Last year I made a change to my consultation paperwork so I now ask all new clients (not just post-natal clients) whether they have any pelvic floor issues or weakness before starting their exercise programme.
I made the change because I had noticed that despite a lengthy conversation at consultation and a thorough screening process many clients were not highlighting the fact that they were living with pelvic floor dysfunction.
I think this is because these women had simply come to accept that their pelvic floor issues were just a normal part of post-childbirth life and therefore had not thought it relevant or worth mentioning.
So, imagine you are signing up to an exercise programme and discussing what exercises you can and can’t do. If you were aware of any other group of muscles in your body that were not functioning properly or displaying signs of weakness you would certainly think it relevant to mention this to your trainer. However, research statistics vary but it is thought at least up to a third of women in the UK are living with pelvic floor dysfunction. Often a failure to address these issues is down to issues of acceptance, embarrassment and stigma.
Add to this the rise of the incontinence products industry where incontinence pads are now widely available and it starts to feel as though pelvic floor dysfunction has become normalised and something women just have to live with. I am all for the removal of shame or embarrassment and solutions which help people to live their lives as normally as possible but I would much rather see the problem solved rather than just addressing the symptoms.
I would prefer to see women empowered to address their pelvic health issues and not have to avoid certain exercise and activities, suffer with anxiety resulting from worry about leaking or live with a risk of pelvic organ prolapse (where one or more of the pelvic organs have descended downwards into the vagina).
Unfortunately, women’s pelvic health is a massively neglected area. Anyone who has been through childbirth will be familiar with the six-week post-partum check-up, which is all that is currently in place from the NHS in terms of a post childbirth health check where women are given the all clear to return to exercise. However, often issues won’t fully have surfaced by this time or life with a new baby is so overwhelming that women are not very focussed on themselves or their bodies, hence many women who would not be termed post-natal are still suffering the effects of childbirth on their pelvic floor often many years post giving birth.
WHAT ARE PELVIC FLOOR MUSCLES AND WHAT DO THEY DO?
The pelvic floor is a group of muscles that form part of our core. The muscles are like a double layered ‘sling’ from the pubic bone at the front of the pelvis to the base of the spine at the back of at the pelvis and are held in place with ligaments.
Their role is to;
-Provide stability of the pelvic girdle.
-Support the organs of the pelvis and abdominal contents (the bladder, uterus and bowel).
-Continence control of both urine and faeces.
-Respond to changes in sudden abdominal pressure bought about my coughing, sneezing, laughing, exercising etc.
-Help sexual function.
WHAT ARE THE SIGNS OF PELVIC FLOOR DYSFUNCTION?
-Leaking urine with activity such as coughing, sneezing, laughing and during exercise – known as stress urinary incontinence.
-Needing to get to the toilet in a hurry and not making it in time.
-Heaviness/dragging in the pelvic area.
-Pain with intercourse.
WHO IS AT RISK OF PELVIC FLOOR DYSFUNCTION?
Pregnant and post-natal women are at risk because during pregnancy these muscles stretch considerably to allow for childbirth, causing them to become saggy and weak. However, it is not just an issue that affects mums and mums to be as there are other factors including lifestyle factors which can cause pelvic floor weakness (and not just in women!). These include;
-Lack of exercise and not keeping active
-Repeated heavy lifting
-Prolonged long term coughing
-High impact activities
WHAT CAN I DO TO IMPROVE MY PELVIC HEALTH?
The good news is that the majority of pelvic health issues can be rectified so even if you neglected to do your pelvic floor exercises during pregnancy or post baby, it is never too late to start strengthening your pelvic floor or seeking specialist help to address your pelvic floor dysfunction (see announcement below!)
However, it can be a very confusing for women in this situation as when you look at the above risk factors, on the one hand being overweight and not keeping active is a risk and on the other hand certain exercises can also be a risk.
Although you do not want pelvic floor issues to prevent you from exercising, if you are looking to start an exercise programme please don’t ignore your pelvic floor issues as certain exercises could increase the pressure on your pelvic floor and lead to further problems.
Rest assured you don’t need to avoid exercise or resistance training but exercising through stress incontinence is never a good idea and you need to adapt your programme and scale back if this is happening to you. If in doubt ensure you seek the advice of a qualified trainer.
So, takeaways are;
Q. Is pelvic floor dysfunction common? A. Yes!
Q. Is it normal? A. No!
Q. Can I do something about it? A. Yes!
Q. Will it get better if I ignore it? A. No!
Q. Do you now feel empowered to do something about it? A. Only you can answer that but I really hope so.