We all know that dreadful feeling of needing to find a bathroom suddenly to empty the bladder at completely the wrong moment. Imagine that awful feeling and then not making it to the bathroom on time?
Worse still is the fear of not being able to control stool or gas. Both women and men up and down the country are dealing with these awful problems. Help is available to give yourself back your freedom without fear of bladder and bowel leaks, for normal sexual function (to be able to orgasm or climax correctly) and to ensure optimal bowel & bladder emptying, as well as solve constipation!
How Can Pelvic Floor Muscle Training Help?
Progressive pelvic floor muscle training is recommended as a first line treatment for incontinence (CG171 NICE Guideline 2016). Two thirds of women with any type of incontinence who have pelvic floor muscle training see improvements or cure it, with 75% of women reporting resolution of symptoms such as episodes of incontinence (National Institute of Research doi:10.33310/signal-000702. That’s 2 out of 3 women who will be cured of incontinence with pelvic floor muscle training and the third woman will be improved!
What Is Pelvic Floor Therapy?
Pelvic Floor Therapy is specialised pelvic physiotherapy to train the pelvic floor muscles and ensure they are working normally, and it is vital for women and men as preventative or essential therapy. Pelvic floor physiotherapists know now more than ever with new advances in diagnostics such as ultrasound and MRI imaging how to best train the pelvic floor muscle muscles. They are skilled and highly experienced in the different exercises and routines needed to fully train the pelvic floor and ensure optimal results.
It's Not Just A Female Issue
One in three women, from the 24 to 85 age group, have urinary incontinence. Pregnancy & childbirth are leading causes of incontinence for women, but men can have the same symptoms as women too, often caused by natural ageing. Many hide the problem and are too embarrassed to deal with the issues. Both women and men wear incontinence pads, reduce their sexual activity, their exercise levels, and their social life, too. In some case it can affect a woman’s decision to return to work after having a baby or to apply for a promotion. Many fear that there may be an odour from the leakage, or that there might be wet patches on clothing or after sitting down on furniture, too.
There are several reasons why women suffer from incontinence after having a baby. Changes to the pelvic floor muscles begin in pregnancy. As early as at 10 weeks, hormonal changes will take place to soften the pelvic ligaments and fascia (the things that support our pelvic organs, the bladder, the bowel, and the vaginal walls); these changes, along with the increasing bump, put pressure on the pelvic floor muscles and they become weak over time. Some women can have incontinence in pregnancy too, especially if it’s a woman’s second or third pregnancy.
Normal aging and prostate issues affect men, giving the very same bladder and bowel issues and erectile dysfunction. 50% of men over the age of 40 have erectile dysfunction.
What About Your Pelvic Floor And Menopause?
What problems can arise that maybe HRT can’t resolve? There are hormonal changes around menopause that affect muscle function. Though HRT will work on those hormonal changes, it won’t train the pelvic floor muscles, and the bladder and bowel muscles can also be affected by hormonal changes too, as can sexual function.
Common symptoms such as fatigue and sleep disturbance can also have an impact on the pelvic floor muscle function. By keeping your pelvic floor muscle function in the normal range before, during and after menopause it will prevent and treat bladder, bowel, prolapse and sexual problems – it’s so important!
Where Is My Pelvic Floor?
As they are internal, it’s often hard to understand where exactly the pelvic floor muscles are in the body. Firstly, think of the area of your body between your waist and the top of your legs. This is where your pelvis is located, think of it as a basin-shaped region.
Your tummy area is where your core muscles are located. The pelvic floor muscles form the base of the pelvic basin and are really the “underneath” part of your core. The pelvic floor muscles hold up or support your organs correctly in the pelvic cavity. These organs are your bladder and your bowel, and for women your vaginal walls and your womb too.
The pelvic floor muscles have four main parts to normal function:
The first one is muscle bulk, you can think of this as muscle thickness too.
Next, the fitness or endurance is another important feature: this is to do with the number of muscle contractions a person can do.
