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The Myth of the Pelvic Floor

The Myth of the “Pelvic Floor”

Yes ladies, that’s right we are going to talk about the Pelvic Floor. That mysterious group of muscles that we know we all have ‘down there’…somewhere, which we know we are supposed to squeeze once in a while!

Weakness of these muscles is usually caused by; pregnancy, child birth, constipation, obesity, chronic coughing, heavy lifting, ageing, limited physical activity and poor posture.

If the pelvic floor is weak it may lead to incontinence, pelvic organ prolapse and bowel and bladder dysfunction, such as urgency and frequently going to the toilet.

So what is it? The pelvic floor is just that…. it is the “Floor” of the “Pelvis”. It is made up of muscle and other tissue, which stretches like a hammock from the pubic bone at the front to the tail bone at the back. A woman’s pelvic floor helps to support the bladder, uterus and bowel. The urethra (urine pipe), vagina and rectum (back passage) all pass through the pelvic floor muscles and therefore it has an important role in controlling them.

In my clinical experience a lot of women are not doing their pelvic floor contractions properly. When we do a pelvic floor contraction we need to think about its functional role, which is to ‘squeeze’ around the openings and ‘lift’ up the organs. Therefore when we contract the pelvic floor we need to squeeze around the openings to the bladder/ bowel and vagina, then pull up.

A nice analogy I like to use is… Imagine a bucket of water. If you dropped a marble into the water, it would send ripples out. Think about your pelvic floor but in reverse. The ripples coming in and the marble lifting out of the water. You should feel you perineum “area between your vagina and back passage”, pull up a little.

Common mistakes I see in women is bringing in other muscles such as the abdomen and buttocks. You need to keep these areas relaxed. So to begin with practice your pelvic floor lying down on your back with your knees bent up slightly. It is also CRUCIAL that you don’t hold your breath when doing your pelvic floor contractions! Try to just breathe in and out gently as you hold. This is difficult and can take some practice. Initially hold for just a few seconds and increase as you feel stronger.

After child birth, nerves and tissue have been stretched. So initially you may not be able to feel your pelvic floor contractions. You may need to use a mirror to look for your perineum lifting, or place a finger inside your vagina to feel the tightening. It is important that if you have pelvic floor issues, that you visit your Women’s Health Physiotherapist first, to ensure you are doing everything right.

Happy ‘squeeze and lift’ ladies!

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