Achieving Pelvic Health: We Asked The Experts

Most of us know little (and care little) in the way of pelvic health, until pregnant or showing symptoms that is. But what if we knew a little more? What if we knew what a healthy pelvic floor felt like, or didn’t? What if we could reduce symptoms, spot early signs, or perhaps prevent pelvic issues?

What if we could reduce symptoms, spot early signs, or perhaps prevent pelvic issues? We need answers, and so do up to a third of all women who experience pelvic problems at some point during their lifetime. We’re banishing the taboo on incontinence, faeces, sex and sphincters, and according to the experts, it’s never too late to join the party.

What is the 'pelvic' floor?

The pelvic floor is group of muscles situated at the bottom of the pelvis that are responsible for five functions, pelvic health physiotherapist Clare Bourne explains. “These are very key roles and often we don’t think about them until we become pregnant or experience symptoms”.

1. Sphincteric - keeping us continent of urine, faeces, and wind.

2. Support - they help to support our pelvic organs, including the bladder, uterus, and bowels.

3. Sexual - they contribute to our sexual pleasure.

4. Stability - they work with other muscles to support the spine.

5. Sump Pump - they help to pump blood and lymph around the area.

What are the symptoms of pelvic floor dysfunction?

Common signs of a weakened pelvic floor include urinary or faecal incontinence, experienced as an urge to pass urine or faeces, or when increased stress is placed on the pelvic floor such as coughing or sneezing, and pelvic organ prolapse which often presents as a heaviness or dragging sensation in the vagina. Although there is much focus on symptoms occurring due to the weakening of muscles, Clare explains some issues can arise due to the muscles being too tight, known as pelvic floor tension. 

Pelvic floor tension can contribute to incontinence or prolapse symptoms and/or painful penetrative sex, increased frequency and urgency to pass urine, or struggling to fully open our bowels… This shows the importance of assessment of the pelvic floor muscles for each individual to help determine what is causing their symptoms and not simply tell everyone to work on pelvic floor squeezes.

What can cause pelvic muscles to become weak or tight?

Other than the more obvious culprits such as pregnancy and childbirth, pelvic floor dysfunction can also be caused by chronic constipation, pain with intercourse, altered breathing patterns, menopause, and even chronic coughing.

Can activating and strengthening the pelvic floor improve symptoms?

Absolutely, working on pelvic floor exercises, making sure we are fully contracting and relaxing the muscles, can over time help to treat symptoms. However, for some of these symptoms the focus would not be on strengthening or contracting initially, but actually working on relaxing the muscles, through breath work and stretching.

How can we improve the pelvic muscles?

According to Clare, regular pelvic floor exercises are the best way to strengthen. She suggests the following steps to help you learn how to do them correctly:

  • Take a deep breath in, expanding the base of your rib cage and letting your tummy relax.
  •  As you breathe out, think about holding wind around your back passage.
  • Visualise this contraction coming forwards to the pubic bone, at the front of the pelvis.
  • Then fully let go before repeating.

We should focus on two types of contractions, short and long. The short contractions are simply contract (as above) and let go, 10 times. For the long contractions we contract, hold the contraction for 10 seconds, whilst we breathe in and out, and then relax, before repeating 10 times. If we have symptoms, we should be aiming to do 10 of each type (short and long), 3 times a day.

It is never too late to try and don’t panic if you are not doing this many. Doing some is better than nothing!

Is it possible to prevent weakening of the pelvic floor, particularly for pregnant women?

Good news, mums-to-be! Keeping up with your daily pelvic floor exercises have been shown to significantly reduce the risk of urinary incontinence in the 3rd trimester and postpartum. But don’t dismiss your bowel health. “Trying to prevent constipation and straining on the toilet is also really important” says Clare, “Sitting in the correct position on the toilet creates the optimal position to open our bowels by allowing our pelvic floor to relax. This includes raising our feet up onto a stool and leaning forwards. The aim is to have our knees above the level of our hips, and to be as relaxed as possible.”

Can men suffer too?

Men too have a pelvic floor and can experience pelvic floor symptoms, explains Clare. These often include urinary incontinence (especially after prostatectomy), erectile dysfunction, pelvic pain, sexual pain, and difficulty opening their bowels. Fortunately, men can also improve their pelvic health to reduce symptoms by performing specific exercises.

What about pilates for pelvic health?

“Every single body can benefit from Pilates”

- Sian Marshall, U Pilates Founder

In addition to improving strength and flexibility, performing isolated pelvic floor exercises in your Pilates routine is the most effective way to strengthen the pelvic floor. For optimum results, Sian suggests utilising the mind muscle connection. “It’s important to breathe deeply and focus on breathing out whilst squeezing and lifting these deep internal muscles”. One of her favourite pelvic exercises is a shoulder bridge, you can find this exercise alongside an incredible range of pelvic focused Pilates led by Sian over on the U Pilates Instagram and App.

to help you get there... the elvie trainer

Designed to cut out all of the guesswork, Elvie Trainer is an easy, fun and effective way to strengthen and tone your pelvic floor anytime, anywhere.

The device connects to a free app that guides you through fun, 5-minute Kegel exercise workouts while visualising and correcting your technique in response to your muscle movements.