Supporting Your Pelvic Floor

Supporting your pelvic floor-

Picture yourself: 20, childless, fit, doing 200 jumping jacks with ease in your favorite group fitness class. Meanwhile, that middle aged woman with four kids behind you seems to need all her concentration just to make it through before running frantically to the bathroom.

You have difficulty understanding what the problem is.

Let me introduce you to your pelvic floor.

While you may not even notice how seamlessly it works in your teen years, as you age or have more and more children, it is hard NOT to be aware of this very important body part.

What is your pelvic floor?

The pelvic floor muscles support the pelvic floor organs and play a role in orgasm, continence, core strength, and more. Weakness in the pelvic floor can cause sexual dysfunction as well as urinary incontinence and even pain.

Depending on the severity of the issues, prolapse of the organs normally supported by the pelvic floor can occur. As we age pregnancy, gravity, and some exercises can weaken the pelvic floor.  While common for women, it should not be ignored and can be prevented and even fixed with the right information and help.

So let’s talk about supporting your pelvic floor, things you can do to strengthen it, and ways to avoid harming it.

Avoid episiotomy and/or vaginal tearing if possible-

Episiotomy, or the cutting of the perineum, the tissue between the vagina and the rectum, was once a common practice in childbirth. This is sometimes done to speed the pushing stage of labor, though the practice is falling out of favor and we see numbers dropping.

Obviously, this can do damage to the pelvic floor, especially since women sometimes have further perineum lacerations as the tissue continues to tear past the initial cut. Avoiding episiotomy, which is most effectively done by choosing a care provider who does not perform them unless necessary, is one way to protect your pelvic floor.

Studies do vary, however.  This study found women who tore had more issues as well but did not find episiotomy to be a contributing factor.

Navigating studies can be difficult, since this one did find operative delivery (episiotomy) to be a contributing factor to pelvic floor dysfunction. They also noted that often times may risk factors coexist together- episiotomy, operative delivery, forceps, and tearing may all be part of a managed birth.

Birth matters-

At least one study found that epidurals in labor and longer second stage (pushing) also contributes to pelvic floor dysfunction. We know that pelvic floor issues are more of a risk for women the more common the more children they have. Choosing a great provider can help as well as avoiding an epidural. (Relaxation practice during pregnancy is a great way to do this.)

Do your Kegels-

Doing Kegel exercises for your pelvic floor can help support and strengthen. Research on the effectiveness of Kegel exercises is fairly well documented. You can read here about Kegels. Practicing Kegels during pregnancy and afterward can be helpful in strengthening and supporting your pelvic floor.

Learn other exercises that can protect or strengthen your pelvic floor-

There are many exercises besides Kegels which can strengthen and support your pelvic floor. Bridging, squatting, seated pelvic rocking, bird-dog, and other exercises can help strengthen the pelvic floor. Read more here about exercises that can help support your pelvic floor.

Know what exercises can compromise your pelvic floor-

While some exercises help, others can truly be damaging, especially during pregnancy. As a good rule of thumb, things that involve pounding like running, aerobics, jumping jacks and other similar things can be hard on your pelvic floor, especially if done in great quantity. This isn’t always the case – you probably know if these are an issues for you- but you may want to talk to a physical therapist specializing in the female pelvic floor if you have issues or questions.

Eat right-

While eating right doesn’t fix everything, excess weight and poor nutrition can be contributing factors to pelvic floor weakness.

Chiropractic-

Chiropractic care can help align the stabilizing bones in your body, helping things function properly. You can read more about chiropractic during the childbearing years here.

Physical therapy-

Physical therapy is a powerful tool for helping rehabilitate the pelvic floor. Find a physical therapist who specializes in female pelvic floor issues and core strengthening. This can be a life-changing intervention, helping return normal function and strength.

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Pelvic floor dysfunction has become such a “normal” part of female health after childbearing that it is accepted and not talked about. This should not be. We must talk about the realities of what can happen to our bodies as we age and bear children and we must search for solutions- they exist.

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http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12092/pdf

http://www.ncbi.nlm.nih.gov/pubmed/19911728

http://www.ncbi.nlm.nih.gov/pubmed/12806450

http://www.ncbi.nlm.nih.gov/pubmed/18307071