When learning about the pelvic floor, it’s common to come across information detailing the importance of preparing the pelvic floor for childbirth in women, and helping with recovery postpartum. The reality, however, is that our pelvic floor plays an incredibly important role for both men and women throughout our lives, forming part of our deep core muscles, and with pelvic floor problems affecting everything from continence to sexual health to back pain.
As such, our women’s, men’s and pelvic health physios can help with a range of problems – some that may surprise you. Here’s a look into why your pelvic floor is important, the kinds of problems our patients face when their pelvic floor isn’t functioning effectively, the relationship between the pelvic floor and the common problem of incontinence, and how our pelvic health physiotherapists work with both men and women to help.
The Pelvic Floor In Men And Women
Think of the pelvic floor like a supportive trampoline for your pelvic organs – a sheet of muscle and connective tissue that extends from the pubic bone at the front to the tailbone at the back and includes the inside wall of the pelvis. The pelvic floor also wraps around sphincters (valves) at the base of the bladder and at the anus, playing an important role in helping them stay closed and preventing leakage.
The role of the pelvic floor in men
- Contracting the pelvic floor muscles tightens the openings of the urethra and anus to help delay emptying the bladder and bowel
- Relaxing the pelvic floor muscles lets urine and stools pass freely
- The pelvic floor is also important for male sexual function and is partially responsible for erectile function and ejaculation
- It assists in providing support to the lumbopelvic complex and the hip joint
- The pelvic floor helps prevent pelvic organ prolapse
The role of the pelvic floor in women
The role of the pelvic floor in women is similar to that in men, still maintaining importance in sexual function (including reducing pain from intercourse and heightening sexual sensations), while also keeping the uterus supported both throughout daily life, and in pregnancy.
Changes To The Function Of Pelvic Floor Muscles
With the pelvic floor playing an important daily role for both men and women, changes or dysfunction of the pelvic floor muscles can result in some significant problems – and despite many assumptions, the cause of that dysfunction can often be completely unrelated to pregnancy or childbirth. Causes for pelvic floor muscle dysfunction in both men and women can include constipation, regular heavy lifting or high-impact activities, excessive coughing, being overweight, age-related changes, having surgery for bladder or bowel problems, and neurological conditions that may affect pelvic floor muscles like diabetes.
Signs that that your pelvic floor muscles are not working effectively include:
- Leaking urine or faeces during activities such as running, jumping, sneezing, coughing or sexual activity
- A sudden and urgent need to pass urine, frequent urination, or starting and stopping when passing urine
- Passing wind when bending over or lifting
- A heaviness or dragging feeling in the pelvis or back
Men may also have symptoms of erectile dysfunction, and women may experience pain with intercourse, reduced sensation or heaviness at the vagina, and recurrent urinary tract infections.
Incontinence
Problems with the pelvic floor is one of the most common reasons for incontinence, where there is involuntary leaking from either the bladder or the bowel, often when sneezing, coughing, exercising or laughing. Incontinence now affects one in three Australians, and despite having the potential to cause serious long-term health problems, 70% of those with symptoms aren’t seeking any medical advice or treatment.
With urinary incontinence, over-contraction, under-contraction or altered activation patterns of the pelvic floor muscles can all contribute to problems. Having a pelvic floor that is over-contracted can increase pressure on the bladder. This increase in pressure can then lead to ‘urge’ incontinence (an overactive bladder) where you feel a sudden urge to urinate, followed by involuntary emptying the bladder or some leaking. Under-contracted, weak or altered pattern of muscle activation can cause ‘stress’ incontinence, which is the leakage that uncontrollably happens after a sneeze, cough, laugh, heavy lifting, or extraneous exercise.
Physio For Incontinence And Other Pelvic Floor Problems
The good news is that if you’re having problems with your pelvic floor, then a women’s, men’s and pelvic health physio can help. These physios have a thorough understanding of the conditions that result in dysfunction of the pelvic floor muscles in both men and women. Physiotherapy has been shown to successfully treat incontinence in 80% of cases. Moreover, the comprehensive understanding your physio has about your body and the musculoskeletal system means you can also discuss any other pains or issues you may be having at the same time, such as chronic pelvic pain or back pain.
Your Physio Appointment
Your appointment with your physio will start with a detailed history, understanding the severity of the problem and how it’s impacting your day-to-day life, and then a physical exam. Your physio will discuss the results of your assessment with you and discuss the treatment options available to help you get the best results.
Treatment will be uniquely tailored to your assessment findings and designed to meet your needs. Ensuring you have a good understanding of your results and your options for treatment will be a key part of your physiotherapy session. Treatment options may also include specific exercises targeting the pelvic floor muscles or other associated muscles such as your gluteals, abdominals etc.
Your physio will track your progress over time, and make adjustments to your treatment plan as you progress and see results.
Pelvic Floor Exercise At Home
If you’re experiencing pelvic floor-related symptoms and are wanting to start working on your pelvic floor while you wait for your appointment, start by identifying your pelvic floor muscles. There are several ways to do this:
- When going to the toilet, gently try to stop or slow the flow of urine midway through emptying your bladder. If you can do this you are squeezing the correct muscles.
- Sit or lie down with the muscles of your thighs, stomach and buttocks relaxed. Gently squeeze the ring of muscle around the anus as if you are trying to stop the passing of wind. Squeeze and let go a couple of times to ensure you have found the right muscles. Try to avoid squeezing the buttocks muscles themselves.
Next, try to gently squeeze and lift. Squeeze and draw in your pelvic floor muscles (think about lifting them up inside). Try to hold them while counting to eight, then relax. If you can’t hold for eight counts, just hold for as long as you can.
While doing pelvic floor muscle training remember to keep breathing, avoid tightening your buttocks, and keep your thighs relaxed.
See Our Team Of Experienced Physiotherapists
If you need help with pelvic floor pain or dysfunction, or if you’re experiencing symptoms and aren’t sure what’s going on, our experienced and caring physio team here at Allsports are here to help. You can book your appointment online or call the clinic nearest you.
References
[1] https://pubmed.ncbi.nlm.nih.gov/25401779/
[2] https://www.continence.org.au/news/new-data-reveals-incontinence-affects-1-3-adult-australians
[3] https://pubmed.ncbi.nlm.nih.gov/15904449/