Pelvic floor is a common phrase these days; in Pilates, in pregnancy/post natal periods, and just even in general women’s health. It’s all over the internet and social media. So it’s likely that you’ve heard of the “Pelvic Floor” but do you actually know what it is and it’s function, as well as what can happen if it’s not in optimal health?
The pelvic floor muscles are (technically three) layers of muscles that support the pelvic organs and span the bottom of the pelvis. The group of muscles run from coccyx to the pubic bone (front to back) and from one sit bone to the other (side to side) and work to be a bit like a hammock/trampoline – flexible support! There are also muscles around the anus (the anal sphincter) and around the urethra (the urethral sphincter).
The pelvic floor muscles encase the openings of the pelvis – the urethra, the anus and the vagina for women and when a pelvic floor is healthy and strong, the muscles wrap firmly around these holes to help keep the passages closed – effectively so nothing should come out. (Unless you need it to). As long as these muscles function well, you’re in total control.
As the pelvic floor is muscle, the genetic make up of muscles are primarily fibres which can either be slow twitch fibres and fast twitch fibres. Slow twitch fibres are the endurance team – they work at a lower level for longer periods of time. Fast twitch fibres are your sprinters – they work super hard and fast, but will tire quickly*. (*this is important to know but we’ll get to that later…)
The pelvic organs for us ladies are bladder, bowel, and uterus, so naturally when we go through pregnancy and then childbirth, the pelvic floor is affected to some degree by the physical and hormonal changes we experience while growing and delivering a tiny human. And when the muscles lose their resilience or are damaged, that’s when issues can start to arise. Prolapse, incontinence, involuntary gas release are a few of the symptoms of a weak pelvic floor.
So. Now we know that the pelvic floor is muscle. We know the pelvic floor muscles support the pelvis from front to back, and side to side. We also know that the muscles wrap around the openings of the pelvis and that there are additional muscles within the openings too. And finally we also know that the fibres that make up a muscle can be fast or slow. Why is all of this important?
When we initially are introduced to the pelvic floor and exercises to strengthen them, we’re told to do one or two straightforward, one dimensional exercise – squeeze as if you are trying to stop yourself mid-flow when passing urine. But that’s not a comprehensive enough approach, considering all the muscles and their position within the pelvis. We’ve got to be able to squeeze hard and fast so that when you don’t want to pass gas during a Pilates class (it is common, it’s not a big deal and it does happen to everyone at some point) or if you want to jump on a trampoline or cough without a little leakage. We’ve got to squeeze long and slow so that you can go for a big long walk and not have to worry about access to a toilet.
We’ve got to isolate each opening and work on them individually. We’ve got to think about passive work as well as concentrated effort. We’ve got to think about working the muscles laterally and medially as well. We’ve got to think about muscles slings and how they work with the pelvic floor. We’ve got to think about postural position, breathing, isolation, and then we’ve got to think about combining fast and slow in with the lateral and medial work as well and to a safe degree of contraction.
In essence, a pelvic floor routine shouldn’t be too simple, or indeed too long. You shouldn’t work too hard, or too soft. Little and often programmes work best for pelvic floor strengthening rather than contracting the area for an hour solid.
The PF’s relationship with other parts of the body is a complex one. The function of the pelvis is essential, ESSENTIAL, for the performance of almost every physical task we perform in life. You can’t do kegel exercises alone to strengthen your pelvic floor. The supporting structures also need to be addressed. In short? No one function in the body can work by itself without affecting another part of the body to some degree.
Every part of the body is a link in a chain. And when there is the presence of a weak link, this will cause a chain reaction through the body which results in greater stress on other areas of your body.
Muscles, whether you see them or not, need to be worked in order to keep them healthy. You know your heart is a muscle and that we are told to exercise cardio-vascularly to keep strong and healthy. Your pelvic floor should be treated in a similar manner. Work it to keep it strong. Strengthen it if it’s weakened. Release the muscles if they are tight. Treat it with respect and give it the attention it deserves so that you can cough without having to cross your legs.