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World Continence Awareness Week - Day 4 - The pelvic floor & leakage

Uncategorized Jun 18, 2020

The pelvic floor muscles are like a hammock sitting at the base of the pelvis. They span the whole of the pelvic outlet, from pubic bone to tail bone and seat bone to seat bone. They also merge with connective tissue known as fascia to provide a dynamic support for your pelvic organs. They're like a cushioned sofa for your bladder, womb and bowel!

So why do I need to train my pelvic floor?

Pelvic floor muscle training is an effective treatment for urinary incontinence. In a review of 31 trials, looking at the effects of pelvic floor muscle training on incontinence in 1,817 women, women experiencing stress urinary incontinence were 8x more likely to report a cure and women with other types of urinary incontinence were 5x more likely to report a cure, if they had undergone a programme of physiotherapist guided pelvic floor muscle training.

You can take a closer look at this information here:

Let's take a closer look at the pelvic floor.

The pelvic floor is made up of two muscle layers, the superficial (see image above) and the deep (see image below).

All the muscles are skeletal muscles, which means that you can control them, you can train them, just like any other skeletal muscle in your body. As you do in the gym for your arms and legs, in Yoga and Pilates for your core, so you can train the pelvic floor.

Although made up of individual muscles, the pelvic floor works as a team, producing the same direction of movement during a 'squeeze' or a 'kegel'. The movement produced is in an upward, inward and forward direction, lifting, supporting and closing the pelvic organs. The release is in the opposite direction, lowering and opening the organs.

Skeletal muscle, when trained over time, will produce more muscle fibres, bulking the muscle up. This 'bulking' increases the muscles' power, range of movement and closure pressure. The 'bulking' also improves support of the pelvic organs, even when the muscles are at rest.

Full function involves power, range, release, control, endurance and speed. a good and effective training programme will work in a gradually progressing plan designed to improve all of these essential areas of muscle function. An effective training programme involves more than just random squeezes through the day.

How does the pelvic floor keep me dry?

The pelvic floor, when trained well and functioning optimally can provide closure pressure to prevent leakage from the bladder or bowel. For example, if the pelvic floor is squeezed just prior to and during a sneeze, the bladder and bowel openings are squeezed closed, just as the abdominal pressure rises. This prevents escape of urine, wind or stool.

Even a relaxed but bulky pelvic floor can provide cushioning to the pelvic organs, causing them to rest in better positions within the pelvis. If the pelvic organs are located correctly, they are less likely to cause problems, such as leakage.

The pelvic floor, when able to relax fully, will allow full and complete emptying of your bladder and bowel. This will help you to reduce problems associated with functional constipation, incomplete emptying and overflow incontinence.

A strong pelvic floor, under your complete control can help you to resist increased pressures from lifting and impact, helping you to be more active and do more in terms of exercise and fitness.

And then there's the new found confidence in your body, helping you to try more things out, get back to fitness levels you thought you'd have to abandon and even, get you back to wearing all the range of clothes you want to. Leakage is a nightmare for making you step back into the shadows with dark and looser fitting clothing, not always the most flattering and not always the clothing you would naturally pick out. 

A well functioning pelvic floor that keeps you dry and comfortable will have a huge impact on your day to day life, your feelings of well-being and your psychological health, not just physical fitness and activity levels.

And who feels 'normal' wearing a pad anyway?!

Where can I get help to start my pelvic floor training journey?

> Find your local pelvic health physiotherapist in the NHS (UK) or private practice. In the UK, take a look at

> Use the Squeezy App to help with reminders in the day and keeping a record of what exercises you've completed each day

> Try my RE-CORE-NECT online courses that help you to fully understand your core and pelvic floor, why you have the problem(s) you do and how to fix them.

> There are weights like Aquaflex and machines like the Kegel8, but these are not necessarily the best options in the first place. Make sure your technique is right first of all and then add in the extras as they apply to you!

> See your GP if you are concerned about your continence and want to see an NHS physiotherapist (some locations allow self-referral to physio but not all, check your local area).

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