What is your pelvic floor?
The pelvic floor has been described as the “trampoline of muscles” because it is flexible and can withstand pressure day in and day out.
However, like all other muscles in our bodies, it needs to be trained to stay strong and flexible - and this is especially important during and after pregnancy. Your pelvic floor forms part of your core along with your diaphragm, transverse abdominis and back muscles and it runs from your pubic bone to your coccyx. All of these muscles hold your organs in place, help you breathe and help you go to the toilet. If your pelvic floor isn’t working properly it can affect your breathing and cause incontinence.
Physiotherapist Cassile Wiles from Six Physio gave us some more key information about the pelvic floor.
It has five functions:
Supports your pelvic organs - bladder, uterus and rectum.
Helps to stabilise your pelvis - the load transfer when walking around, getting in and out of bed or a car.
Incontinence - your pelvic floor muscles keep urine and faeces in but if they don’t work properly then it can lead to incontinence.
Important for enjoyment during sex.
Important during labour - if it is very strong it can help with turning the baby’s head.
There are two types of pelvic floor problems women are diagnosed with:
Overactive - can cause pain in sex, SPD (pelvic girdle pain) and incontinence. If your pelvic floor is tense all of the time it will cause issues
Underactive/weak - can cause incontinence and pelvic organ prolapse.
Tips for strengthening your pelvic floor
Your pelvic floor is like any other muscle, if you train it every day it will change. If you exercise 3/4 times a day you will notice a difference.
Everyone has very busy lives and a lot to juggle so it is easy to forget to do these exercises. Cassie recommends associating something in your day with doing them. This could be doing them while you breastfeed, or every time you turn the kettle on, while watching TV or when reading your children their bedtime story.
There are two types of exercises you can do:
Fast contractions
Lie flat on the floor with your knees bent. Take a deep breath in and as you exhale imagine you’re stopping yourself from breaking wind. Squeeze then try to lift up towards your belly button. Then release. Aim to do three sets of 10 of these each day.
Slow contractions
Lie flat on the floor with your knees bent. Squeeze and then try to hold for 10 seconds or as long as you can. When you feel the hold floating away let go. Aim to do 10 holds of however many seconds you can do, three times a day.
If you are over 16 weeks pregnant it is not recommended that you lie flat on your back so perhaps prop yourself up to a 45 degree angle with some cushions or you can do them standing up.
It is safe to do these exercises throughout your pregnancy and post pregnancy. If you keep them as part of your daily routine it could help prevent problems during menopause and later in life.
SPD, or pelvic girdle pain, during pregnancy
SPD stands for symphysis pubis dysfunction which is part of an umbrella term for pregnancy related pelvic girdle pain. You will either have pelvic pain over the front around your pubic bone or across the back over your bottom bone. There is often not one obvious reason why this is uncomfortable but causes could be:
The amount of hormones your body is producing causing changes in your body. For example as well as making your ligaments softer, relaxin also makes your tissues more sensitive.
Your changing body shape and posture. Your back may become more arched with your bump which means there is more pressure on your bum muscles and your hip flexors may become quite tight. Your pelvic floor can also become tight and aggravated.
You may find that the pain is worse when doing things which involve standing on one leg such as climbing the stairs or putting on trousers or shoes. Other instances could be when rolling over in bed or getting in and out of the car. This is because you are taking your legs apart which puts pressure on your pelvis.
Resting is the main thing you can do to help with pelvic girdle pain but there are also exercises you can do to strengthen your bum muscles and stretch out your thighs.
Pregnancy belts can also help - you will know as soon as you put it on if it’s going to work for you as it will immediately feel better.
Many women who have pelvic pain during pregnancy can have a normal vaginal birth. Think about birth positions which will be comfortable for you and put them in your birth plan. Being in water can help take the pressure off your joints so you may want to use a birthing pool during labour.
If you have any postnatal pelvic pain or think you may have a prolapse it is best to speak to your GP and book an appointment with a women’s health physiotherapist.
:: The Six Physio website has videos of exercises you can do to strengthen your pelvic floor and relieve pelvic girdle pain. Find out more here https://www.sixphysio.com/video