Next of all we need to mention the muscle strength; this is squeeze strength or the power that is generate when the muscle contracts.
Lastly, muscle movement is another key important element of function: this means contracting or squeezing as well as relaxing or letting go properly and moving forwards and upwards, in an automatic or reflex way.
Why Are Pelvic Floor Muscles So Important?
If the pelvic floor muscles are not in the normal range of function, then our bladder and our bowel may not fill, store and empty urine (our wee) and stool (our poo) correctly. If we are not eliminating our waste material (wee and poo) correctly we can become unwell, with urinary tract infection or obstructed bowel or constipation.
If our bladders and our bowels are not working correctly or if we have prolapse or sexual dysfunction, our quality of life can be severely affected. We can’t live our lives, go to work, travel or exercise without worrying about bladder or bowel leaks or stressing about need the bathroom urgently. We won’t feel well if we can’t empty or bowels or our bladders and we might not sleep well either which means our energy levels will likely be poor, and we may feel anxious.
Who Should Train Their Pelvic Floor Muscles?
Absolutely every adult can benefit from training their pelvic floor muscles! Though some people need to be extra vigilant about training their pelvic floor muscles on a daily basis. Women who are approaching, going through or are after menopause need to train their pelvic floor muscle daily. Women who have had a difficult childbirth & delivery, especially those who had a long second stage of labour (the pushing part, particularly if it was longer than 1-hour), new mums who needed forceps to deliver their baby, or those unfortunately with a thing called a 3rd or fourth degree tear.
Great help is available from pelvic physiotherapists in all maternity hospitals in Ireland, but you must start your pelvic floor training on day 1 after giving birth; of course you may not feel like doing it, but it is so important. Training these muscles can truly help give confidence and quality of life back, without fear of any leaks. And whilst is best to start as early as possible, it’s never too late to begin.
Pelvic floor muscle dysfunction can cause problems for women before, during or after the menopause from a sexual function point of view. Women can have pain during sex, and they can have issues with climax and leaks of urine, wind, or stool. Pelvic floor muscle training will help with all of these problems.
How Do I Start Training My Pelvic Floor Muscles?
So, how do we exercise the pelvic floor muscles? Like any other muscle training, it’s through specific exercises even though they are internal. It’s extremely important to note, however, that it’s not a quick fix. NICE European guidelines tell us it can take 3 months to fully train the muscles! Training the bladder muscle itself and training the bowel and gut reflexes is needed too. The exercises and routines need to be targeted to the different muscle fibres, and you need to progress them and keep doing them for life at a maintenance dose but much more frequently in the beginning.
Spectrum Health / The Physio Company have partnered with International Pelvic Physiotherapy Management (IPPM) to bring you Home Pelvic Routines, online pelvic training videos and e-books. It can take 3-to-6-months to get the muscle bulk, endurance, fitness, movement, and automatic function working in the normal range. The bladder and the bowel muscle themselves need to be trained too, with lifestyle changes and some other exercises. The exercises need to be targeted to the different muscle fibres, and you need to progress them and keep doing them for life (at a maintenance dose but much more frequently in the beginning). It is not a quick fix, but it works, and it is so worth it!
For more information on the partnership and to purchase Home Pelvic Routine, click here.
To read more about women’s health physiotherapy and the service we can provide, click here. To read more about men’s health physiotherapy and the service we can provide, click here.
This blog was written by Specialist Physiotherapist Aoife Ni Eochaidh of IPPM. IPPM partner with pharmacies and many companies to provide online Home Pelvic Routines for both women and men in Ireland, as well as internationally, as well as a portfolio of services in the pelvic physiotherapy space. Patients are seen in clinic for in-person appointments, as well as the online physiotherapy appointments.
IPPM provide medico-legal pelvic physiotherapy expertise in Ireland and the UK, in addition to consultancy for companies, investors, hospitals and other physiotherapists. Their expert pelvic physiotherapy services have been provided in the UAE, Switzerland, Austria, the UK, and here in Ireland.