It's Sunday morning and here I am sitting writing about pelvic floors.... Not exactly how I imagined my career as a Personal Trainer to be!! However, joking aside this is actually an extremely important subject and one that unfortunately doesn't get enough coverage. I specialise in training women, particularly mums pre and post-natal and since becoming a Personal Trainer I have been shocked at how many women out there are still suffering with post-natal pelvic floor issues. This really shouldn't be the case in this day and age. So, I thought it would be a good idea to write a blog about the pelvic floor, what happens when things go wrong, what you can do to keep yours strong and healthy and why this is so important for all women...
I freely admit that before I became a mum I didn't even know I had a pelvic floor! Then when I was expecting my first baby people kept telling me to do my pelvic floor exercises, but nobody really explained why this was so important. I did them here and there but to be honest didn't really pay as much attention to it as I should have done. 16 hours of labour with a back-to-back baby including one trip to theatre (forceps and ventouse delivery) and one 8.5 lbs baby later my pelvic floor was wrecked. The first few months post-natally were a bit of a blur, but I knew that things weren't right down there. I just assumed they would get better, but they didn't. Frequent trips to the toilet were needed and sneezing or coughing with a full bladder was a no-no! I also didn't realise that I had a mild uterine prolapse, and it took a while to regain any feelings down there too. Nobody had really warned me that his might happen, and I felt really embarrassed about it. It affected my self-confidence and I didn't really know what to do about it - it wasn't something I felt I could talk about! I just thought this was the way it was meant to be, and accepted this is what happens when you have a baby. Then one day I googled my symptoms and was quite horrified to realise that I had a prolapse and mild incontinence. Not what I was expecting at age 33!
However at that point I also realised that I needed to do something about it and I went back to see my GP, who referred me to the women's health physio team at my local maternity hospital. They examined me and confirmed that I had a mild prolapse and prescribed pelvic floor exercises to help strengthen things again. From then on things began to improve. It took a while, and a few trips back to the physio's for check-ups (by which point I was back at work, nearly a year later) but things got better. I wouldn't say they got back to where I was before (I don't think anyone ever really gets back to "normal" after having a baby") but they are vastly improved. I will probably always have a weakness in that area, and it is something I remain aware of in terms of making sure I don't overly strain it, but I am so glad that I went back to my GP and got it checked.
Unfortunately I see a lot of female clients in the same situation, probably as high as 30-50% of them. For some of them it can be quite a number of years since they gave birth and they are still living with pelvic floor issues. It affects many areas of their lives, and this makes me quite sad because this isn't the way it should be. I think in this country although there is help available from our often-overstretched NHS we are really poor at talking about post-natal issues, and like me many women just accept that this is how it is. When I run my mum and baby fitness classes (which are suitable for babies 3 months +) I make a point about talking about the pelvic floor, and sharing my experience because I think we need to become more open about these issues and that way more women will be encouraged to seek help. If you have a problem in this area, you will find that as you age and the muscle tissues weaken as a natural part of the ageing process the problem will worsen, and by this stage it will be much more difficult to do something about it. Therefore if you have any concerns in this area you really should do something about it sooner rather than later because the problem will not go away without treatment.
So, what actually happens to cause these problems? The pelvic floor is a "hammock" of muscles that runs from the front to the back of the pelvis. These muscles support the internal organs in the pelvis (including the bladder, uterus, vagina, small bowel and rectum). Anything that increases pressure in the abdomen to a large enough degree can increase the likelihood of pelvic floor problems. Pregnancy, labour, and childbirth are the most common causes as the weight of the growing baby places a greater load on the pelvic floor muscles, but other causes can include obesity, constipation, hysterectomy, pelvic organ cancers and respiratory problems with a long-term cough. Labour and childbirth can cause damage to the muscular connective tissue, and the nerves of the pelvic floor (hence the reduction in feeling down there). Gravity takes over, and due to the decrease in support this creates an environment for decreased support of the pelvic organs and they may start to droop.
Symptoms of problems with the pelvic floor can include :
How can you avoid, or reduce the risk of these problems happening to you? Well, there are several things you can do to help :
I do pelvic floor exercises with the mum's in my mum and baby classes. We do two types of exercises, and I encourage them to do these daily at home. Firstly you need to identify what muscles it is that you are trying to work. To do this get yourself in a position where you can best feel them working - it doesn't matter if that's sitting, standing, lying down etc and ensure your thighs, buttocks and stomach muscles are relaxed. To find where the pelvic floor muscles are you need to do two things. Squeeze the ring of muscle around your back passage as if you are trying to stop the passage of wind. Try not to squeeze your buttocks. Relax and try again a couple of times to make sure you have found the right muscles. Next, when sitting on the toilet to empty your bladder, try to stop the stream of urine (note do not to this regularly as it may cause your bladder not to empty properly). Now that you can feel them working you can start your exercises. I recommend the following and these are the ones we do in my mum and baby classes:
As you can see, the pelvic floor is a very important part of the female anatomy and I really recommend that you try to keep it healthy. If you have any concerns in this area please visit your GP and ask for a referral to a women's health physio. I hope that this blog has encouraged you to seek help if you need it and also to talk about these issues. Hopefully together we can improve things for all women out there.
If you've found my blog helpful please feel free to like, comment or share it with friends who would also benefit from reading it - thank you!
Exercise For Mum's was created by PT mum Susan Flintoff. Susan is a busy working mum of two who specialises in helping other busy mum's fit health and fitness back into their lives, and hopes to inspire them to be the best mum they can be!!