Pelvic floor exercises

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The Pelvic Floor

Your pelvic floor is a sling of muscles and ligaments that stretches from your pubic bone at the front to your coccyx or tailbone at the back. 

A woman and a baby

What is the pelvic floor?

Your pelvic floor is a sling of muscles and ligaments that stretches from your pubic bone at the front to your coccyx or tailbone at the back. It is, literally, the floor to your pelvis. Your pelvis is simply a set of bowl shaped bones that contains your pelvic organs – your bladder, bowel and womb.

Why is it important?

The muscles and ligaments of the pelvic floor work together to ensure that your pelvic organs remain in place and to give you control over your bowel and bladder. If these muscles become weak, or the ligaments become stretched, then the organs can sag down (a prolapse) or you can find that you leak urine when you cough sneeze or run (stress incontinence).

What causes the pelvic floor to weaken or stretch?

The most widely known reason for the pelvic floor to weaken is childbirth. The muscles and ligaments have to stretch in order for your baby to be born and without any attention afterwards, this weakness can remain and get worse. Simply being pregnant itself can increase your risk of pelvic floor problems so having a Caesarian Section doesn’t always help matters.

Having a big baby, a forceps delivery or a long labour can all make it more likely that you will develop a prolapse or leak urine.

However, there are other risk factors too. Being constipated is a big risk factor as is being overweight, over-doing your aerobics or stomach crunches or heavy lifting. Even smoking can make your pelvic floor tissues weaker.

The menopause is the next significant problem for the pelvic floor. The hormones oestrogen and progesterone help to keep the pelvic floor healthy and strong and when these hormone levels drop, many women find that they develop pelvic floor problems for the first time. Although the symptoms may only appear at the menopause for some women, the pelvic floor may actually have been weakening for many years. This is why it is so important to look after your pelvic floor throughout your life, even if you don’t experience any problems, so that you can sail through the menopause problem free.

How can I look after my pelvic floor?

The good news is that there are lots of things that you can do to strengthen, protect and treat your pelvic floor. Pelvic floor exercises are the first thing that you should try. If you find that you struggle to do a pelvic floor exercise, you can’t feel anything happen or are unsure if you are doing them correctly, your next step is to visit your GP to ask for a referral to a Women’s Health Physiotherapist or specially trained Continence Advisor. The Association of Chartered Physiotherapists in Women’s Health (ACPWH) will have a list of specialist physiotherapists in your area. 

By Alison Bourne MA (Cantab) BSc MCSP ACPWH