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What is a pelvic floor?

By Lee Ajzenman and Lauren Charlton, Physiotherapists

Most of us have heard of it, but what is it? Or why we should even care? Both women and men have one, so listen up everybody!

If you think of your torso like a cylinder, the top part is your diaphragm (helps with breathing), the rounded edges are your deep layers of back and tummy muscles and the base is your pelvic floor.

Your pelvic floor is a group of muscles that stretch like a hammock front to back from your pubic bone (at the front, like at the bottom of the fly of your unzipped jeans) to your tailbone and side to side from one sit bone to the other. They hold up your pelvic organs which include your bladder, bowel and reproductive organs.

So it’s a muscle, does that mean you can exercise it? YES!

Why bother with pelvic floor exercises?

Let’s consider what pelvic floor muscles do:

  • These muscles ‘hold up’ all the organs in your torso. If your pelvic floor muscles are weak then other structures (fascia and ligaments that act like guide ropes to hold your organs together) may stretch, or become damaged – and are very difficult to ‘fix’, whereas pelvic floor muscles are easier to train to prevent this occurring.
  • When contracted, pelvic floor muscles help to hold in things that we definitely want to have control over – like doing a wee, poo or flatulence (wind).
  • Pelvic floor muscles can assist in sporting performance and exercise to prevent injuries, especially of your spine, as they facilitate the abdominals and back muscles to stabilise and support your spine.
  • During pregnancy, pelvic floor muscles help to hold up increased weight of the belly and uterus and play a role in the birthing process and reducing your risk of prolapse.

Is your pelvic floor weak or ‘loose’? Or is it too tight?

  • If any of the above points are not quite right, you might have weak pelvic floor muscles.
  • Pelvic floor muscles can also be overactive where they can’t relax or be controlled as you want or need. This can lead to pain in the pelvic floor region at rest or difficulty going to the toilet.

A health professional such as a GP, physiotherapist or continence nurse can formally diagnose you with weak or overactive pelvic floor muscles (and help).

Why would it be weak or ‘loose’?

  • Obesity (heavier weight placed on pelvic floor muscles)
  • Ageing (especially after menopause in women)
  • High impact exercise (running/aerobics)
  • Heavy lifting (through exercise or work/life demands)
  • Chronic coughing due to asthma or other medical conditions
  • Straining on the toilet often (either due to constipation or other reasons)
  • Pregnancy/childbirth for women
  • Lack of pelvic floor muscle exercises or awareness.

Ok, so how do you engage them or give them a ‘work out’?

It might feel a little like ‘trying to wiggle your ears’  but start easy by laying on your back and while maintaining normal breathing draw in your back passage like you are holding in wind or bowel movements, and holding in a wee, then relax. Begin to distinguish the difference between the two sensations. DO NOT hold your breath, tighten your bottom or thigh muscles and definitely don’t feel like you are bearing down, rather feel a drawing up and in sensation.

How many, how often, how long?

There are two main types of exercises, some shorter holds and some longer holds. Shorter holds help you with your strength when you are running or jumping, need to cough, sneeze or burst out in laughter! Longer holds help you when you are busting for the toilet and can’t quite find the keys in your bag and the phone rings and then someone else is in the toilet and…

It all depends on the strength and endurance of your pelvic floor muscles to know how many, how often and how long is appropriate for you – just like any exercise program would. Here is a guide to start, but be mindful of the DO NOT points above.

Shorter holds: Aim to squeeze and lift as strongly as you can for 1-2 seconds then relax for 1-2 seconds. Do this as many times as you can for up to 8 – 12 times.

Longer holds: Aim to squeeze and lift for up to 8 seconds then relax for 8 seconds. Do this as many times as you can up to 8 – 12 times.

Positioning: from easiest to hardest are laying on your back, side, sitting then standing.

Quality not quantity!

A few good quality squeezes are better than some incorrectly done or half hearted ones, so focus on the quality of your squeezes and control. Ideally you will work your way up to three sets of the 8-12 squeezes of both the shorter and longer holds every day, but take your time to increase the sets. As you are getting started, allocate time to focus and ensure you are doing them just right, but as you become more efficient, you can begin to multitask and do them while sitting at traffic lights or waiting for the kettle to boil.

Give them a ‘squeeze and lift’ and you will reap both immediate and long term rewards without a doubt!





Last updated: August 5, 2020 at: 3:10 pm

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