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Pelvic Floor Basics

Updated: Jan 21, 2021

Many of us might not even think about our pelvic floor and it can remain pretty irrelevant to us until we become pregnant. Suddenly, we become more aware of this area that is giving us support and that potentially a full term baby will need to pass through.

That's where knowledge becomes power. If we know where it is, what it`s job is, how to engage it, how to relax it and overall look after it- we are winning!

So here are some pelvic floor basics to help bring your awareness to these muscles and what to do if you need further help with pelvic floor issues.

Anatomy of Pelvic Floor Muscles

Source: Peter Lamb

The Pelvic floor is a bowl of muscles sitting in the base of our pelvis. There are 2 layers to it. The superficial layer (that you can see when you look at your perineum or vagina) and a deeper layer, known as the levator ani.

It has 3 openings:

the anal opening, the vagina and urethra.

Its job:

It supports our organs like a sling (mainly bladder, bowels and uterus).

It keeps us continent.

It has a sexual function (you can feel it contract during orgasm).

So pretty important and vital jobs! (which is why i love my job:).

So when it is NOT working efficiently, the symptoms of that, can affect our lives and self-esteem greatly.

Signs that our pelvic floor is not working efficiently for us:

  • Leaking (urine or faeces)

  • A heavy feeling in our pelvis/vagina

  • Not being able to empty your bladder or bowels properly

  • Constipation

  • Pain during sex

If you are experiencing any of these, the good news is you don't have to put up with it! More info on this below....

The pelvic floor is the foundation of our core. (the diaphragm is the top of the core, the back muscles and abdominal muscles are the walls for your core)

Did you know?

The pelvic floor works alongside your diaphragm and moves every time you breathe? – you inhale the diaphragm moves down alongside the PF. You exhale – the diaphragm and pelvic floor both rise together. Amazing.

Did you also know?

That a well coordinated, strong pelvic floor will contract up to 3000 times during a 30 min run? By itself, automatically. So you don't need to engage your pelvic floor during a run! It needs to be relaxed to work efficiently.

How to find and engage your pelvic floor

The pelvic floor spans from your tailbone to your pubic bone. So, to engage it, think of gathering up around your back passage, vagina and urethra in that order up and drawing them upwards inside your pelvis. Try to hold that gathering for the length of an exhale and then ensure you fully relax it on the inhale. Just gather it to 80%, so not a grip or squeeze.

Watch for cheating, like bum gripping, pelvic tilting or tummy gripping, when you are trying to isolate your pelvic floor.

When you get the hang of this- you can also add in some longer holds whilst breathing and some quick flicks to train all the different muscle fibres.

So just to remind you before i finish...

Day-to day signs that the pelvic floor isn’t functioning properly are:

  • Pain in pelvic/perineum

  • Persistent painful sex

  • Leaking urine or faeces

  • Not fully voiding bladder

  • Heaviness/dragging sensation

  • A feeling of a bulge inside the vagina

If you have any of these common signs- you would benefit from a pelvic exam.

A women`s health physio/pelvic health physio can carry out an internal check via the vagina to see where the issue might be coming from

What does an internal pelvic exam involve?

At first, we will check the pelvic floor from the outside, the perineum and where it is sitting can give you a lot of information.

Then vaginally we can get to your deep pelvic floor sling with our finger. We can check your PF for tone, tension and check if you are connecting to it and lifting it/relaxing it correctly. We can assess its strength and control to see if it is being effective for you.

We will also screen the pelvic organs to see where they are sitting in your pelvis and if they are a little lower than usual (pelvic organ prolapse).

From that 10 min check- we can then tailor an individual pelvic floor program for you which may involve one of many approaches.

We only have 1 pelvic floor and it works hard, so my motto is ''Show it some love and it will love you back!''

Niamh Burn

Women's Health Physiotherapist

@Maternity Physio

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