Pelvic floor 101 - Part 2
Five things I want you to know about your pelvic floor
Last week I spoke about the importance of learning how to relax your pelvic floor (read blog) and this week I am sharing two more must-know points that lead on from there.
In case you missed it, your pelvic floor is a sling of muscles that resides at the base of your pelvis and helps to hold your bladder, uterus and rectum inside your body. It also plays a role in continence and the management of intra-abdominal pressure. Point 1 was to learn to relax your pelvic floor. My second must know point is all about knowing what symptoms to be aware of when it comes to your pelvic floor and why you shouldn’t ignore them (even if they don’t bother you now, they may one day).
Point 2
Symptoms are symptoms and should be addressed
Pelvic floor muscle weakness can occur if the muscles are under-active OR overactive. I spoke of a bicep losing strength over time if the arm never extends to straight. Same goes for the pelvic floor. This is important because as you can see below, some of the symptoms of an overactive pelvic floor overlap those of an under-active pelvic floor. The treatment for each condition however, is quite different.
Under-active Pelvic Floor
Stress urinary leakage
Inability to control “wind”
Losing control of the bladder or bowel before making it to the toilet
Low back pain
Pelvic or vaginal discomfort
Prolapse of pelvic organs
Overactive Pelvic Floor
Stress urinary leakage occasionally
Urinary urgency or frequency
Pelvic or vaginal discomfort and or/pain
Inability to feel contraction or release of the pelvic floor
Pain with sex
Slower flow of urine and the feeling of incomplete emptying
Difficulty or pain with emptying the bowels
Now there are also symptoms of pelvic organ prolapse (rectum, baller or uterine) that can be similar again to some of these as shown below.
Pelvic Organ Prolapse symptoms (bladder, uterine or rectal prolapse or a combination of the three)
Bulging sensation at the opening of the vagina
Lower back discomfort
The feeling of “sitting on a ball”
Discomfort (usually pressure or fullness)
Pressure in the pelvic region that gets worse as the day goes on or during bowel movements
Urinary leakage, difficulty with starting the flow of urine.
Frequent UTIs
Urinary frequency and occasional feelings of improper emptying
Difficulty with bowel movements
So why is it important to do something about it? Even if your symptoms aren’t that bad or don’t bother you that much? Because, they will often get worse over time, particularly when you arrive at menopause. At this point in time, the dip in oestrogen and age related muscle atrophy will result in decreased pelvic muscle tone.
If it is already weak, the symptoms that may have been tolerable are suddenly not and you have to start at a much lower point from which to strengthen. It’s a much better idea to tackle it early before you have all the additional challenges that menopause can bring. Your first port of call should be to see a women’s health physiotherapist. See below for some in Newcastle.
This leads on nicely to my third point which might ease the apprehension about seeing a women’s health physiotherapist.
Point 3
What happens at the women’s health physio?
During your first consultation, your physio will often ask you many questions about your urinary and bowel habits, sexual activity, childbirth and pregnancies, exercise and movement levels and also diet and water intake.
She will then assess your pelvic floor using real time ultrasound (non-invasive) or via an internal exam. This exam involves the physio inserting a gloved and lubricated finger into your vagina to feel the pelvic floor muscles. She is assessing the way that the muscles feel, if there is any scar tissue or differences from one side to the other. She will then often get you to do a couple of different contractions and some coughing to assess what your pelvic floor does in these situations. These initial checks are done lying down. Sometimes, they will be performed standing as well. During this digital exam, your physio will talk to you about exactly what she is doing before she does anything and continue to get approval from you. If at any time, you want her to stop, she will do so.
Based on what she discovers, your physio will generally have a diagnosis about what is causing your symptoms during your first consultation. She will then devise a plan to improve symptoms based on all of these various aspects.
You don’t need a referral to see women’s health physios publicly but there is often a waitlist. It is usually organised via the hospital’s physiotherapy department. You can also see them privately without a referral and your initial consultation will cost somewhere between $90-150 and there is a Medicare rebate for part of this.
If you are in Newcastle, here is a list of women’s health physiotherapists. If you are not local to me, simply search for “women’s health physiotherapy near me” and you will be able to find someone that can assess and treat you.
Complete pelvic floor physiotherapy - Eileen and her team - Kotara
Female Focus Physiotherapy - Erin & Eleanor - Adamstown
Hunter pelvic clinic - Carolyn and her team - Maitland
Pelvic form physiotherapy - Amy - Salamander Bay
Want to know how you can help your pelvic floor at home and where to get more information? Read the final blog here
Have you recently had a child and want to make sure you support your body in returning to strength? The Unwind Pilates Studio Post Natal Program may be just what you need in your life right now. Have older kids and want to build strength and flexibility all over? Then the Unwind Pilates online membership may be worth a look.
