There are many reasons why a person may experience urinary or bowel leakage on a regular basis. It could be due to a surgery, a certain illness or condition, after pregnancy, excessive loading as seen in elite athletes, or for no real reason at all. But leakage, despite what many may think, is not normal and is not something that you need to live with! How?! – Read on to find out more …
What are the pelvic floor muscles?
The pelvic floor muscles are the muscles located at the bottom of your pelvis and form the base of your “core” (that’s right, its not only your abs!). These muscles are responsible for controlling and supporting the organs that lie within the pelvis – namely organs relating to urination, reproduction, and evacuation (poop!). It important to remember that both MEN and WOMEN have a pelvic floor.
- The people most at risk of having a problem with this area are:
- Women who are pregnant or postnatal (no matter whether its 6 months or 50 years since giving birth!)
- Women who are no longer going through menopause (postmenopausal)
- Anyone who has undergone gynaecological surgery, for example a prostatectomy in men, or a hysterectomy in women
- Elite athletes
How do you know if you have problem?
Here are some common symptoms:
- Accidental leakage of urine or bowels, for example when coughing or laughing
- Not being able to hold for very long when you need to go to the bathroom (urgency)
- Unable to completely empty your bladder or bowel
- Waking up multiple times in the night to use the bathroom
How to activate your pelvic floor
A very common treatment for pelvic floor muscle weakness is to do exercises that involve contracting those muscles, but how do you know how to find them? A proper pelvic floor contraction should have a feeling of something lifting when you contract and a distinct sense of ‘letting go’ when relaxing. It is important you keep breathing and don’t brace your tummy muscles. Here are some visualisation prompts that can assist you in learning how to activate your pelvic floor:
- Try to stop imaginary urine from passing
- Try to stop imaginary wind from passing
- For men, try to get a sense of the muscles that raise your testicles
- For women, imagine squeezing something sitting within your vagina
How to exercise your pelvic floor
So, you’ve got a sense of where your pelvic floor muscles are now? Now to turn that awareness into an exercise regime that can be practiced regularly to see if you see any improvement in your symptoms. Try the following in a lying position at first:
- Maintain a contraction for a maximum of 8 seconds (build your way up to this duration if you are unable to at first)
- Rest for 10-20 seconds to allow your muscles to recover from that maximum effort
- Repeat this cycle 8-12 times – contract phase and relaxation phase
- Repeat this 2-3 times daily
- Progress from lying to standing when you can do the above comfortably in lying
Tips for toileting
Here are some other things to remember when toileting if you are experiencing symptoms of pelvic floor weakness:
- When you’re on the toilet, try get your knees slightly higher than your hips by going up on your toes or using a footstool
- Lean forwards with your hands resting on your thighs and try to get your spine straight
- Do not strain or hold your breath – give your body time
- Visualising your waist widening as you empty your bowels can also help!
When to seek help
So, when should you seek professional help from a pelvic floor physiotherapist?
- If you are experiencing feelings of vaginal heaviness
- If you have pain in the bladder/bowel
- If you have difficulty emptying your bladder/bowel
- If you are experiencing severe leakage that does not resolve with basic pelvic floor exercises are described above
The symptoms of pelvic floor weakness can be embarrassing and uncomfortable, but it is important to know that there is help available to you and you can see improvements or even resolution of your problem! If you are unsure and would like to discuss your symptoms with one our Physiotherapists, please call us on 8555 4099 or Book Online. Please note that InnerStrength of Bayside does not have a Pelvic Floor Physiotherapist, however we are able to help identify if you have a weakness, provide you some advice and refer you on as necessary.
Written by Meg Doyle (Physiotherapist)