As we age, our bodies change, and one of the areas that can be affected is the pelvic floor. This is especially true for women going through the perimenopause. When oestrogen declines rapidly, so does muscle strength throughout the body, including the pelvic floor muscles. And with lack of strength, often comes lack of control; incontinence both urinary and anal, lower back pain and lack of core strength.
What is the purpose of your pelvic floor muscles?
The pelvic floor muscles are located at the bottom of the pelvis, and they support our organs, including the bladder, bowel and uterus. They also play a crucial role in sexual function and hip stability. If your hips are not stable you will likely get lower back issues. However, many people don't realise the importance of keeping these muscles healthy and strong. By learning exactly how to control your pelvic floor and how to maximise its health, you can feel in control of your continence, back health and sexual health, both now and into old age.
What does a healthy pelvic floor look like?
A healthy pelvic floor is one that can lift on command but also relax on command. We want it to have a full range of motion. If you cannot do either of those things, then that is the first thing you should learn to do. They say practice makes perfect and there is no exception here.
How to lift your pelvic floor
Stage one of having stronger pelvic floor is just to get the feeling of being able to lift the muscles. I know when I had just given birth, I couldn’t even feel my pelvic floor at all. So just practice, imagining you are stopping yourself from going for a wee. And then do the same thing but imagining you are holding in wind. See if you can do both of these things together. This contraction movement is called a Kegel. This can be done anywhere, anytime, and no one will know you're doing them!
Once you have that feeling, start your practice by contracting your pelvic floor muscles and holding for a count of 10 before relaxing. Can you hold them for that long? My experience of women I help is that many of them can’t. If you can, then great, but if you can’t, this should be your goal. Repeat this ten times, and do it at least three times a day.
You also need to work your fast twitch muscle fibres that kick in when you are laughing, coughing, jumping etc. If these are not strong enough then you might leak a tiny bit of urine at times of high pressure. To build up your fast twitch fibres, you do the same contraction but do it as quickly as possible. As soon as you contract, you immediately relax the muscles again. Do 10 quick reps alongside your slow reps, three times a day.
How to relax your pelvic floor
Some women, have symptoms such little leaks of wee, but actually, rather than needing to strengthen their pelvic floor, their pelvic floor is too tight and needs to relax more. Without an internal exam by a women’s health physio, it is hard to know for sure whether your pelvic floor is overactive or under-active (it is possible to be both). Other clues might be that you have hesitancy starting a wee, painful intercourse or it feels hard to defecate. But remember, a healthy pelvic floor is one that lifts and relaxes. So, whenever you practice one, you must always practice the other also.
If you are not sure how to relax your pelvic floor muscles, try lying down. Put some cushions under your hips to raise them up (which takes some of your organ weight off your pelvic floor) and then do a full lift followed by a full relax. I find in this position a big sigh at the same time can help you relax the muscles. Really get to grips with this feeling and progress to doing it standing up when you are ready. This may take a few minutes or may take weeks. Every person is different. Raising your legs up the wall can also help. If you don’t get it straight away, then make this is a daily practice until you do. It’s a good daily practice for anyone anyway. 🙂
I do my Kegels but I still have little accidents. What do I do?
Kegel exercises are great for getting those first sensations of control. But they are usually done in a stationary position. If you practice in a stationary position, your pelvic floor will only be strong in a stationary position. As soon as you introduce movement, it may not withstand the forces being put through it. That is where I come in. My pelvic floor and core rehab course teaches you how to move and breathe during both your daily activities and for your exercise.
We start slowly at the very beginning and build you up over 6 weeks of practicing movement for just 10 minutes 3-4 times per week, plus my weekly sessions with you. In this way both previously fit and unfit women manage to quickly build up their internal core strength. And women who start with me who are very unfit, find it manageable to then start considering harder exercise.
Is there anything else I can do to help my pelvic floor and core?
There is loads that you can do outside of just exercising your muscles. Your pelvic floor is not a muscle that works in isolation from any other factors. You can help strengthen and protect your pelvic floor by nourishing it with healing food and drinks, by maintaining a healthy body weight, avoiding constipation, avoiding smoking and having good posture. Avoid foods/drinks that are bladder irritants such as caffeine, alcohol, fizzy drinks too. And that is just naming a few things, there are so much more.
I go into all these lifestyle factors including nutrition in detail over my 6-week course. We learn and we put everything into practice to maximise your chances of gaining and maintaining full control of your body for the rest of your life.
In summary, start with basics. Nail them and then join me to get you moving with confidence. 😉 And if you have any pain, always seek an appointment with your local women’s health physio. You can get appointments through the NHS if you can wait, or I’d recommend seeing one of the lovely physios at Sussex Physio Pilates if you are near Worthing.
