What Is the Pelvic Floor:
The pelvic floor is a layer of muscles shaped like a dome that sits at the bottom of your pelvis, separating the area above (pelvic organs) from the area below. It surrounds important organs like the bladder, intestines, and, in females, the uterus/prostate.
The Main Jobs of The Pelvic Floor Muscles Are:
- To support the organs in your abdomen and pelvis
- To help you control when you urinate and have bowel movements
- To enable activities like going to the bathroom, sexual activity, and childbirth
How Does the Pelvic Floor Work?
The muscles contract to lift the pelvic organs (bowel, bladder, uterus) and tighten the opening to those organs (vagina, anus, urethra). When the muscles relax, they allow for the openings to the pelvic organs to open so that you can urinate, defecate, and have sex, for example.
What Is a Weak Pelvic Floor?
A weak pelvic floor means that the pelvic floor is not functioning sufficiently to cope with the demands that are placed on it.
Risk Factors for Developing Pelvic Floor Dysfunction:
- Pregnancy or those that are new mothers due to physical and hormonal changes
- Post menopausal due to hormonal changes
- Injury to the levator ani muscle from childbirth or other trauma
- Family history of pelvic organ prolapse
- Hysterectomy as the procedure can damage the pelvic floor muscles
- Prostate surgery due to altered nerve function
- Chronic coughing due to repetitive strain on the pelvic floor
- Low socioeconomic status due to less availability of information and health services
- Overweight due to increased pressure on the pelvic organs
- Constipation as this can cause nerve damage
- Lifting heavy objects due to increased pressure on the pelvic organs
- Elite athletes that engage in high-intensity sports, e.g., gymnastics, weightlifting, running
- Chronic low back or pelvic pain as you can alter how you use the pelvic floor when in pain, i.e., likely to not engage the muscles as it hurts to
What Can Happen if The Pelvic Floor Is Weak?
- Loss of bowel/bladder control
- Sexual difficulties due to reduced sensation and function (in males)
- Pelvic organ prolapse
What to Do if You Think Your Pelvic Floor Is Weak?
First and foremost, it is best to see a physiotherapist to get assessed and individualised treatment.
Things you can start considering are ensuring you drink an adequate amount of water (minimum 2 litres), limit caffeine intake (coffee, tea, chocolate, energy drinks), and limit alcohol intake. It can be helpful to make a fluid diary to track how much fluid you ingest and what types of fluid you’re having; often, people think they are drinking more water than they actually are, so this helps with accuracy.
You can do the same with your bowel and bladder movements; this may show a pattern, and you can track how your bowel and bladder react to increasing your water intake and reducing caffeine/alcohol.
If you struggle with a sudden urge to pass urine, it can be helpful to distract yourself to train your bladder to hold more volume; you can meditate, listen to music/podcasts, read, paint, or any other low-stimulus activity.
Avoid getting constipated by ensuring you stay hydrated, eat a balanced diet high in fibre, exercise often, and empty your bowels when you need to (i.e., don’t try to hold on for too long just because you may not be in a convenient/comfortable place).