Wednesday, 3 June 2015

Ladies, how is YOUR pelvic FLOOR?


Ladies, how is YOUR pelvic FLOOR?

As a mother of 2 with a past history of pelvic floor injury myself I have lived through my fair share of IVE GOTTA PEE!  moments.  Physiotherapists are not immune to pelvic floor dysfunction but we do know how to get rid of one.

I often ask my patientsDo you sprint for the bathroom as soon as the key hits the front door?!  Do you struggle to get home to the bathroom and do you know the location of every public toilet within a 3km radius of your home?  If you're saying YES!to either one of those questions, your pelvic floor probably needs some whipping into shape.

The lovely ladies behind body beyond birth and their beautiful children. 
Did you know the pelvic floor is really supposed to be strong enough to hold a good 2+ cups of urine, a baby, and all of your abdominal contents?  I know it can be a boring, taboo or medical blah blah blah but the pelvic floor is really quite an amazing part of your body ladies!  I treat patients with pelvic floor dysfunction who are trying to figure out what to do to get their muscles back into gear.  Im here to tell you, its not so mysterious.  The pelvic floor is just another muscle but it just happens to be, you know, in a private spot. Im going to tell you how to exercise this muscle AND how to make 100% sure that you are doing your pelvic floor exercises correctly.  Listen up

So incontinence, its a REALLY sexy topic right?  NOT!  However, pad ads are trying to make you think its a normal part of being a woman but Im telling you as a woman myself and as a womens health physiotherapistits absolutely NOT ok to pee when you laugh, sneeze, or pick up your kid!  I usually have a cringe when I see those incontinence pad ads that advise you to wear a pad because its normalto have bladder leakage.  Some marketing person has even made up a name for it - light bladder leakage, eeek! its ALL a marketing campaign ladies.

So how do you prevent bladder leakage whether its during a sneeze or during a workout? Its pure and simpleyou exercise the pelvic floor or, as I like to say, the sphincter that holds all the stuff in that you don't want to leak out! 

How To Activate the Pelvic Floor- You need to visualise squeezing, lifting and holding the pelvic floor up as if you're trying not to pee or pass wind (or toot as my sweet granny used to say!)  It is the exact opposite of what you do when you bear down to do a poo, instead of pushing, think hold it in. 

How Do I Know If Im Doing it Right? - The best and ONLY way to know if you're actually doing pelvic floor exercises correctly is to get hands on.  You place your index and middle finger into the vagina (you know where the tampon goes) then turn on your pelvic floor and assess whats happening with your muscles. I know, I knowits kinda gross but cmon, do you really want pay someone else to do this for you?  Its not brain surgery girls it just takes a bit of bravery.  Also, a hand held mirror a locked door and some KY jelly seem to help as well.  With your fingers held inside your vagina in a Vshape, you should feel a squeeze AND a lift as you turn on your pelvic floor muscles.  Try holding this for 5 seconds then relax.  Try this a few times to get the hang of it. 

If you didn't feel anything happening, you're not activating the pelvic floor muscles properly so keep trying AND palpate using your fingers.  If you felt a muscle flicker then nada, the pelvic floor knows how to activate but has NO endurance so keep practicing to increase your strength.  Count how long you can actually hold a contraction then make that your personal best.  For example if your PB is 3 seconds then this is where you start do 3 second holds x 3 reps, 5 x daily.  If you can hold a contraction for 5 seconds, then do a 5 second holds x 5 reps 5 x daily. Progress your exercises by one second each week with the below schedule.

3 sec hold x 3 reps 5 x daily

4 sec hold x 4 reps 5 x daily

5 sec hold x 5 reps 5 x daily

Each week progress up to

10 sec hold x 10 reps and you only need to do1 X DAILY from then onforever!

Remember use it or lose it, if you don't exercise a muscle it gets weak and functions poorly.  The good news is, if you are doing any type of exercise that focuses on core strengthening, then you're exercising your pelvic floor at the same time i.e. Pilates, some yoga, or my online Body Beyond Birth program.

But don't be too hard on yourself, if you have really given it your all with exercise and your pelvic floor still wont come to the party, then its time to call in reinforcements.  Make sure you get a referral to a pelvic floor physiotherapist, or visit an OB or gynaecologist.  Good luck with your pelvic floor workout mums and spread the word that its normal to do pelvic floor exercises daily, not to wear a pad just in case. 

Becky Dyer
Womens Health Physiotherapist, Mother & Co-Founder of Body Beyond Birth the physio prescribed online postnatal Pilates workout for mums. Check it out! 

Body Beyond Birth

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