Pelvic Floor Muscle Dysfunction

The pelvic floor (PF) muscles exist in both men and women. The role of the PF is to keep your organs such as bowel and bladder in position especially on movements that cause an increase in intra-abdominal pressure like lifting, sneezing and carrying. The pelvic floor needs to be effective when passing urine or a bowel movement and in maintaining an erection or vaginal sensations.

Other functions of the PF are:

• Keeping the bladder and bowel closed to stop ‘leaking’.

• Bladder and bowel emptying.

• Sexual function – maintaining an erection, preventing premature ejaculation in men and improving sensation and ‘grip’ in women.

The pelvic floor muscles are also important in supporting postural and spine health and stability.

• Urinary dysfunction

• Pelvic organ prolapse

• Sexual dysfunction

• Pain in the lower back, vagina or abdomen

• Pregnancy and childbirth – hormonal ligament laxity, vaginal delivery, episiotomy/tears.

• Obesity and being over-weight – extra downward pressure of the pelvic organs.

• Repetitive heavy lifting – this increases the intra-abdominal pressure on the pelvic organs.

• Strong family history – inherited weaker collagen type.

• Age – age-related changes to muscle tissue composition.

• Menopause – hormonal changes can make symptoms worse.

• Chronic constipation – straining can increase intra-abdominal pressure.

• Chronic cough – as above.

• Previous pelvic surgery – POP repair, hysterectomy, prostate surgery in men.

1/3 of women experience issues with their PF during their lifetime. The pelvic floor is essential in keeping the pelvic organs in the correct place inside the body. Pelvic organs include the bladder, uterus and bowel.

As you can see with the number of symptoms, contributing factors pelvic floor dysfunction need to consider other differential diagnoses. Pelvic Floor Dysfunction considerably impacts quality of life through reducing physical activity levels, pain and the possible impact on mental health. At Pure Physiotherapy, our skilled clinicians will be able to help determine the factors contributing to your symptoms, pain and discomfort and work with you to develop a personalised and progressive management and exercise plan.

Improving pelvic floor strength is a fantastic way to make steps towards improving your symptoms and your Physiotherapist can teach you how this can be done. Your Physio will also provide you with information on PF dysfunction so you can best manage your symptoms and the issue.

Try these steps to help you engage your PF muscles:

1- Get comfortable either sitting or standing.

2- Imagine that you are trying to stop yourself from passing wind and urine at the same time. Draw the pelvic floor muscle upwards and forwards away from the bowel – as if your reaching them to the tip of your chin.

3- Try not to hold your breath or squeeze your buttocks or legs together.

4- Now fully relax your pelvic floor and tummy muscles before having another go.

To improve your pelvic floor strength, try the above steps with 10 long squeezes (aim to hold for 10 seconds each) followed by 10 short squeezes. Make sure that you completely relax your pelvic floor and tummy muscles between each squeeze. Your Physiotherapist can progress your exercises so you can engage your PF muscles more effectively, helping to address the issues you experience.

Always go to your GP if you are concerned about urinary/bowel incontinence or if you get pain on trying these exercises.

Click here to read about Anna’s story of how she managed with incontinence for more than a year after giving birth to her first child.