The mini-trampoline in your pelvis
By Continence Foundation of Australia
You hear it all the time: “do your pelvic floor muscle exercises, make sure the pelvic floor is strong,” but what exactly are the pelvic floor muscles? For something we can’t see, they’re awfully important.
Visualise them as a round mini-trampoline made of firm muscle. If that doesn’t do it for you, try imagining a hammock in your pelvis that stretches from the pubic bone to the tail bone, and from side to side. This hammock is no tropical island holiday - the muscles should be regularly worked and exercised to make sure they can keep doing their vital function.
When they’re working at their best, the pelvic floor muscles help with bladder and bowel control and wrap around the urethra, vagina and anus to help keep these passages shut. They also team up with the abdominal and back muscles and diaphragm in order to support the spine.
Midwife, maternal child health nurse and continence nurse advisor, Janine Armocida, sings the praises of the pelvic floor and its supportive role.
“It’s lucky we have pelvic floor muscle because if we didn’t have these muscles our bladder, vagina, uterus and bowel would just fall out! They are also vital in maintaining continence, so we need to make sure they are in good working order no matter our age.” Janine says.
All this is especially important if you’re pregnant, planning to be, or have already had a baby, because pregnancy and birth places pressure on your pelvic floor. This is when your ‘mini-trampoline’ needs to fulfil its role and respond to this load efficiently – just like a trampoline when kids bounce on it. Leakage and incontinence is a common issue and you may have been warned that one in three women who have ever had a baby wet themselves.
It’s important to realise that any leakage is not normal, even during pregnancy or after delivery, and demonstrates you have some pelvic floor weakness which needs attention. Don’t be disheartened, as the majority of incontinence issues can be better managed, treated or even cured. Bladder and bowel control will improve in the first six months after giving birth, once your hormones return to normal and your pelvic floor muscles have some time to recover.
“Research shows that when pelvic floor exercises are done during pregnancy, the pelvic floor muscles recover more quickly after birth and they can even help shorten the first and second stage of labour,” Janine says.
Getting familiar with this muscle can have additional benefits – in women, voluntary contractions of the pelvic floor can contribute to sexual sensation and arousal.
The pelvic floor should be trained, just like any other muscle group, but thankfully it doesn’t need an expensive gym membership or activewear.
You can go about your daily routine and be lifting and squeezing anywhere, without anyone knowing. If you are at the gym though, Janine has some advice: “If you experience any leakage when exercising - such as running or at the gym - this demonstrates some pelvic floor weakness, which warrants treatment and a modification of your exercise regime until your pelvic floor muscles get stronger.
NICE TO MEET YOU If you’re getting acquainted with your pelvic floor for the first time, try sitting up with good posture and relaxed shoulders. Focusing on your back passage, lift and squeeze upwards and inwards as though you are trying to avoid passing wind. Then bring the pelvic floor lift forward to the front as though you are attempting to stop the stream of urine.
You should feel a distinctive ‘squeeze and lift’ – this is your pelvic floor muscle you’re working. See how long you can hold these muscles for and start by holding for three seconds, which you can aim to build to about 10 seconds in time. Initially try three to five holds in a set, moving up to 10 over time, and repeat three times a day. Remember to stay relaxed and not hold your breath while doing the exercises.
“We know that a lot of women do not do their pelvic floor muscle exercises correctly, so it is worth seeing a continence specialist like a pelvic floor physiotherapist to make sure you are doing them effectively,” Janine says.
If a spot of ‘baby brain’ means you’re forgetting to regularly do your pelvic floor muscle exercises, try associating the exercises with daily tasks like after going to the bathroom or making some food. The simple actions you can take now will mean better outcomes down the track.
The Pelvic Floor First website www.pelvicfloorfirst.org.au and [The Pregnancy Guide(https://www.continence.org.au/resources.php/01tG0000009XZkbIAG/the-pregnancy-guide) has more information on safe pelvic floor exercise and where to get help. Phone the Continence Foundation of Australia’s free and confidential National Continence Helpline on 1800 33 00 66 to speak with experienced continence nurse advisers who can offer information, advice and local referrals.
Find out more about Continence Foundation of Australia at www.continence.org.au