What is the pelvic floor?
The pelvic floor is a group of muscles and ligaments that are in your pelvis. To simplify it, these muscles act like a hammock that goes from your pubic bone to your tailbone which lifts up to support your pelvic organs such as your bladder, bowel and uterus.
The pelvic floor muscles relax to pass urine, wind and faeces and contracts to hold it all in. They also have a big role in sexual sensation and arousal too!
What happens when we don’t look after our pelvic floor? What are the symptoms?
Looking after our pelvic floor is so important to so many areas of our health. A few things that can happen is pelvic organ prolapse (this is when the bladder, uterus, bowel or small intestine can descend down into the vagina). We can also get pelvic and lower back pain.
We can have urinary or faecal incontinence (this is when you leak urine, faeces or wind when you don’t want to and you’re unable to control it).
This can happen when you cough, sneeze, laugh or jump and can be worse during pregnancy and in the postpartum period.
You can have urgency symptoms which means you might be rushing to the toilet more frequently and not be able to hold it in. If your pelvic floor is too overactive you may have vaginal pain which is worse with sexual intercourse (this is very common in young females who do lots of abdominal exercises).
You may feel a dragging or heaviness sensation in your vagina. If you are pushing or straining to pass a bowel motion you can damage your pelvic floor.
What are the best ways to strengthen the pelvic floor?
First of all, I recommend you be checked by a trained Pelvic Floor Physiotherapist to make sure you’re squeezing properly!
Once I assess internally, I then offer my recommendations. You don’t want to be doing pelvic floor exercises if you’re already too tight!
I always tell my patients to train your pelvic floor muscles like you would any other muscle. Don’t just do a few squeezes here and there throughout the day, you need to get into a habit of doing them at a set time and in a quiet space so you can concentrate and do them with effort.
Some patients also need feedback devices to help them squeeze. It’s really important to remember that squeezing is great but you must relax after every contraction. If you just squeeze squeeze squeeze all the time then you can become overactive and have pain.
We know you love Pilates! What type of exercises do you recommend for the pelvic floor?
I love exercises on a swiss ball and anything that work the adductors (inner thighs) at the same time, squeeze your pelvic floor. If you can co-contract your adductors with your pelvic floor you generally achieve a better contraction.
For example, lying on your back with your knees bent and a small ball between your legs just above your knees, at the same time you’re going to squeeze your pelvic floor, squeeze the ball and breathe out. Then relax.
But again that is only my personal preference. If my patients don’t want to do that and prefer gym-based exercises or running etc., I will tailor their program to their exercise of choice.
Why is pelvic floor health especially important for women? Is it important for men?
So many people think it’s ‘normal’ to leak and it’s ‘normal’ to have pain with sex every now and again. But it’s definitely not and can be treated! I’ve mentioned above the things that can happen if you don’t look after your pelvic floor, it’s so important!
Women experience unique events in their lives such as pregnancy, childbirth and menopause. These life events can cause damage and/or weaken the pelvic floor.
The female urethra (the passage that goes from the bladder to the outside of the body) is also shorter than males so our organs (bladder, uterus, bowel) have more chance of slipping down.
It is also important for men! Around 30% of men experience incontinence and sexual dysfunction!
If you suffer from endometriosis, do you need to make any adjustments to the exercise?
There is SO much we can do for endometriosis!
Where do I start! Firstly women who do experience endometriosis shouldn’t be doing too many of the intense Pilates classes where they are constantly squeezing their abdominals and not relaxing.
They need to learn how to relax their pelvic floor between each exercise and be guided by a Women’s Health Physio on how to correctly coordinate their breathing with their pelvic floor.
This doesn’t mean they should not do these classes at all, it just means their symptoms can become worse (i.e. pain with sex) if they are constantly squeezing everything in.
If they want to do the classes, they should ensure they relax their pelvic floor very often throughout the class.
Why did you choose to specialise in this area?
I remember my first ever patient hadn’t had sex for 4 years due to intense pelvic pain and after a few weeks of treatment, she came to me and told me she had sex for the first time without pain. From then on I knew that this is what I wanted to do!
It is such a unique area of Physio and it has the potential to change many lives! It can be an embarrassing area that no one really talks about, but really we should be talking about!
We spend so much money these days on fitness plans, meal plans, gym memberships, activewear etc. to maintain a ‘healthy’ lifestyle yet we can be so reluctant to pay for our health (i.e. pelvic health).
More about Sarah.
Sarah Anderson is a Pelvic Floor Physiotherapist born and bred on the Gold Coast. She studied her Doctor of Physiotherapy degree at Bond University and currently works in a Private Practice as the primary Pelvic Floor Physiotherapist. Her passion is treating young adults who have overactive pelvic floor muscles and of course ante- and post-natal mums.
We love her! She is a wealth of knowledge and you should follow her to get all the pelvic floor info and inspiration! We met her at Essence of Living (the studio we teach at in real life) and LOVE having her in our Yoga and Pilates classes.
After reading this and learning from Sarah, we have even MORE love for Yoga and Pilates!