Exercise key to a strong pelvic floor
Iam always pleased to overhear people chatting about their latest health concerns – especially when it involves things that used to be considered a little ‘‘taboo’’ – contraception, sexual health, depression, anxiety and so on.
I can put my hand on my heart though and say I have never walked into the tea room at work or waited at a bus stop and heard people talking about their bladder leakage, faecal incontinence or pelvic floor weakness.
Yet more than 40 per cent of us will suffer from this at some point. It can have huge impacts on our wellbeing, quality of life and relationships but it remains something we consider a little secret, and often something we feel slightly ashamed of.
Can I stress two things: please don’t feel like this and please do start talking about it – even if it’s just to your doctor or nurse.
No one will judge you and there are likely to be some pretty simple solutions that can make a big difference to your symptoms.
Your pelvic floor is effectively a sling of muscles that sits underneath your pelvis, holding up your bladder, genital organs and rectum. It is essential for not only bladder and bowel control, but also for sexual function and enjoyment.
As it’s not visible, it is often a part of the body that is ignored in terms of our exercise routines – so it is not uncommon for even very fit people to have poor pelvic floor strength.
Signs that your pelvic floor may not be as strong as it should be include:
❚ Accidental leakage of urine when you cough, sneeze, laugh, jump or run.
❚ Constantly needing to go to the toilet, and if you can’t get there, having leakage.
❚ Accidentally losing control of your bowel.
❚ Involuntarily passing lots of wind.
❚ Painful sex or reduced sensation while having sex.
❚ A ‘‘prolapse’’, which is essentially a bulging of tissues downwards, either from the vagina or anal area.
❚ Pain or a dragging sensation in the pelvic area generally.
Anyone can be affected by pelvic floor weakness, but certain things can increase your risk, some of which can be avoided:
❚ Obesity.
❚ Constipation – the constant straining to pass a bowel motion increases pressure on the pelvic floor.
❚ An ongoing cough or constant sneezing, such as with poorly controlled asthma or hayfever.
❚ Being pregnant – the pressure of the baby pushing down on the pelvic area very often leads to pelvic floor problems.
❚ Ever having had a child, even if it was years ago – this risk is especially great if you had a very big baby, or required any sort of assisted delivery, like, forceps or a ventouse extraction, or sustained damage to the pelvic floor during the birth.
❚ Women who are menopausal – the drop in hormones after the menopause leads to laxity of lots of muscles in our body, including the pelvic floor area.
❚ After certain types of surgery – this includes hysterectomies for women and prostate surgery for men.
❚ Elite athletes or people who regularly lift heavy weights during gym sessions.
It is possible to prevent pelvic floor damage by starting early in life and incorporating good pelvic floor exercises into your daily routine.
However for many of us who haven’t been so diligent, that ship may have already sailed. So if you are starting from scratch, here are some tips:
First, check with your doctor that this is indeed the underlying issue. Other things, such as urine infections, bowel issues or diabetes can present with similar symptoms so it’s important to check that nothing serious is missed.
Once you have done this, do some reading so you understand exactly what you are trying to do in terms of exercise – good websites include continence.org.nz and pelvicfloor.co.nz.
Be patient – strengthening these muscles won’t happen overnight but is usually successful if you do the exercises correctly and give it enough time.
Be diligent – if you only do these exercises every now and then, you won’t get the results you hope for. This may not be such an issue now but, as you age, any symptoms you have will inevitably worsen. If you’re not making progress, get help – there are now plenty of good resources you can access.
A physiotherapist who specialises in pelvic floor issues can be invaluable. I suspect sadly there aren’t such specialists in every part of New Zealand, but if you have one close to you, it is a
service worth accessing. They can assess you thoroughly, tailor an exercise regime, and follow up to make sure it is making a difference.
Lastly, ask your doctor to send you to a urologist or gynaecologist if your symptoms aren’t improving. It’s not the first option, but for some people surgery can make a huge difference.
Be diligent – if you only do these exercises every now and then, you won’t get the results you hope for.