I think it is fair to say that when it comes to the Pelvic Floor it is very much ‘Out of sight, out of mind!’ It certainly isn’t a muscle we are taught to exercise and strengthen throughout our lives until of course we become Pregnant! Many of us have a weak pelvic floor but just accept this as part of life.
What amazes me, now that I have learnt so much about the Pelvic Floor, is why we are not being taught to use and strengthen these muscles like any other muscle in our body. It is, after all, one of the most important muscles in our body and plays a very important role!
Role of the Pelvic Floor
The Pelvic Floor muscles are a layer of muscles that sit at the base of our body. They form a hammock, and as the name suggests, they provide the floor of our pelvis pushing up against our pelvic organs, the bladder, uterus and bowels. They play a role not only in supporting these organs and keeping them in place, but also with their function too!
Signs of a Weak Pelvic Floor
- Any leakage of urine (no matter how small) when coughing, sneezing, bending, laughing, lifting weights, squatting, pushing trolleys/prams, jumping, jogging, blowing your nose, vomiting, straining your bowels.
- Leakage of urine when hurrying to the toilet
- Leakage of urine when hearing running water
- Increased frequency of urination
- Dragging, aching or feeling of heaviness down below
- Problems in controlling wind or bowel contents
- Lower Back pain
- Abdominal separation (Diastasis Recti)
What makes it Weak?
- ANTERIOR TILTED PELVIS. This is a common problem for postnatal women, as your bump grows, your hips may tilt forward, resulting in an increased arch in your lower back, this altered posture doesn’t necessarily just correct itself and may stay with you after baby is born.
- PREGNANCY – as the muscles become stretched and the weight of the baby pushes down onto the muscles
- VAGINAL BIRTHING which produces varying degrees of soft tissue trauma which has a direct impact on the function of the Pelvic Floor
- PERSISTENT COUGHING without mindful control of intra-abdominal pressure
DID YOU KNOW – Even if you had a C-Section your Pelvic Floor will be still be weak from the weight of the baby bearing down on these muscles during pregnancy.
What puts pressure on it?
- Straining to go to the toilet
- Coughing, sneezing, laughing
- Lifting weights
- Jogging / running
- Any other high impact activities
How do we strengthen it?
Our Pelvic Floor muscles can be strengthened by exercising but it must be the right type of exercise. Your body goes through many changes during pregnancy and childbirth so there are a number of other factors that need to be addressed before commencing an exercise programme.
Alongside the changes to our Pelvic Floor Function, what else changes?
- YOUR POSTURE – you may have noticed lots of aches and pains you didn’t have pre pregnancy, This can be due to changes in your posture as some muscles become tight while others become weak.
- THE WAY YOU BREATHE. As your baby grows, your internal organs are pushed out of the way. One of these is your Diaphragm (your breathing muscles) which means it doesn’t function optimally. You may have noticed you feel more out of breath, you may be taking shallow breaths or even holding your breath more
- YOUR ABDOMINAL MUSCLES. As your bump grows, your abdominal muscles are pushed apart causing a separation which is known as Diastasis Recti. This doesn’t always go back to normal following the birth and you can be left with a separation.
How can we correct all these changes?
To correct all these changes is a bit like a jigsaw puzzle and we can’t do one without the other as they are all interconnected!
For us to be able to strengthen our Pelvic Floor we also have to correct our Posture, the way we Breathe, and heal Diastasis Recti (abdominal separation)
- If we don’t correct our posture, we can’t correct the way we Breathe
- A Diastasis won’t heal if we don’t correct our Posture and Breathing
- We can’t strengthen our Pelvic Floor if we have a Diastasis and are not breathing correctly.
The steps that we need to take to Strengthen our Pelvic Floor are:
- Learn Diaphragmatic Breathing
- Learn how to correctly engage and activate the Pelvic Floor and Core as we breath
- Correct our posture by releasing what is tight before strengthening what is weak
- Embark on a corrective exercise programme that has been designed to heal Diastasis Recti and improve Pelvic Floor Function.
- Take steps to avoid any unnecessary pressure on the Pelvic Floor to stop the weakness becoming any worse. For example, avoiding high impact activities.
What type of exercise should we be doing to Strengthen our Pelvic Floor?
The pelvic floor muscles are made up of 2 types of muscle fibre:
- Slow Twitch Fibres which help to keep the Pelvic Floor going for longer – for endurance (when you are holding on as you can’t find a toilet nearby!)
- Fast Twitch Fibres which need to switch on quickly for sudden movements and activities like coughing, sneezing and running
We therefore need to incorporate:
Slow Movements – Mindfully connecting to the Pelvic Floor and Diaphragm using our breath and working slowly and controlled.
Fast Movements – Including quick lifts of the Pelvic Floor where you lift up and let go as quickly as you can.
Functional Movements – Connecting to the Core and Pelvic Floor whilst we move the entire body in many different ways.
If you are returning to exercise after childbirth then Pelvic floor and Core exercises should come before weight loss and running!