Do you need help with pelvic floor dysfunction? Yes? Great! No? Still great, take a read!
Pelvic Floor (PF) Physiotherapy is a type of rehab meant to target the muscles of the pelvic floor, along with the tissue, joints, muscles, and bones that make up and surround the pelvis. Our pelvic floor is comprised of several muscles (aided by ligaments and fascia) which have function in:
-Supporting our organs against gravity (bladder, uterus, rectum, intestines etc..). As well as intra-abdominal pressure created during daily activities (lifting, jumping, laughing, sneezing etc..)
-Controlling openings that allow the passing of urine and stool
-Sexual function; orgasm, blood flow to the pelvis, providing tone to the vaginal and rectal canals
-Stability of front and back pelvic joints: helps to unload the spine
-Contraction of the PF muscles that act as a sump pump to help our venous and lymphatic system evacuate fluids and avoid pelvic congestion
Not everyone needs to see a pelvic health physiotherapist but everyone could use some reminders on how to keep their pelvic floors healthy! Pelvic dysfunction can be a sensitive topic; people are embarrassed to talk about their issues or don't know that they can get help for them! Hopefully in reading this you can find a few new ways to take care of your pelvic floor, OR realize that there is someone out there who can help you do this.
The following are 10 habits or tips that we can all practice in pursuit of pelvic health!
Tip #1 - Listen to your body
When it tells you to go, GO! Ignoring the signals our body sends us can desensitize our rectum and bladder to the sensation of stretch, this can lead to irregularities in our bowel and bladder function. Occasionally, due to environmental circumstances we must hold it, and some people with overactive bladders will practice urge delay- but don’t make a habit of it!
Tip #2 - No pushing or straining
Sometimes we just want to get in, and get out! Maybe we don’t feel like we have fully emptied, or you don’t feel like you can go without pushing… Pushing (bearing down) creates intra-abdominal pressure which puts stress on our pelvic floor. Chronic straining can increase risk of future incontinence or prolapse. Our pelvic floor also needs to relax to allow for stool and urine to pass so when we strain there is often reflexive contraction of the pelvic floor which makes it more difficult to pass waste.
"You are doing a good job, keep it up" – Jade Fisher
Tip #3 - Manage stress
Long term stress can result in increased tone in our PF muscles. A tight muscle is a weak muscle! If our PF is tight and weak, then it’s probably not able to keep up with the demands we place on it. This can lead to symptoms such as incontinence, prolapse, and pain! If we already have pelvic floor dysfunction or pain, long term stress can lead to sensitization of our central nervous system wherein we have a lower threshold for our perception of stimuli as painful.
Tip #4 - Nutrition and hydration
The amount and different types of water and food we consume play a big role in the functioning of our digestive system. Getting 8-10 cups of fluid per day, approximately 25-35g of fiber/day, and adequate amount of healthy fats will help optimize the consistency of our stool for passing. If our stool is too hard or too soft it can cause irregularities in the movement of our bowels which can have an effect on our pelvic floor. Symptoms of constipation or diarrhea can be exacerbated or even caused by PF dysfunction, as well as the reverse.
Tip #5 - Optimize the biomechanics of bowel evacuation
Squatty Potty! Our stool must pass through the ano-rectal angle to be evacuated. This angle is less kinked when our knees are spread apart and resting higher than our hips, which makes it easier for stool to pass!
Tip #6 - Evaluate your bladder activity
The average person voids (urinates) between 5-8 times/day, or every 2-3 hours. If your numbers are extreme on either side of these values and it interferes with your life, you might want to see your Doctor or a Pelvic Health Physiotherapist
Tip #7 - Have you heard of a reverse Kegel?
A Kegel is a pelvic floor contraction, and while it can be a very important exercise for some, not everyone needs to strengthen their pelvic floor! A lot of people need to work on fully relaxing their pelvic floor, which is what we call a reverse Kegel. You can practice this by taking a deep breath in and imagining all of that air expanding down into your pelvis and in between your sit bones, trying to relax the pelvic floor muscles as you do so. This can be hard to do; you can also imagine butter melting or a flower opening, or that you are allowing the release of urine or gas.
Tip #8 - Pelvic pain is NOT normal
If you have pain during sex, bowel or bladder function, activity, or without any provocation, you might want to see your doctor or a Pelvic Health Physiotherapist.
Tip #9 - If you think you have a UTI, ask your Doctor to do a urine culture and wait for the results BEFORE prescribing you antibiotics
A recent study by Clarke et al. 2021, showed nearly half of women treated for a UTI are prescribed the wrong antibiotics.¹ Unnecessary exposure to antibiotics can contribute to antimicrobial resistance, susceptibility of the patient to yeast infections, AND delay finding the actual source of a patient’s symptoms!
Tip #10 - Give your pelvic floor a break!
If you have had a long day on your feet or a day of high activity, stress, or sport, take some time to take the pressure off our pelvic floor. The following are three nice wall stretches that allow the lengthening and relaxation of our pelvic floor and surrounding muscles. Pair with deep breathing to add to the relaxation, stay in each position for 5 breaths.
Keep your butt on the wall for the first 2 stretches. Have your butt off the wall for the 3rd, knees at 90 degrees with feet flat on the wall but pointed outwards
Have questions?
If any of these tips made you think that you might need pelvic help, talk to your Doctor or give us a call at Shift (587) 442-3111 to see if you could benefit from PF Physiotherapy!
1-Clark, A., Durkin, M., Olsen, M., Keller, M., Ma, Y., O’Neil, C., & Butler, A. (2021). Rural–urban differences in antibiotic prescribing for uncomplicated urinary tract infection. Infection Control & Hospital Epidemiology, 42(12), 1437-1444. doi:10.1017/ice.2021.21
2-Pelvic Health Solutions. “Level 1: Female & Male Urinary Incontinence.” Lecture, Zoom, December, 2021.
3-Toilet squatting - a rear story. Toilet Found! https://toiletfound.com/toilet-squatting-rear-story/. Published April 28, 2020. Accessed February 6, 2022.
4-Uptight and tightly wound: The anatomic origins of Pelvic Pain. Doxwell. https://bodyconnecthw.com/uptight-and-tightly-wound-the-anatomic-origins-of-pelvic-pain/. Accessed February 6, 2022.