When it comes to groups of muscles, the pelvic floor is an unsung hero. Perhaps it is because close to this region of the body, the rectus abdomens, or ‘abs’, take the spotlight. This is clearly evident when looking at men’s health magazines, as strong abdominal muscles are de rigueur for those wishing to look seriously fit. Yet hidden in the base of the body’s trunk is a group of muscles, that although not on show, provide us with a better quality of life.
Perhaps it is the name ‘Pelvic floor’ is simply not appealing, compared to more casually rugged terms like ‘pecs’ and ‘quads’. Regardless, it is the quiet achiever of the muscle groups, providing support and strength without the fanfare. Surprisingly for most of the population, they are only really paid attention once they are weakened, and then the role they play is truly realised.
Where is the pelvic floor?
The pelvic floor, as described sits at the bottom of our torso, spanning the area underneath the pelvis. If you were to sit cross legged on a hard surface and mark the points where the left and right points of your hip bones make contact, and then place a mark directly below where the pubic bone at the front and the tail bone at the back are, these four points would make a diamond. The area within these four points is connected by a muscular and elastic layer across the bottom of the pelvis, that are somewhat like a hammock supporting our lower internal organs.
What role do these muscles play?
A strong pelvic floor helps to support the bladder and bowel in men, and the bladder, bowel and uterus in women and when tightened it normally lifts these organs and closes their openings. These muscles play an important role in bladder and bowel control and sexual function. They also help control pressure inside the abdomen to deal with downward forces when you lift or strain, for example during exercise.
When weakened this can lead to incontinence and disfunction of the bladder and bowel, through to pain and discomfort in the pelvic area and lower spine. It can also lead to prolapse, that being a stretching of the ligaments that support the pelvic organs, which consequently results in the pelvic organs stretching and dropping down out of their usual position. As an extension of this, these conditions can create a private misery, social isolation and a reduced quality of life.
What a strong pelvic floor can offer?
Strengthening your pelvic floor muscles can help reduce urinary leakage, improve bowel function and prevent prolapse. In the process a strong pelvic floor can improve core stability to aid balance, posture and support to the lower back.
As a natural part of ageing, and the hormonal changes that occur, the pelvic floor can be weakened in both women and men. Exercises can be incorporated to strengthen the pelvic floor. Firstly though some lifestyle factors should be considered, such as avoiding regular heavy lifting, maintaining a healthy weight, resolving constipation or chronic coughing – if these are causing repetitive straining of the abdominal area.
In women pregnancy and vaginal delivery can cause or worsen pelvic floor muscle dysfunction. Damage to the pelvic floor may be prevented by the practicing of pelvic floor muscle exercises during pregnancy. As a pregnancy progresses it can support the downward pressure of a growing baby, during birth it can reduce the chance of injury and following the birth can assist in a faster recovery. Throughout the pre and post natal stages it can also offer much needed stability and strength to the body, as it is a member of the muscle groups that create core stability.
Finding and exercising the pelvic floor muscles
There are some simple methods with which to feel the pelvic floor muscles working. Firstly sit on a firm chair and pay attention to the four points of the diamond described earlier, or more simply the part of you in contact with the seat. Then to do a pelvic floor contraction, squeeze your back passage whilst breathing normally and keeping your buttocks, legs, and everything above your belly button, relaxed. If you are doing this correctly then you should feel your back passage lift up and away from the seat. The feeling of this lift and squeeze inside the pelvis is the pelvic floor muscles working.
If you are unable to do this then it could be that the pelvic floor muscles are too weak. There are other exercises, such as stopping the flow of urine midway through emptying the bladder, but it may be wise to consult your physiotherapist or doctor for more information, as pelvic floor exercises are most effective when individually tailored and monitored.
Exercising the pelvic floor muscles
Once you have a technique that suits, where you can confidently contract the pelvic floor muscles, it is important to find your base level of strength, and improve upon it. To find this level, try to hold a contraction for as along as possible and take note of how many seconds it is held. Repeat this four or five times, with a five second break in-between each held contraction – taking note once again how may you are able to complete and their duration. You will not be able to feel the last contraction as the muscles will be too weak, yet at this point you will know your limit and subsequently the base level of your pelvic floor strength.
Having this base level of strength accurately recorded, will enable you to establish a goal of increasing the number of contractions and their holding time. By exercising six times a day (assuming you have not recently had surgery or an injury related to that area) and keeping a diary of your limits, you will be able to track your progress, with an increase in limits visible within the first week.
Seeking further help to strengthen the pelvic floor
Should it be that after a couple of weeks there is no improvement, then simply check with your physiotherapist as you may find that your technique needs adjusting. If you are still having problems then your doctor may recommend a referral to a specialist.
Like other muscle groups in the body the pelvic floor can take up to three months to reach maximum strength. Ultimately if you are able to achieve 10 to 15 repeat contractions and a holding of 10 seconds for each contraction, six times a day, you can say that you have reached an adequate level of pelvic floor strength.
Even though no one will be able see the improvements, rest assured that real strength lies within.