Hi.

Welcome. I answer questions you might be too embarrassed to ask. Here's to pelvic health!

Your pelvic floor

Your pelvic floor

The pelvic floor muscles

Why should you give your pelvic floor a bit of love?

Because YOU ALL have one (even you blokes out there) and because pelvic floor dysfunction can cause:

  • Leakage of wee or poo
  • Painful sex or the inability to have sex
  • Constipation
  • Lower back, hip or pelvic pain
  • Prolapse (when the pelvic organs fall into the vaginal canal)
  • Running to the toilet all the time with urgency
  • Erectile dysfunction

And $47 BILLION DOLLARS a year are spent in Australia due to incontinence!!

How likely is this to happen to you?

Pretty likely, as it turns out:

  • One in three women who have had a baby wet themselves
  • One in 10 people have fecal incontinence (they leak poo)
  • One in two women over 50 have vaginal prolapse

That’s a hell of a lot of people. But hardly anyone talks about it!

So what is your pelvic floor?

The pelvic floor is the part of the body that sits at the bottom of the pelvis (the circular ring of bone, on which you rest your hands when you're grumpy). It includes a number of muscles, ligaments and connective tissue that span from the pubic bone at the front, to the tailbone at your back and connect to your sit bones on either side – basically, it is your saddle or gusset area. Your bladder, uterus (not if you’re a male, obvs) and bowels rest on this hammock of muscle, and 3 passages (or two, for you males) run through these muscles from their corresponding organ: urine tube, vagina and anus.

 The female pelvic floor  Image courtesy of the Continence Foundation of Australia

The female pelvic floor

Image courtesy of the Continence Foundation of Australia

 The male pelvic floor. 

The male pelvic floor. 

 

And what do they do?

It’s a rather important group of muscles. They should work in unison with the diaphragm (breathing muscle) and abdominal wall to: 

  • Stop your guts from falling to the floor (most specifically your bladder, bowel and uterus)
  • Provide stability to the lower spine and pelvic joints, much like the foundations of your house
  • Stop leaking from your bladder or bowels
  • Control the excretion of urine, feces and babies
  • Give you sexual function

So how do you contract your pelvic floor?

Now this is the tricky bit, as about 30% of women, when asked to contract their pelvic floor as if they are stopping the flow of urine, do it incorrectly. They may actually contract other muscles in the body, or ‘bear down’ on their pelvic floor instead.

Your pelvic floor muscles, when contracted, squeeze inwards toward your mid-line, upwards towards your head, and forwards towards your pubic bone, causing a ‘squeeze and lift’ sensation inside your pelvis. A hilarious pelvic floor cueing brainstorm session with colleagues ended up with these (rather abstract) cues to contract your pelvic floor:

  • Imagine you’re standing in an elevator on the morning after taco night, and you feel a nasty fart brewing, and you need to squeeze strongly around your bum hole without anyone else in the elevator knowing what you are doing
  • Imagine you are sitting on a silk scarf, and you want to lift that scarf up into your vagina (Why it has to be a silk scarf, and not a cheaper polyester one, I’m not sure)
  • Try to suck a green pea, through a straw in your pee-hole 
  • Try to suck a piece a spaghetti up into your vagina
  • Men: try to shorten your penis, or lift your junk up like you’re walking into a cold sea, or suck your scrotum right up to the inside of your belly button

And you need to do all these things, but nobody else should know that you are doing it (ie no lip pursing, eyebrow wiggling, buttock squeezing or breath-holding). Do it now. Wherever you are. Go on, I dare you.

Oh and a pelvic floor contraction should occur simultaneously with a deep abdominal contraction (welcome to your true 'core'!), which is a gentle drawing inward of your lower tummy. Also, the pelvic floor works in a piston like motion with your diaphragm, so gently contracts when you exhale. When you inhale, the pelvic floor should drop and let go, and the abdominals should bulge and relax. Got it?

Try this:

-Sit up nice and tall in your chair, with your weight even through each sit bone (the bony bits in your butt cheeks), and shoulders relaxed.

-Take a breath in to your lower ribs, keeping your shoulders down. Feel the tummy gently bulge, and your pelvic floor/perineum melt down towards the chair.

-Exhale; feel your lower tummy draw inwards and squeeze and lift your perineum off the chair.

- Repeat 10x

- Now look around you and see if anyone is looking at you strangely. If so, you were more than likely squeezing your butt cheeks and bouncing up and down (incorrect technique), wiggling your eyebrows up and down (incorrect technique), taking big, erratic breaths (incorrect technique), or look like your taking a poo (incorrect technique).

If you can’t do it, or if you ever wet your pants, poo your pants, grit your teeth through the pain of sex, have a bulging/heavy sensation in the vagina, or pain in the tailbone/saddle area/pelvic area, then take you and your bits to a pelvic floor physio and your GP. 

- the vagina physio

Image credit: www.pintrest.com

7 question quiz: What does a vagina physio do?

7 question quiz: What does a vagina physio do?