What and where is your pelvic floor?
Your pelvic floor is a muscular and connective tissue ‘hammock’ that is diamond shaped. It runs from your pubic bones in front, out to your sitting bones either side then back in to your tail bone (coccyx). If you are female, there are three holes that pass through your pelvic floor (from front to back):
- The opening for your bladder (urethra),
- The opening for your vagina, and
- The opening for your bowel (anus).
Males only have two openings passing through their pelvic floor and don’t carry babies on top of theirs, so are therefore less prone to pelvic floor weakness. In fact, in a survey of 3010 Australians aged 15 – 97 years, only 4.4% of males reported urinary incontinence, while 35.3% of women surveyed reported suffering from the same complaint.
Role of the pelvic floor
Your pelvic floor is an amazing piece of equipment! It prevents your pelvic ‘bits and pieces’ (ovaries, uterus, bladder, bowel) from falling out, supports your bowel when you pass a bowel motion, along with your abdominal ‘core’ muscles, forms part of the muscular ‘brace’ that supports your spine, and contributes to sexual arousal and pleasure. If your pelvic floor becomes weak, this can lead to incontinence (loss of bladder and or bowel control) or prolapse (dropping or sagging of) your bladder, uterus and or bowel. According to an Australian study published in 2000, pregnancy, regardless of how you deliver your baby (caesarean, vaginal delivery), simply being pregnant and giving birth greatly increases the likelihood of incontinence and or prolapse later on. Other factors that make you more likely to have problems with your pelvic floor:
- Increasing age
- Being overweight
- Excess coughing
- Numerous pregnancies
When to have your pelvic floor assessed
Because your pelvic floor is mostly muscular, it can, like any other muscle become overused, strained or torn. Your pelvic floor can also be a source of pain during the second and third trimesters if it is overused or strained from an uneven gait caused by an old ankle, knee or hip injury. If you feel this may be a problem for you, make an appointment with an osteopath who works with pregnant women for a thorough assessment. Your closest osteopath can be located at www.osteopathic.com.au and search under the ‘Find an Osteopath’ tab. A strong but elastic pelvic floor during pregnancy will go a long way in preparing you for a smoother vaginal delivery and recovery.
Exercises to strengthen pelvic floor:
There are two different types of muscle fibres in your pelvic floor. The first are slow twitch ‘endurance’ fibres that should be slightly switched on most of the time to hold your pelvic ‘bits and pieces’ in place. The second are fast twitch ‘power’ fibres that should be able to switch on quickly when you bend, sneeze, cough or laugh to prevent any ‘accidents’. And as there are two different types of fibres, there are two different types of exercises. They are:
Endurance fibres: Gently lift your pelvic floor about 1 cm and hold. You should be able to hold for at least 6 – 10 seconds. Repeat up to 10 times or until you fatigue. Some ideas to make sure you’re actually lifting your pelvic floor:
- Imagine holding in a bowel motion
- Imagine holding a full bladder
- Imagine resisting against a tampon being pulled out
Power fibres: Quickly lift your pelvic floor as high as you can and release again straight way (don’t hold it). Repeat 10 – 20 times or until you fatigue. Rest for a couple of seconds in between each contraction.
- Clench your glutes. Your glutes are NOT part of your pelvic floor.
- Hold your breath. You should be able to do your pelvic floor exercises while breathing.
- Squeeze your knees together. These muscles are also NOT part of your pelvic floor.
When to do pelvic floor exercises
Do the above exercises twice a day during your pregnancy. Vary the position you do the exercises in eg. when standing in line at the supermarket, sitting in the car, lying in bed. You should be able to switch on your pelvic floor exercises in any position. You should always switch on your pelvic floor before and during a cough, sneeze or bend to prevent it from straining.
So for a healthy pelvic floor, remember your endurance and power exercises – twice a day and if you are experiencing pelvic pain or would like to have your pelvic floor assessed, see an osteopath who works with pregnant women.
- Womens Health – a textbook for physiotherapists, Sapsford, Bullock-Saxton, Markwell, WB Saunders Great Britain.
- The prevalence of pelvic floor disorders and their relationship to gender, age, parity and mode of delivery, Maclennan, Taylor, Wilson and Wilson, BJOG: An International Journal of Obstetrics and Gynaecology, 2000 Dec:107(12): 1460-70