Let me introduce you to the pelvic floor!

The pelvic floor – the muscle group we are not 100% sure where they are, what they do, and often don’t hear about them until we are pregnant. However, are they just important for those of us who are pregnant or have had babies…absolutely not! They are for us ALL throughout life and our pelvic health is relevant from childhood until our older days.

So why are pelvic floor exercises important?
Well, they are crucial for many daily functions that we often take for granted, including:
● keeping us continent of urine, faeces and wind
● contributing to sexual pleasure
● supporting our pelvic organs, including the bladder, bowels and womb
● working with the deep abdominal & spinal muscles to help regulate pressure and provide a corset of support. So, very important I think you will agree and this is why we all need to be aware of our pelvic floor and how we can look after it.
But where are they?
The pelvic floor muscles are exactly where they say they are…in the floor of the pelvis. It is made up of a number of little muscles that work together. A true sign of teamwork! They attach to the coccyx at the base of the spine and to the pubic bone at the front of the pelvis, as shown in the diagram below. Like other muscles in the body they are made up of fast and slow-twitch fibres, to be specific 30% fast-twitch and 70% slow twitch. This allows the the pelvic floor to respond to different demands, for example increased pressure when coughing, and holding in a wee when we are not near a bathroom.

So what might we feel if our pelvic floor isn’t happy?
We often hear about pelvic floor weakness, however we can also have pelvic floor tension.
There are a variety of symptoms that we can experience including:
– Incontinence of urine, faeces or wind
– Vaginal prolapse, which often presents as a heaviness or dragging sensation in the vagina
– Pain during sexual intercourse
– Difficulty opening our bowels
– Urgency and frequency of passing urine
– Pelvic pain

So, how do we do pelvic floor exercises?
Our pelvic floor muscles are just like other skeletal muscles in our body and can be trained to get stronger and more flexible to optimise their function. It is important to say at this stage that we must ALWAYS be working on strength AND flexibility, just in the same way you will be working on strength and flexibility for the rest of your body through the app.

So let’s get started and get to know our pelvic floor muscles a bit better:
● Take a deep breath into our lower rib cage, allowing your tummy to relax. This helps
your pelvic floor to relax.
● As you breathe out, think about holding in wind, so tightening around the back
passage.
● Visualise this contraction coming forwards and upwards to the pubic bone.
● Then fully relax (the relaxation is as important as the squeeze.)
● Try and repeat this 10 times. These are called short contractions.
● Whilst doing pelvic floor exercises your legs and bottom muscles should be relaxed.
● Now try doing what are called long contractions.
● So think about holding wind again but this time hold the contraction for up to 10 seconds and breathe in and out whilst holding. You can start holding for 3-5 seconds first and slowly build up from there.

If you have symptoms of incontinence or prolapse then it is recommended we aim to do x10 short and x10 long contractions, 3 times a day. If you don’t have symptoms then you can just aim to do x10 short and x10 long a day. It is just starting somewhere, learning how to do them and understanding their importance in our overall wellbeing and health. Please note that pelvic floor squeezes are often not advised for someone with a tighter pelvic floor, so if you are experiencing pain with intercourse or inserting tampons then please do speak to your doctor first or try and see a pelvic health physiotherapist. Also focus on deep breathing as mentioned above to try and help pelvic floor relaxation.

Let me introduce you to the pelvic floor puzzle

Whenever we think about pelvic floor health there are 4 key puzzle pieces. The first two we have already talked about, strength and flexibility, but we also need to work on endurance and coordination. No one runs a marathon without training for it, we have to work on our endurance over time, gradually building up
distance and pace. This is similar for our pelvic floor, when we work on our long holds, we start with a few seconds and build up over time to 10 seconds. Coordination is our ability to use different parts of our body together smoothly and efficiently. Our pelvic floor needs to do the right thing, at the right time to keep us continent, to let us pass urine and open our bowels. Sometimes it needs some help to know how to do this correctly.

Is it ever too late to start pelvic floor?
No! We can strengthen our pelvic floor at any age! So whether you are a teenager, in your 20s, pregnant, postnatal, perimenopausal, or have been through the menopause – pelvic floor exercises are for you.

How else can we care for our pelvic health?
Looking after our pelvic health is not just about pelvic floor exercises; we also need to think about our bladder and bowels. Preventing constipation is key and making sure we are not straining on the toilet. Drinking enough water, having a good fibre intake and using a little stool to raise our feet up when on the toilet is so important. Additionally certain liquids, for example caffeine, citrus juices and alcohol, can irritate our bladder. This can lead to increased urgency or frequency of passing urine and also leaking for some. So making sure we modify how many irritants we are drinking can help our bladder a lot. Pelvic floor health can influence so many other aspects of our health. We often don’t think about how our pelvic health interplays with other aspects of our health, including our bone health, mental health and heart health. Pelvic floor symptoms, such as incontinence or prolapse can really hold us back from exercise. They can stop us feeling confident to do impact exercise or lift weights out of fear, which is totally understandable. We know the benefits of impact and resistance training for our bone health, especially for women, however so many of us shy away or struggle through with bladder symptoms. Additionally, we know the benefits of exercise for our mental health, however again symptoms can hold us back. So I want my message to be loud and clear, pelvic health and doing pelvic floor exercises is foundational to so much of our health, so please don’t suffer in silence and know it is absolutely worth the commitment.

How can you get help?
If you are experiencing any of the symptoms mentioned above please speak to your GP for support and seek referral to a pelvic health physiotherapist who support women rehabilitate their pelvic floor and live a pain and leak free life. For anyone struggling to feel your pelvic floor contraction, even if you don’t have symptoms, you can also see a pelvic health physiotherapist, but this isn’t available on the NHS. There are lots of pelvic health physiotherapist working privately who would love to help and support you. The best way to find someone in your local area is via the The POGP website www.thepogp.co.uk or Squeezy App Directory www.squeezyapp.com/directory .