How to keep your pelvic floor muscles healthy

Pelvic floor muscles are one part of a group of three muscles that form the core of the body.

They are a layer of muscles that supports pelvic organs and line the bottom of the pelvis.

Normally this is a very firm band of muscles from the tail bone (coccyx) to the pubic bone. Pelvic organs are the bladder and bowel in men; and bladder, bowel and uterus in women.

Pelvic floor muscles play a major role in providing control over the bladder and bowel, enabling one to delay emptying until it is convenient.

They are also important for erectile function during sex in both men and women, among other functions. Pelvic floor muscles in women also provide support for the baby during pregnancy and assist in the delivering process.

Weakened pelvic floor muscles mean internal organs are not fully supported and one may have difficulty controlling the release of urine, faeces or wind. This can cause urine incontinence or make the vagina or uterus to protrude.

On the contrary, pelvic floor muscles can become too tight especially in women.

Causes of weak pelvic floor muscles include child birth. Weakness can start during pregnancy and continue after child birth.

Women who have had multiple births, instrumental births (with forceps), or severe perineal tearing due to large babies (birth weight over four kilos) are at greater risk of pelvic floor muscle damage.

Chronic constipation: Repeated straining on the toilet can lead to pelvic floor weakness and/or prolapse of the organs into the vagina (for women) or the anus. It is important to learn good toilet habits.
High impact exercises: Sports such as basketball, netball or running may mean an increased risk of leaking urine, especially for women. This applies to elite athletes as well.

Chronic coughing: Persistent coughing increases the risk of urinary incontinence and prolapse, especially if the pelvic floor muscles are compromised. This is due to increased in-fra abdominal pressure.

Heavy lifting: This can create pressure on the pelvic floor and ultimately lead to prolapse. Men and women in professions such as nursing or heavy weight training are at particular risk of straining the pelvic floor. Also, pelvic floor muscles tend to get weaker with increasing age.

Other reasons are pelvic surgery and obesity.

What to do about weak pelvic floor muscles. Managing the condition depends on symptoms such as incontinence, protruding organs, constipation, low sex drive, or impaired sensation.

Extreme cases

Kegels are the most common exercises which help to rehabilitate these muscles.

Imagine you are in the loo passing urine and someone opens the door. You have to stop the flow of urine. Understand the muscles used to aid this activity and tighten them — hold for 10 to 15 seconds and release.

Be keen not to hold your breath or pull in your belly button. Make 10 repetitions. Do not do this exercise while peeing as continued holding of urine may cause urinary tract infection.

Two, electrical muscle stimulation. This is done in extreme cases where one has faecal or urine incontinence.

It involves use of electrodes which are either placed externally or internally to stimulate the pelvic floor muscles. It is very effective but should be done under the supervision of a physiotherapist.

After abdominal surgery, support the lower abdomen if you experience a cough or sneeze. This offers external support.

Weak pelvic floor muscles can strain marriages and lead to break ups.

Both men and women have been subjected to psycho-social trauma due to effects of weak pelvic floor muscles.

There is no need to suffer any more, visit your physical therapist and get the necessary help.