Pelvic Floor Health and the Importance of Pelvic Floor Exercises

Offered By Roseanna Grace Physiotherapy

The subject of pelvic floor health is something we hear a lot about.  So, let’s start off by understanding some anatomy and physiology – what is our pelvic floor muscle and where is it?  The pelvic floor is the base of a group of muscles referred to as your ‘core’.  These muscles are located in your pelvis and stretch from the pubic bone at the front of your body, all the way back to your coccyx (or tail bone) at your back.  Imagine them as a hammock that stretches both from front to back as well as side to side.  Both men and women can experience weak pelvic floor muscles in a variety of ways from pregnancy and childbirth through to prostate cancer treatment obesity and straining due to chronic constipation.  The results of which can be both upsetting and embarrassing from urinary leakage to reduced sensation.  So, understanding the benefits of pelvic floor health is really important, but crucially understanding the type of exercise that will benefit is ultimately they key to success.

What are pelvic floor exercises and how can strengthening your pelvic floor can be of benefit?

So firstly, let’s clear one thing up here; pelvic floor muscle exercises aren’t the most important thing about pelvic floor muscle rehabilitation! The most important thing is actually getting your muscles assessed to see how to approach the rehabilitation of them!  

You may be surprised to learn that similar symptoms of pelvic floor conditions can be connected to different diagnoses requiring very different treatment.

For example, if the pelvic floor muscles have too much of a higher resting tone, then the co-ordination of these are impacted and can result with urinary leakage, this would require down training. The same symptom (urinary leakage), can also resolve from a pelvic floor muscle group that has normal tone, but is too weak and therefore would require strength training. It is easy to assume that leakage is second to weakness, but it is important to remember it can be either types of dysfunction. Some women have no signs of a pelvic floor that is too high tone, others may have some tell tail signs being pelvic pain, inability or difficulty on inserting or removal of a tampon and intercourse may be painful.

Signs of a weak pelvic floor can also have pain, usually lower abdominal and be reported as a ‘dragging’ or ‘heaviness’ sensation in the vagina / pelvis. This is usually second to pelvic organ prolapse and can be massively helped through seeing a highly specialist physiotherapist.

Symptoms that would warrant an appointment would be any of the following:

  • Urinary leakage (stress, urge or both)
  • Urinary frequency and/or urgency
  • Pelvic organ prolapse (vaginal heaviness, bulge, dragging, pressure sensations)
  • Unable to do specific exercise second to urinary symptoms or vaginal discomfort
  • Painful sex
  • Reduced sensation during intercourse – difficulty or inability in achieving orgasm
  • Childbirth episiotomies / tears causing any pain or discomfort
  • Faecal incontinence
  • Faecal urgency
  • Incontinence of wind (vaginal or anal)<

All the above can be massively improved by getting your pelvic floor muscles assessed and implemented into an individualised pelvic floor exercise programme for you. 

It is important to understand that these symptoms can be hugely helped, and there is no need to feel shy or embarrassed.  As healthcare professionals, specialist physiotherapists are focused on working with you, within complete confidence and offer nothing but individualised support and guidance.  According to National Institute for Clinical Excellence (NICE) figures, the prevalence of pelvic organ prolapse is high in UK primary care with 8.4% of women reporting either a vaginal bulge or lump (that’s a staggering 2,840,880 women) and on examination, prolapse was found to be present in up to 50% of women.  Other figures according to Squeezy, the bladder pelvic floor app, suggest that more than 600 million men and women worldwide suffer from the effects of pelvic floor dysfunction. So, it’s important to understand that when you are looking to seek help, the figures go to show, you are not alone.

So, What Can You Do?

Before you decide to self-help by purchasing devices such as vaginal weights, machines or other adjuncts that have cleaver marketing, do consider instead seeing a specialist and experienced physiotherapist – they will give you direction and education about what the right approach is specifically for your pelvic floor.  A personalised approach to your pelvic floor health is something to consider and from which can come a personalised treatment plan.

An examination will consist of gathering the below information:

  • Strength / Power of contraction
  • Tone of the muscle
  • Co-ordination of the pelvic floor
  • Reflexibility of the pelvic floor
  • Endurance ability
  • Speed of your contractions and the ability to let go

Depending on these findings, an individualised programme will be prescribed to you and on average, improvements can be seen by 12 weeks (the same as any other muscle!).

When looking for a specialist pelvic physiotherapist, you can refer to the Pelvic Obstetric and Gynaecological Physiotherapy (POGP) which is a recognised professional network of the Chartered Society of Physiotherapy (CSP) where you can find information for patients, including links to patient booklets.


Want to keep learning? Find more articles from Roseanna Grace Conway - Roseanna Grace Physiotherapy

Musculoskeletal Health Women's Health

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