What is an over-active pelvic floor? Women's Health Wednesday

This week charlotte, our women's health physio in sutherland, explains AN OVER-ACTIVE PELVIC FLOOR?

Like any muscle in the body it is important that the pelvic floor can both contract and relax.

If you think of your bicep muscle this needs to be able to contract to pick something up and relax to put something down. Imagine if the bicep was contracted all day long, it would be really hard to use your arm functionally and your bicep muscle would not work efficiently. Especially when strength is needed, the pelvic floor is the same.

Some women have pelvic floor muscles which have difficulty relaxing and remain constantly contracted. This however does NOT mean they are strong, imagine how tired they would be when you need them! 

OVER-ACTIVE ≠ STRONG

What are the symptoms of an over-active pelvic floor?

Symptoms will vary from person to person, but often include:

• Pain with sex

• Pain with using tampons

• Pain with pap-smears

• Pelvic or back pain

• Difficulty emptying bladder or bowel (constipation)

• Incontinence

• Increased sensation of needing to urinate

Who is at risk of an over-active pelvic floor? 

People who tend to have a higher risk for an over-active pelvic floor include:

• People with an overactive bladder, this is due to always needing to squeeze their pelvic floor to minimise leaking

• Strong athletic women with strong outer core muscles

• People with anxiety

• Sedentary work/life style (poor posture can shorten the pelvic floor muscles)

• Mouth/chest breathers

What is the treatment for an over-active pelvic floor?

Our initial treatment will always look at the way you breathe!

If you imagine your core and trunk muscles as a box, your pelvic floor is the base of your core with your transverse abdominus being the walls and your diaphragm muscle (breathing muscle) being the ceiling.

It is really important that all aspects of your core are working efficiently. If you are always breathing through your mouth, with a chest pattern of breathing the pelvic floor does not have a chance to relax.

Diaphragmatic breathing or “belly” breathing is essential as this allows the pelvic floor to descend and relax. 

Can I still do pilates with an over-active pelvic floor?

Yes! However more focus should be on the strength of your muscles (not including your pelvic floor initially) therefore you should not actively contract your pelvic floor during initial pilates sessions. 

As symptoms decrease, we start to add in a graded strengthening program for you pelvic floor

Post Natal / Mums and Bubs Pilates Sutherland

MUMS & BUBS PILATES | Monday & Thursday, 11:15am at Flow Physio Co Sutherland

Postnatal Pilates usually begins 6 weeks after the birth of your child.

Prior to commencing classes, we offer a 6 week postpartum check where we thoroughly examine the integrity of your pelvic floor and transverse abdominus (deep core muscle). We will also check for a Diastasis Recti (abdominal separation), wound check if you have had a Caesarean and a general assessment to ensure you are safe to return to exercise.

Following the 6 week check we recommend joining the Mums and Bubs Pilates class. This class has a maximum capacity of 2 people which allows room for you to bring your baby and allows the Physiotherapist to monitor you more closely. 

This session will be 50 minutes.

WOMEN'S HEALTH PHYSIO - SAFELY RETURNING TO EXERCISE AFTER PREGNANCY

Although a lot of women are keen to get back their pre baby routine it is really important to make this return as safe as possible.  

Whether you have had a caesarian or vaginal delivery we recommend you starting your pelvic floor exercises along with light walking as soon as you feel comfortable.

6 week check with your Women's Health Physio

At 6 weeks you will have a follow up appointment with your Obstetrician or GP, after this we recommend having a 6 week check up with a Women's Health Physiotherapist who will check the integrity of your pelvic floor. This is to make sure you can get a contraction, as some women's pelvic floor can be inhibited after birth and they can struggle to contact their pelvic floor muscles. It will also involve assessing the position of your pelvic organs to make sure there is no prolapse, checking for a abdominal separation and deep core contraction. Following this we will be able to safely prescribe a postnatal exercise program for you to begin. 

What about returning to running or high intensity exercise?

Although every woman’s body recovers differently, we still recommend waiting a minimum of 12 weeks, as well as having no incontinence issues, no pain or no prolapse symptoms before participating in any outer abdominal exercises such as sit ups or any high intensity core work that increases your intra abdominal pressure. This intra abdominal pressures directly puts strain on your pelvic floor.

Running is another hight impact exercise that places strain through these muscles and we recommend before beginning to run that your have your pelvic floor assessed and pass a pelvic floor stress test.

Pelvic Organ Prolapse - Women’s Health Physio

Pelvic Organ Prolapse

Did you know? 

One in two women who have had a baby will experience prolapse at some stage in their life, that’s why it is so important to have an understanding of what it is and the symptoms experienced with prolapse.

What is pelvic organ prolapse? 

Pelvic organ prolapse is when one or more of the pelvic organs (bladder, uterus and bowel) slip down into the vagina causing a bulge or a heavy dragging feeling. Prolapse happens due to damage of the support structures of the pelvic floor including muscles, fascia or ligaments.

What are the symptoms?

Symptoms of prolapse include:

• Sensation or heaviness/dragging/buldge in the vagina

• Incomplete emptying of your bladder/bowels

• Discomfort in the lower abdomen

• Recurrent urinary tract infections

• Sexual discomfort

• Incontinence

 

Prevention and management strategies

The good news is there is lots that can be done to prevent or manage prolapse. The pelvic floor acts as a sling supporting the pelvic organs, therefore pelvic floor strength training is one of the treatment options that can prevent or help alleviate symptoms of prolapse.