Pelvic floor dysfunction in women is hugely common — whether they’ve given birth or otherwise! It can develop from childbirth, incorrect exercise under load or ageing. Men, too, are not exempt from pelvic health issues. But the good news is, there are numerous ways to strengthen and restore your pelvic floor.
What is your pelvic floor?
The pelvic floor involves the network of muscles, ligaments and fascia that supports your bladder, vagina, uterus and bowel. A weakened pelvic floor can arise from poor posture, straining to open the bowel, incorrect breathing patterns, excess weight or repeated heavy lifts. Many women don’t know how to engage their pelvic floor correctly, and instead, they learn to substitute outer tummy muscles for the correct pelvic floor action.
A weak pelvic floor can then result in issues such as urinary or faecal incontinence or obstruction, vaginal or uterine prolapse and/or pelvic pain. Pelvic floor dysfunction can present itself in children and teenagers, athletes, during pregnancy or after birth — and can also present or worsen during menopausal years, or become evident after abdominal or pelvic surgery, spinal injury or with ageing.
So how can I learn correct pelvic floor action?
- By improving posture
Learn to keep your inner postural muscles switched on by continuing to control your upright spinal posture in sitting, then in standing. Keep your body weight down through your sitting bones under your butt, not slumped and rolled back onto your sacrum. Slumping shuts down your inner postural muscles and allows your pelvic floor to subside.
- Breathe correctly
When you breathe, the base of your ribs and abdomen should open up as your shoulders stay relaxed. If you constantly pull your stomach in at the waist, then you probably lift up your chest and shoulders when you breathe in.
This poor breathing pattern inhibits your diaphragm from smoothly moving up and down. This is important because your diaphragm and pelvic floor move together. If your diaphragm is not free to move down when you breathe in, and up under your lungs when you breathe out, you will not be able to effectively engage your pelvic floor.
So attention slumpers! If you do sit in a slumped position daily, then your diaphragm has no room to move down when you breathe in. This, in turn, prevents your pelvic floor from working correctly!
A million sit-ups will not help!
This is important — especially for those who do have an overwhelming motivation to workout.
Increasing pelvic floor strength will not increase from you simply going hard out at the gym or throwing weights around. We understand the pressure that women feel after having a baby... they're often driven to "get their bodies back" and want to get back into high-intensity exercise soon after birth. This is where we advise caution and education!
Heavy lifting especially can cause a strong internal downward pressure on the pelvic floor. After childbirth, many women can have weaker pelvic muscles and tears in supporting fascia, therefore continuing to lift heavy weights can cause more strain and damage to a pre-weakened pelvic floor. So go steady here, especially if you’ve had a baby.
Overdoing sit-ups and crunches will not help improve a weakened pelvic floor in the early stages. Crunches engage your rectus abdominis (the 6 pack) and the external obliques and push inner pressure down on the pelvic floor. Continuing to strengthen outer abdominals when the pelvic floor is weak or uncoordinated, can cause more than good.
If your outer abs are dominant, without the stabilising effect of the inner pelvic floor and deep abdominals muscles, you can stretch the ligaments that support your pelvic organs from above — and if they’re stretched, they cannot support your bladder, vagina, uterus or bowel, leaving you more prone to prolapse. Rather than focusing on these external muscles, we need to focus on the deep abs. It’s these deep abs that are responsible for drawing your belly in.
So the trick here is to go slow and steady... and know that in time, these issues can be corrected!
Even if you know that strengthening pelvic floor muscles are important, many women don’t actually know how — they don’t know where to find these muscles, or are using the wrong ones (especially if these muscles are cut, swollen or painful due to childbirth).
We highly recommend seeking the support of a pelvic health specialist, to empower you with the education and technique to take your next steps forward with movement. These speciality appointments will give you a greater idea of your body, any limitations, and further guide and support you in your journey. Knowledge is power!
Don't be afraid of talking about your pelvic floor. Let's better educate ourselves on these topics, and speak up so we too can better educate our friends and family on women's health issues.