Deep inside you is the foundation of your physical being – your pelvic floor. These muscles allow you bladder control, good posture and a flat tummy, and can be the fountain of your sexual joy. A lot rests on the function of these muscles. A third of women over the age of 35 will be dogged by incontinence because their pelvic floor has lost its bounce. Many more will feel aches and pains.
Where is the pelvic floor?
The pelvic floor is the sling of muscles spanning the bowl of your pelvis; it’s attached to your tailbone at the back, and to your pubic bone at the front. In women, the pelvic floor muscles support the bladder, uterus and bowel, as well as work in concert with other core muscles to stabilise your spine. Add your diaphragm to these central moving parts and you’re controlling breathing, too.
What is it exactly?
‘Pelvic floor’, isn’t a very exciting name. Calling it ‘the wellspring of youth’ would be more attention-grabbing. Another reason for our lack of awareness about our pelvic floor is that most of us don’t realise it’s deteriorating. In many cases, it lets go over time as we spend increasing hours sitting, then slumping, at our desks and on sofas. By the time your neck is chronically aching, you wouldn’t think to connect the pain with the fact that your pelvic floor muscles have gone floppy.
In other people – often women who have just had a baby, or baby number two – their pelvic floor loses it, right at the time when life is asking most of them: lifting a toddler, toting a baby, carrying shopping, hoisting strollers in and out of the car. In this situation, light bladder leakage may just seem like part of everything you have to cope with.
When your pelvic floor is working well, you take it for granted that you feel good. Your tummy stays flat without effort, your bowels function properly, and you’re rarely caught short when you need to pee. You can work at a desk without experiencing peripheral aches and pains, carry weighty shopping and lift children with ease. And everything runs smoothly in the bedroom.
How can it all go wrong?
A wide range of factors can take their toll on your pelvic floor. For example, women train themselves to go to the toilet when they don’t need to. As girls, they are often encouraged to pee before leaving the house, cafe or changing rooms. By doing this, they train their bladder not to hold on and so come to experience the urge to urinate when their bladder is only half full, or less. And as this part of the pelvic floor is rarely asked to wait until the bladder is full, eventually it can’t.
School of bad habits
Consistent poor posture in children, along with a more sedentary lifestyle, also allow the pelvic floor to be idle. As a significant part of the pelvic floor’s role is postural, it switches on when you’re upright or moving. The less you switch it on, the more out of condition it gets. And, for many of us, these habits become more entrenched as we become older.
Add situations such as moving house (lifting too-heavy items), renovating and childbirth to an inactive lifestyle and your pelvic floor can become even more disabled. In certain people, the pelvic floor becomes hyperactive, which can lead to spasm (resulting in painful sex, constipation, a sore tailbone when sitting and other problems). Menopause, with its lowered levels of oestrogen, a hormone important for building muscle tone, also results in slackening of the pelvic muscles.
Where can I get help?
The good news is, there are lots of ways to improve the health of your pelvic floor muscles, starting with the simple toning exercises (above). Pilates, too, is an excellent way to tone up those muscles – check the web for classes in your area.
How to work your pelvic floor muscles...
1. Relax the muscles of your thighs, bottom and tummy.
2. Lift and tighten the muscles around your front passage (urethra) as if trying to stop the flow of urine.
3. Lift and tighten the muscles around the vagina so they move upwards inside the pelvis.
4. Lift and squeeze the muscles around your back passage as if trying to prevent yourself from passing wind.
5. Identify the muscles that contract when you do all these things together. Then relax and loosen them.
6. Put all the exercises together so the muscles around the front and back passages lift and you can feel them squeeze up inside your pelvis.