How to Find your Pelvic Floor - My Journey

Saturday, 17 September 2016

Prior to becoming pregnant, I was all about being strong and feeling strong.  Whether it was climbing ropes, leg pressing 330kg or squatting over 110kg.  Did I consider my pelvic floor? In all honesty, as long as I wasn't wetting myself, the answer was, "No, I did not!" Jump forward and with a 14 month old son, why now?

As a Personal Trainer specialising in Women's Health, I have always been about strength and health over shape and size. However, since going through pregnancy and the postpartum period, I am now a staunch advocate of knowing your own body INSIDE and out. Having a six pack has no link to how strong our pelvic floor and core are.  Outside, we might look great but internally we could be bearing down or heading towards a prolapse in our future.

This is where I get a bIt stumped for words...everyone is individual and even though we all have particular body parts in common, how they react when relaxed and under tension can differ. I can't give you, 'this is the best work out for you,' only an individualised program from a specialist continence and women's health physiotherapist or specialist medical practitioner can help you there.  However, I know we don't all have the time, funds, or access to specialists, so alongside Taryn (a specialist Women's Continence & Health Physiotherapist - owner of Fit Right Physio), we are going to provide for you the best possible alternative.
No one solution fits all but AWARENESS of your PELVIC FLOOR and CORE is so ESSENTIAL to your HEALTH, I can not let it go!

VISITING A WOMEN'S CONTINENCE & HEALTH PHYSIOTHERAPIST

Once your appointment is booked you may feel a little self conscious but believe me it is worthwhile.  Taking control of your health now and for the future is priceless. A strong toned pelvic floor and core is critical to Women's Health.

What to expect?
  • First up your physiotherapist will take a history so it is important to be honest.
  • Next, you may be offered one or both of the below:
    • an external 'trans-abdominal real-time ultrasound' which shows the lifting and relaxing of the pelvic floor muscle
    • an internal 'vaginal examination' which is the only way to test pelvic floor strength, tone, prolapse, support, and hiatal width

I chose to have an 'internal vaginal examination' (much less obtrusive, I think, than a pap smear) not due to any incontinence or other known health issues but because I wanted to have as much knowledge and understanding of my body and where I am at.
  • If you elect to have an internal examination the physiotherapist will grade your pelvic floor on a scale of 0 to 5.
    • 0 - unable to engage your pelvic floor
    • 5 - optimum pelvic floor activation and strength
Keep in mind statistics show even after verbal instruction - only 49% of women performed a correct Pelvic Floor Muscular Contraction, and 25% were bearing down. (Bump et al 1991)
I am so pleased I had this examination because although I am strong muscularly, my pelvic floor needs strengthening if I am to avoid problems in the future.  I rarely have incontinence issues and can feel my pelvic floor engage, however my result was not as high as I had anticipated but thankfully it is not as low as it could have been. What this does mean is that I am going back to basics to ensure my journey towards optimum pelvic floor strength and tone is achieved.

WHAT THIS MEANS FOR 'US'...

We get to experience #thecoretruth whilst bringing attention to and building women's #pelvicfloorandcore across the globe.

#sayYES to this journey so you can #sayYES to an active life!


HOMEWORK

#sayYes Pelvic Floor work for you and me to do before my next blog!

1.) Finding your pelvic floor 

  1. Next time you go to the toilet, stop your urine (wee) midstream 
    • NOTE
    • Don't do this often as it can lead to bladder issues 
    • Yes, it was taught back in the 70s & 80s but we now know there are more effective exercises
  2. Notice what it feels like to hold in flatulence (wind/gas)
Whilst you are doing the above draw those muscles up towards your navel (belly button) and feel a lift.
If you are not feeling the muscles lift - try these positions (Try them anyway!)
    • * stand tall with a neutral spine
        • or
    • * lie on your side, stomach, or back
        • or
    • * kneel on all fours with a neutral spine (flat back)
        • or
    • * sit leaning forward with your bottom sticking out
  • Relax your abdominal (stomach) muscles
  • Take a large breath in, then exhale strongly and completely
  • At the end of this out breath, you should feel your pelvic floor muscles engage - this is what you want to lift up towards your navel
  • Now pretend to stop your wee and wind and lift and squeeze all these muscles up towards your navel.

2.) Pelvic Floor Exercises 

Building the foundation - When you have mastered points 1 & 2 above it is time to start your daily pelvic floor exercises.
    • * Choose from any of the above positions 
      • The standing position works well for me as I am usually standing so I have no excuses not to do my exercises 
    • * Complete each set TWO - THREE times per day
      • Remember to breathe normally throughout each exercise
  • SET ONE:
    • i)    lift and squeeze the muscles
    • If you can only hold this for a couple of seconds that is okay - the aim is to build strength
    • ii)   release gently
    • iii) relax the muscles whilst you take a breath
    • It is really important to feel the muscles 'let go' after a contraction 
    • iv) repeat

  • The goal is to work up to a 10 second hold and to repeat SET ONE up to TEN times.

  • SET TWO:
    • i)    lift and squeeze the muscles - hold for one second
    • ii)  release gently
    • iii) relax the muscles whilst you take a breath
    • It is really important to feel the muscles 'let go' after a contraction 
    • iv) repeat

  • The goal is to be able to repeat SET TWO 10 times
Strengthening your pelvic floor might seem like a long up road battle for some (it can take months) but like any strengthening program, it is about committing to doing your exercises - in this case daily. Choose three times in your day where you know you can make it a regular practice.
    • FOR EXAMPLE
      • during/post your work out time
      • when you brush your teeth
      • whilst preparing meals
      • in the shower
      • tummy time/playtime 
      • NOTE - it is not recommended to do these when you are in the car as we often sit slumped with our pelvis tucked under which is not the correct position
A word of caution from Taryn 
"Quite often people get stuck into pelvic floor muscle exercise and end up making their muscles too tight and overactive, because they are not fully relaxing in between reptitions. And a tight, immovable pelvic floor is not a strong muscle - it's probably a worn out muscle! And tight vaginal muscles can lead to painful sex."

MEET TARYN

This blog post has been prepared inconjunction with Taryn Watson - a Women's Health & Continence physiotherapist with a passion for providing pelvic floor friendly exercise options in the community. 


In 2013 Taryn completed her Masters in Continence & Women's Health Physiotherapy at Curtin University. Her master’s research project was on the incidence of stress incontinence (the leakage of urine with exertion) in women who attend gyms to exercise. The results of this study were that a staggering 50% of the women surveyed reported that they suffered from this incontinence. These results lead to Taryn starting FitRight.  You can read more about Taryn here.



Next blog, I am super excited to show you how to  incorporate your pelvic floor exercises with a core workout. Remember to stretch daily too so you are feeling your best. You can get my Pregnancy & Postpartum Stretching eGuide here.

With Love
D

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Anonymous said...

Thanks for your helpful & informative post about pelvic floor issues! I am a first time mum with a now 11mth old and I think there needs to be more emphasis on how important exercising is before and after birth, as well as making real effort to avoid harmful activities eg. lifting or strenuous housework (which is hard to avoid at times because some things need to be done!)... I got the all clear at 6mth to jog and exercise but I found even that was not enough time to recover so I fear my insides have probably dropped a little and it is bit concerning when you can feel your bits just inside the entrance. Anyways, I will see a specialist in future and get either of the examinations you spoke about. (Ps. I came here from your instagram) Keep up the inspiring posts! Vicky xo :)