Incontinence, bladder urgency, pelvic pain, constipation and pain with sex – all of these symptoms are quite common in women (and men for that matter). In fact, one in three women will leak at some stage in her life. The good news is there is help available.
What is the pelvic floor?
We all have one! The pelvic floor sits like a sling or hammock in the pelvic bowl and supports your pelvic organs (bladder, uterus and rectum). Healthy pelvic floor muscles ensure proper control over your bladder and bowel and make good sex possible.
Problems in the pelvis such as incontinence, constipation and pelvic pain can happen when the pelvic floor is not functioning correctly.
What can go wrong?
It is not just giving birth (natural or caesarian) that can cause pelvic floor dysfunction. Excessive or too little exercise, back pain, religious beliefs, anxiety, previous trauma and so many other factors can cause the pelvic floor to not function optimally. Symptoms may last weeks, months and in many cases forever if left untreated.
What is wrong with Kegel Exercises?
Kegel exercises (pelvic floor contractions) have always been the go-to exercise to cure all pelvic problems. Pelvic floor issues are more complicated than we realise and Kegels are not always the best option. With our fast-paced, stressful lives we are seeing many more ladies who have “hypertonic” or over active pelvic floors, where the pelvic floor muscles are too tight rather than too weak. In these women, learning to relax the pelvic floor is the treatment of choice and doing excessive Kegels will actually aggravate their symptoms.
Even when Kegels are the correct treatment choice for ladies with weak pelvic floors, they are often performed incorrectly which can lead to further dysfunction.
The pelvic floor is a group of muscles so you can also have a combination of some muscles that are too tight and some that are weak or they can be tight and weak at the same time. This is why a detailed assessment by a physiotherapist specifically trained in Pelvic Floor Rehabilitation is essential to make sure you are doing exactly what is needed for your specific problem.
Pelvic Floor/Women’s Health Physiotherapy
There are physiotherapists who have a special interest in women’s health and the pelvic floor. They have done postgraduate courses and training to allow them to best manage issues in and around the pelvis. Always find out from your physiotherapist if they are trained in specific pelvic floor rehabilitation or ask if they can refer you to someone who has the necessary skills to help you.
Some Top Pelvic Health Tips
• Don’t leave any bladder, bowel, pelvic pain or sexual issue. Ask for help from a women’s health physiotherapist, gynaecologist or urologist.
• Learn about your pelvic floor muscles, where they are, what they do and how to contract and relax them PROPERLY.
• Don’t strain when going to the toilet. You should not need to push to empty your bladder or bowels.
• It is never too late to seek help, no matter how long you have been struggling.
By Mandy Roscher, Roscher & Associates Physiotherapy