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Pelvic floor

Updated: Jul 23, 2021

When the discussion of pelvic floor arises, we often palm it off as something for pre- and postnatal women to be concerned with. But the importance of a strong pelvic floor is important for all women and men, at all ages! Like any other muscle group in the body that we train, the pelvic floor needs similar levels of care and attention. Let's have a look in more detail! Functions of the pelvic floor The pelvic floor is the sling of muscles that sits like a bowl within our pelvis. If you place your hand between your legs, this is where your pelvic muscles sit. It also has some pretty major functions that get us through daily life! 1. It supports our pelvic joints 2. It helps keep us dry by preventing incontinence 3. It supports our pelvic organs (bladder, uterus, and rectum) 4. Is responsible for our sexual function Having a functioning, strong pelvic floor is not only essential for our physical wellbeing, but for our mental wellbeing too. Conditions like incontinence, prolapse (the drooping of our pelvic organs) or painful, uncomfortable sex, can understandably have a huge impact on how we feel and our confidence. And these are definitely things we need to be talking about more! We don't need to live with these conditions, there's lots we can do about them. Let's get to the core of it! Did you know that your pelvic floor and core are inter-connected, it works as one? Our core is our deep central stability system. Alongside your glutes, the diaphragm and your pelvic floor muscles comprise the lid and the bottom, whilst your multifidus (back muscles) and transverse abdominus (deepest core muscles) form the walls. Your core is essentially a 'tube', working together all day, every day! Like any muscle group, working too much in one area will imbalance another. We need to work in a holistic way that targets all these muscle groups and strengthens them as one working unit. Breathing As we take a nice deep inhale into our tummies, our pelvic floor relaxes. And as we breathe out, it rebounds back up to support our whole system. It acts like a piston and is a dynamic working set of muscles, working all day for you! So every few hours, take some lovely big tummy breaths. Breathing deep into the diaphragm and pulling it down with each breath, expanding the ribs and filling your tummy. Then slowly release the air. Diaphragmatic breathing is not only excellent for your core and mind-body connection, but also for activating the parasympathetic nervous system and helping us relax! Win win! What other life events may weaken the pelvic floor? It's not just pregnancy that can put the pelvic floor under pressure! Pooing How we poo has a major impact on our pelvic floor strength. In fact, straining to go poo over a sustained period of time can have a higher weakening effect on your pelvic floor than a vaginal birth! Ideally, we should be squatting with our knees higher than our hips to allow your stool to exit more easily. I promise, this will do wonders for your pelvic floor - I use my daughter's Paw Patrol step! Not very glam I know, but does the job! It also takes up to 10 minutes to open your bowels, so take your time and breathe through it without feeling the need to strain. We're in a rush to do everything these days, but if we don't have time to take a poo I think something has gone wrong! Pregnancy and birth Pregnancy and a vaginal delivery are of course big events for your pelvic floor. We have increasing weight bearing down on our pelvic floor for months on end! So regardless of whether you have a vaginal delivery or c-section, the postpartum focus on your pelvic floor is top priority! During pregnancy and the postpartum phase the level of pelvic floor exercises should be increased. See below for more info! Holding your tummy in! It has been programmed into women to hold our tummies in, which makes me really sad, for starters. But it's also not good for us ladies! Not only has it got increased links to IBS, but it increases intra-abdominal pressure and pushes down on our pelvic floor. So let's go back to that big tummy breathing to try and get out of the habit of drawing our tummies in all day every day. It's got to go! Weightlifting Strength training works both ways, it's how we do it that's important. Exercise and strength training is a very important part of strengthening the pelvic floor but we also need to be careful about our breathing! Now you know why I'm always nagging to breathe out on exertion! We want to avoid holding a firm 'braced' position throughout an exercise, especially when lifting heavy. A deep 'in breath' during the lowering phase is important for spinal stability, and breathing out as we go through the lifting phase of the exercise is ESSENTIAL for our pelvic floor. This is important to stop any 'bearing down', increasing intra-abdominal pressure. Keep working on your breathing! Menopause As we know, muscle loss occurs as a result of decreasing Oestrogen levels as we get older and closer to menopause. Other symptoms can include vaginal dryness and decreased lubrication, vaginal tightness (due to decreasing size) and abdominal weight gain. All of these can create a bit of a 'perfect storm' when it comes to our pelvic floor and lead to common conditions like incontinence. This is why nutrition and exercise become increasingly important to help manage these symptoms as best we can. So what can we do? I understand that this is a difficult and uncomfortable subject for anyone to talk about, hence why many tend to 'live with it', despite having a significant impact on our quality of life in many ways. But when it comes to exercise, abstaining from doing it won't help either. We just need to find a comfortable starting point for you and build it up from there. Pelvic floor exercises We want to regularly be performing our pelvic floor exercises. The ultimate goal is to get to 10 short repetitions and 10 long holds (up to 10 seconds), 3 times a day! But many of us won't start here and that's ok! Hold for as long as you can and gradually build it up. Start laying down, then graduate to seated and then finally standing, which is the hardest position due to the increased force of gravity! There are lots of Apps you can use that will give you regular reminders too! How to do them We want to squeeze from the back passage round to the front and up, imagine you are pulling your anus up to your belly button.Squeeze the muscles forward and lift up, as if you are trying to stop yourself from farting! Try not to rely on your core and breathe through them. And as you release, be sure to release slowly and gently so as not to 'bear down' as you come out of the contraction. If you are pregnant, do these more frequently and work up to getting to 12 reps of each type (short and long), 3 times a day. What's the 'take home'? I don't want your pelvic floor to stop you or to impact your quality of life. Just because you may have had children or you're at an age where you think these things are 'par for the course', it's definitely not the case! We don't need to live with any of these conditions and there are things we can do about it. It's not about being all or nothing, it's just about regressing to a stage that is right for you and building from there. Your pelvic floor exercises is the best place to start! I always recommend consulting a Women's Health Specialist / Pelvic Health Professional if you are concerned before starting any exercise regime. They are best placed to advise you and then using fitness professionals like myself, we can help you put this into action. It's that old adage ladies, use it or lose it! So let's make some time for ourselves and our pelvic floors for everyday wellbeing, because that's what health and fitness is all about. Have a great week everyone! Lots of love, Emma x

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