much as you can. Hold it for a 5 count as you hold your breath then let it slowly drop with control on the inhale. Have a break with a breath or 2 before repeating. We suggest starting with 4 or 5 for a week then adding an extra one in per week. If you start to lose the ability to control or feel what’s going on you should drop back to allow the muscles to slowly build up some more strength. It’s the equivalent of going into the gym having never worked out before and doing a really hard workout, be kind to your pelvic floor and give it time to get stronger!

If you experience any pain, can’t feel your pelvic floor or have trouble progressing your pelvic floor exercises you should see a pelvic floor physiotherapist for an internal examination. We recommend Jess from 18Physio in Malvern. She can help both females and males. If you have any questions for us or would like to book a session to see how we can help please book a free 15min consult here.