Pelvic floor – not to be swept under the carpet!
You’ve probably heard the ads on the radio, or seen them on TV – you know the ones, they make you cringe, or at least leave you thinking “not that ‘embarrassing little problem’ again!” If you think you’ve heard enough already then get ready for complete saturation when the pelvic floor hits the headlines during World Continence Week (June 24–30). So why does the New Zealand Continence Association (NZCA) and Physiotherapy New Zealand (PNZ) want to shine the spotlight on ‘down there’?
Recent research by PNZ highlighted that 41% of the 1000 people surveyed didn’t even know where the pelvic floor was, let alone how important it is and what sort of problems might occur if it isn’t working properly. So let’s clear that up first of all. The pelvic floor is an extremely important group of muscles that sit between your legs, spanning from the back of your pelvis (tailbone area) to the front of the pelvis (pubic bone) and from side to side. If you think of your pelvis as a ring or cylinder, the pelvic floor muscles are the ‘floor’ or base of that cylinder. They surround the three openings – the back passage (anus), birth canal (vagina) and the front passage (urethra) and therefore allow us to control the passage of urine, wind and faeces. They also contribute to supporting our spine and pelvis (as part of our ‘core’ muscles) and play an important role in sexual sensation and function.
So why are they so important? When your pelvic floor isn’t doing its job properly the results are a range of problems that can really reduce your quality of life and get in the way of you doing the things you want to do. In the study by PNZ, 52% of the women surveyed had accidentally leaked urine at one time or another and 30% had experienced trouble achieving orgasm. Of the men surveyed, 25% had experienced erectile dysfunction and 26% had experienced difficulty achieving orgasm. These are all issues that can be related to pelvic floor function.
Other unpleasant consequences of having a pelvic floor problem can be: not being able to hold on when you need to go to the toilet or constantly needing to go; finding it difficult to empty your bladder or bowel; accidentally passing wind or losing control of your bowel; a prolapse (where the pelvic organs drop down lower into the pelvis and you feel a heaviness, pulling or dragging sensation); and pain in the pelvic area or pain during sex.
Despite the fact that these problems sound like the sort of thing we’d all like to avoid, 41% of the PNZ survey participants never exercised their pelvic floor muscles. This could be because they didn’t know how to or didn’t realise exercising was so important for treating or preventing the above issues. Or perhaps they just had trouble establishing the habit.
So I asked pelvic floor experts Vicki Holmes and Jill Wood, both physiotherapists, what they found helped people stay on track with pelvic floor exercises. They made the following key points:
1. In order to feel motivated about doing pelvic floor exercises people need to really understand the pelvic floor related problems they have or are trying to prevent. We don’t have the space to go into detail here but readers can access information on how to exercise their pelvic floor muscles correctly on the NZCA website (www.continence.org.nz), on the PNZ website (www.physiotherapy.org.nz – under ‘Your Health’) or from their local physiotherapist.
2. People need to understand that it takes time to get results – early improvements can be seen in 3 weeks but lasting improvements take 3-6 months – and maintenance exercises (doing exercises at least 1–2 times per week) are important for everybody. This means that finding ways to stay motivated is crucial.
3. If people aren’t getting results or have a specific problem then they can get expert help from a urogynaecological or women’s health physiotherapist, or start by talking to their usual physiotherapist. Physiotherapists can provide an individualised programme suitable to the client’s needs and lifestyle which will be more effective than trying to go it alone. It can be a lot easier to tackle these issues with support and the physiotherapist can help the client stay motivated.
So please don’t sweep any ‘embarrassing little problems’ under the carpet. Get informed, get motivated, and get exercising your pelvic floor muscles. And if you need expert help go online to the NZCA website and find a health provider to help you tackle your specific pelvic floor issue.
Vicki Holmes and Jill Wood, Auckland Urogynaecology.
NZCA, New Zealand Continence Association: continence.org.nz
Physiotherapy New Zealand: physiotherapy.org.nz
Renée Vincent is a physiotherapist at Total Mums in Auckland. She specialises in treating pregnant women and mothers of young children. When she isn't working she is looking after toddler Charlie.
Published 24 June, 2013