Kids on the coast

by Dr Fiona McGrath

The pelvic floor is a layered sheet of muscles, stretching like a sling or hammock from your pubic bone (at the front of your pelvis) to your tailbone (at the back). Both men and women have a pelvic floor, which functions mainly to help you control the passing of urine and opening of your bowels, as well as supporting the internal organs. When you’re pregnant, your pelvic floor helps support the weight of the growing uterus and baby.

Looking after your pelvic floor

An estimated 40% of women (and many men, especially those who’ve had prostate surgery) live with bladder control problems — urinary incontinence — due to weak or poorly coordinated pelvic floor muscles. A weak pelvic floor can also lead to sexual dysfunction, such as reduced sensations for women, and erectile problems for men.

Ageing, being overweight, and the abdominal pressures associated with pregnancy or chronic constipation can all weaken the pelvic floor. So can poor posture, lifting overly heavy objects, frequent coughing (combined with incorrect pelvic floor action), and straining on the toilet.

The good news is that, like any other muscle group, pelvic floor muscles can be strengthened by proper use and regular exercise.

Developing stronger pelvic floor muscles can help to reduce stress incontinence, (small amounts of urine leaking out during activity or coughing or laughing). Both men and women can benefit from daily pelvic floor exercises. Other ways to keep your pelvic floor strong include adopting good posture, breathing deeply and allowing the lower ribs to expand, and learning to lift properly.

Pregnant or planning a pregnancy?

Now’s a good time to start doing pelvic floor exercises. Keep them up after your baby’s born, and you’ll increase your chances of avoiding incontinence later on.

How to do pelvic floor exercises

You can feel your pelvic floor muscles if you try to stop the flow of urine when you go to the toilet. To strengthen your pelvic floor muscles, sit comfortably and squeeze the muscles 10-15 times in a row. Avoid holding your breath or tightening your stomach, buttock, or thigh muscles at the same time.

When you get used to doing pelvic floor exercises, you can try holding each squeeze for a few seconds (this helps the exercises be more effective). Every week, you can add more squeezes, but be careful not to overdo it, and always have a rest in between sets of squeezes.

After a few months, you should start to notice the results (less incontinence, improved sexual function). Keep doing the exercises, even when you notice them starting to work.

If you don’t notice any improvement, see your GP and ask about a referral to a physiotherapist with special training in this area. Don’t give up; a little guidance may be all you need. It can be a bit tricky to get these exercises quite right and a specialist physio can assess you individually so you get the maximum benefit.

I can also recommend the book Hold it Sister by Mary O’Dwyer, an experienced Sunshine Coast physiotherapist.