The muscles you shouldn’t ignore

Learning the right technique can make all the difference when strengthening your pelvic floor, explains gynaecologist

It could be a small sneeze or maybe that massive chuckle you had with friends over a coffee – whatever it is, it takes you by surprise and can cause some embarassment when you don’t hold tight. And all because of those pesky pelvic floor muscles, which surround and support the vagina, bladder, uterus and bowel. If they’re weak or dysfunctional, it can bring on a host of problems: a leaky bladder when you cough, laugh, sneeze or exercise; painful intercourse (due to muscles that are too tight); constipation; or generalised pelvic pain.

THE EXERCISE EFFECT

When I tell my patients they need to strengthen their pelvic floor muscles, they invariably say, “I do my exercises!” And I’m sure they do. But here’s the problem: studies show that most women perform these exercises incorrectly (which can make things worse) or inconsistently.

To perform a pelvic floor exercise correctly, tighten the muscles while relaxing the thighs, buttocks and abdomen. You can figure out whether you’re doing the exercises right by inserting two fingers in your vagina to feel the muscles contract.

That said, given that these muscles are internal, it’s very difficult for many women to voluntarily contract them to perform this exercise the right way. Plus, a woman’s pelvic floor muscles may, like an overstretched rubber band, simply be too weak to contract.

HAVING PROBLEMS?

The best solution for incontinence or pelvic pain that’s disrupting your life: a personal trainer for your pelvic floor, otherwise known as a pelvic floor physiotherapist. A therapist will first evaluate posture, abdominal strength and body alignment, then perform a detailed external and internal pelvic exam to look for weak or tight muscles. Based on your assessment the therapist will put together a treatment program with home exercises.

AT-HOME HELP

You could be tempted by various devices – balls, beads, jade eggs, cones etc – that claim to help incontinence and sexual issues, but there are no scientific studies to back up their claims. I often recommend over-the-counter devices such as the Elvie trainer (elvie.com); they offer an exercise program and link to an app to provide biofeedback to tell you whether you’re doing exercises correctly. Pelvic floor stimulators, like ApexM, use low-grade electrical muscle stimulation to “teach” the muscles to tighten and relax.

Another option for incontinence: a recent study showed that some forms of yoga, done correctly and consistently, can reduce episodes of unintentional leakage by up to 50 per cent. Quitting smoking, losing weight, and avoiding holding your pee for hours can also be useful.

Need more help? Your doctor can refer you to a urogynaecologist, a doctor who specifically treats pelvic floor disorders in women.