Looking after your pelvic floor

 

 

Our pelvic floor is made up of muscles and tissues that stretch, like a supportive trampoline, from your pubic bone at the front of your pelvis, to your tailbone at the bottom of your spine. It also stretches sideways from one sitting bone to the other. Your pelvic floor muscles work with your core and other trunk muscles to support your spine and control the pressure in your abdomen. 

 Your pelvic floor muscles: 

• support your pelvic organs 
• help maintain control of your bladder and bowel 
• improve sexual function by enhancing sensation and arousal

• support your lower back and pelvis 

They therefore play a very versatile and important role in many functions within our body. Pelvic floor issues are more common than we think! They can happen for anyone at any age, male or female, regardless of activity level and background. This is not something that we want to overlook. 

 Signs that you may have a pelvic floor problem: 

• Leaking urine when you exercise, laugh, cough or sneeze.
• Needing to get to the toilet in a hurry or not making it in time.
• Finding it difficult to empty your bladder or bowel.
• Accidental loss of faeces or wind.
• A vaginal or rectal prolapse.
• Pelvic pain.
• Pain during sexual intercourse.
• Poor sensation or loss of bladder control during sexual intercourse.

 Things that might increase your risk of pelvic floor problems: 

• Pregnancy or post natal women.
• Women who have ever had a baby.
• Menopausal and post menopausal women.
• Women who have had gynaecological surgery (e.g. prolapse, hysterectomy)
• Men who have had surgery for prostate cancer or prostate enlargement.
• Fitness enthusiasts and athletes who perform high impact, high speed and high load activities (e.g. runners, gymnasts, HIIT training and bootcamps).
• If you push and strain to use your bowels if you are constipated.
• If you have a chronic cough or sneeze (such as severe hay-fever, respiratory conditions including asthma and COPD).
• If you are overweight or have a body mass index (BMI) greater than 25.
• If you have had trauma to the pelvic area.
• If you have a history of back pain.

 Exercising with pelvic floor issues

Lower risk resistance exercises	Higher risk resistance exercises
Light weight training for both upper and lower body. Use a weight that you can lift 10-15 times in a row without straining, or a weight that weighs about half the heaviest weight you can lift.  Upper body weight training exercises performed in a seated position on a bench or swiss ball (eg shoulder press, bicep curls, rows).  Shallow or narrow leg squats and lunges in any direction.  Partial body weight exercises lying on the floor with the exception of double leg lowering (eg side lying push-ups, bridges, side lying leg raises, back extensions).  More exercises available to view on the Pelvic Floor First website.	Any weight training where the load is heavy or greater than half the heaviest weight you can lift.  Long stride and/or deep lunges in any direction.  Wide leg and deep squats.  Exercises with both feet off the floor unassisted (eg tricep dips, chin ups).  Body weight trianing when using the full body weight (eg push-ups on toes).  Olympic lifts (eg deadlifts, clean and press, over rows and dead rows).
Lower risk core exercises	Higher risk core exercises
Knees side to side with feet on the ball.  Modified plank on hands or knees.  Wall push-ups.  Ball bridge +/- single lift.  Arm and leg lift on all fours.  Leg lift sitting on a ball.  Shoulder rotations with back on ball.  Standing balance work on bosu or balance disc.	Abdominal exercises (eg sit-ups, curl ups, crunches).  Any exercise with added load (eg resistance bands, dumbells).  Core exercises that require both legs to move together away and towards the torso.  Any weighted rotation exercises (eg seated twists with weight, rotating planks).  Planks with toes and variations of this.

You can see the types of resistance and core exercises that are more ‘pelvic floor friendly’ versus those that are not. It is also important that the exercises are done correctly with an appropriate breathing pattern. As exercise physiologists, we can help to provide you with individual, tailored support in managing your pelvic floor symptoms. 

 Tamika Hassum 

Accredited Exercise Physiologist