For many, the pelvic floor muscles are well hidden and out of mind. However, with pregnancy and over time, they can weaken leading to considerable problems like incontinence and prolapse. The importance of measure to strengthen your pelvic floor muscles to minimise this risk cannot be under estimated.
The pelvic floor muscles support the organs in your tummy. They carry the entire weight of the contents of your tummy including the bowel, bladder and womb. When full, the bladder can store 500 mls of urine or more. Similarly, a pregnant woman can carry a total weight with the baby, water and placenta combined, of 4 kg or more in the womb. Imagine if you had to carry that weight 24 hours a day in your arms. No wonder the muscles come under strain! With childbirth, the muscles then get damaged as the baby passes through the birth canal. They can be torn and stretched and the nerves supplying them can also be damaged by the pressure of the birthing process.
Whilst the origin and many of the symptoms of urinary and bowel incontinence as well as prolapse , can be directly attributable to childbearing, other factors also play a part including:
- Straining e.g. constipation, heavy lifting
- Being overweight
Improving the strength of the muscles will help to reduce the risk of incontinence and prolapse. The best way is to undertake pelvic floor muscle exercises. performed correctly, they can help to maintain muscle bulk and strangth, like any other muscle groups that we exercise when going to the gym. Unfortuantely, this is easier said than done. They are well hidden away. “Out of sight, out of mind” as the saying goes. With some women, their muscles start off weak, even when young. With others, they have a lack of sensation of the pelvic floor. Combined together, it can make undertaking pelvic floor muscle exercises difficult.
The most accurate way of checking if a woman is doing her exercises correctly is by performing a vaginal examination. In doing so, the muscles can be felt for. When they are contracted, the strength and endurance of the contraction can be assesed. Whether one or both sides are moving becomes obvious and any tears leading to a defect in the muscle contours can be felt. Teaching can then be directed to help a woman more accurately tension the muscle.
In some women, the muscles are so weak or the nerves so damaged, that they have little sensation in the pelvic floor region. Teaching them to activate the muscles can then be very difficult. In these instances, I have found the use of magnetic therapy useful. This technique uses magnetic waves to stimulate the nerves of the pelvis. In turn, they stimulate the muscles and can help to strengthen them. It also brings awareness to women about the location of the muscles by improving their sensation. Magnetic therapy is easy to use. It is non invasive and safe. Information on this can be obtained by contacting my office.
In my practice, I offer all women in pregnancy or those planning for a pregnancy, an assessment of their pelvic floor integrity. Where there are weaknesses identified or poor pelvic floor technique is present, I would refer them to a pelvic floor physiotherapist for further teaching.
These notes reflect my personal opinion and are intended for general advice only. It should not be used for any one individual case. You should consult your own doctor to determine the appropriate management of your own individual situation.