Don’t Forget Your Pelvic Floor!

If you or someone you care for experiences bladder or bowel control problems, you’re certainly not alone. In fact, over 4.8 million Australians experience bladder or bowel control problems.

Urinary incontinence affects up to 13% men and 37% of women in Australia alone and 70% of these people do not seek advice or treatment. Incontinence of any level is nothing to be embarrassed about, this is a real problem and it is very important to seek help and advice. Your pelvic floor is a secondary control of your bladder.

The urethra sphincter (muscle that controls amount of urine expelled from the bladder) is stretched during childbirth and so we rely heavily on the pelvic floor to take the rest of the slack. Strengthening your pelvic floor is a must pre and post pregnancy.

The most common risk factors of developing urinary incontinence are:

  • Pregnancy (pre and post natal)
  • Menopause
  • Obesity
  • Urinary tract infections
  • Constipation
  • Surgeries such as prostatectomy and hysterectomy
  • Reduced mobility due to neurological or musculo-skeletal conditions
  • Health conditions such as heart disease/diabetes/stroke

We are lucky enough to have access to Real-time Ultrasound and use this as a tool to assess your ability to activate your pelvic floor. From here we are able to prescribe the right exercises for you and we can teach you how to improve your pelvic floor for prevention or treatment of urinary incontinence.

How To Train Your Pelvic Floor Properly

The pelvic floor (PF) are an important group of muscles that provide a sling for the organs within the pelvis. They all have an important role to play when it comes to continence of the bladder, uterus and bowel.

We frequently come across people explain to us that they activate their PF daily or as much as they can. For example when they are sitting at the traffic lights or by stopping themselves from using the toilet mid stream.

We think it is great that people are actively thinking of improving their pelvic floor however, there is a specific way to go about improving its efficiency. If done incorrectly it can have a negative effect on the pelvic floor and cause more problems than expected.

Here are some helpful tips when improving your pelvic floor size and strength:

1. Do not activate as much as you can
a. Activate your pelvic floor gently! if you are activating as hard as you can this is too much it needs to be a gradual activation only approximately 20-30 % of your max.

b.If you think of activating as much as you can it would be like trying to stop yourself from urinating mid stream this can be detrimental to the control of your PF.

2. Only needs to be practiced 2 to 3 times a week
a. Just like any other muscle the PF can fatigue. It needs to have rest to recover so it is ready to do its job properly.

3. The ideal activation of the PF is a lift of 10mm for 10 sec.
a. We use Real-Time Ultrasound to assess how long you can hold this contraction. If you cannot lift 10mm or you cannot hold for 10 sec you have a dysfunctional PF.

4. Similar to strengthening other muscles
a. Surprisingly the PF needs to be improved in size (hypertrophy) to improve its efficiency as a secondary continence controller and so it can be trained in a similar way any other muscle in the body.

Here is the ideal way to improve your PF:
Complete 3 sets of 10mm lift holding for 10 sec. This only needs to be done approximately 2-3 times per week, not every day or every hour!

Ask one of our Physiotherapist’s or Exercise Physiologist’s if you are would like to have a pelvic floor assessment.

Article by Beth Chiuchiarelli, Exercise Phsiologist & Michael Dermansky, Senior Physiotherapist at MD Health

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