Pregnancy and birthing places a lot of pressure on a woman’s pelvic floor muscles. Subsequently 1 in 3 women suffer some kind of incontinence issues.
Many women don’t address this embarrassing problem of leaking urine or faeces when they cough, sneeze or pick up their baby. Worse, they are using sanitary pads when returning to exercise to absorb the leaks, rather than looking for a long term solution. A recent study found that almost 50% of women who attended gyms or exercise classes experienced stress urinary incontinence (McKenzie 2106). Women should be screened on the function of their pelvic floor, before they undertake any type of exercise, and if symptomatic, be referred for proper support and treatment, rather than attending classes, as this will only increase the risks to the woman’s health.
Leaking urine is common, and the NHS estimates that between 3 and 6 million people in the UK have some degree of urinary incontinence. Companies have used outrageous advertising strategies to make light of this issue, but there should be zero tolerance on wearing pads to deal with incontinence.
Incontinence is an early warning sign that further down the line, there will be more serious issues to deal with such as uncontrollable bowel movements, collapsing of the vaginal walls, prolapse of the bladder, uterus or back passage into the vagina and an inability to enjoy a sex life.
The pelvic floor has a massive job to do, in supporting all the pelvic organs, movements, balance and posture of the body, assisting in lymphatic drainage of toxins from the body, maintaining good sexual function and control of the bladder and rectum.
There are two main types of pelvic floor dysfunction:
Weak pelvic floor muscles (under active)
Tight pelvic floor muscles (over active)
Normal function exists when there is voluntary and involuntary contraction and relaxation of the muscles. The contraction of the muscles is strong and the relaxation of them is complete.
Signs that the pelvic floor are weak are when the muscles cannot contract when necessary and symptoms include urinary or bowel incontinence or pelvic organ prolapse.
Signs of an over active pelvic floor are when the muscles do not relax voluntarily or they contract when full relaxation is necessary. Symptoms include problems emptying the bladder properly, not being able to open bowels fully and painful sexual intercourse.
No matter what type of birth a woman experiences, she will need to work on her pelvic floor and core muscles to help them work properly. Even if a baby was birthed by caesarean, the pelvic floor will have sustained pressure from the increased weight of the baby. Pregnancy also often creates weakness in the muscles in the bottom and tightness in the inner thigh and back muscles creating impact on the performance of the pelvic floor.
Furthermore, the deep abdominal muscles, known as the ‘corset’ or transverse abdominal assist in strengthening our pelvic floor and core. These are cut into when a woman has a caesarean birth, affecting the connection to her pelvic floor, so more training is necessary to establish a re-connection to these muscles.
There are many habits that women develop that affect the optimal functioning of her pelvic floor such as going to the toilet ‘just in case’, hovering over the toilet seat and straining. These also need to be tackled to provide a whole system approach to reconnecting and activating the pelvic floor.
Ultimately, a solution to the problem demands active participation. It’s just like cleaning your teeth. You don’t brush them on Monday and then say to yourself “I’m good now for the week”! There is no pill or pad that will ever solve this problem. Women need to own and respect their bodies and take responsibility for their health. Practising correct floor exercises to create function and retaining continence is a life-long process.
If you are experiencing any trouble with bladder control, then please download and complete this questionnaire that has been designed to help understand the issues you may be facing. Please contact me if you are answering ‘YES’ to many of the questions so we can advise you of your next steps.