By Gaynor, Physiotherapist in Gloucestershire
Recently I met a woman who told me she used to be a runner. When I asked: Why don’t you still run? The answer: “Because 60 hours of labour with my first child and a forceps delivery ruined my desire to run anymore.”
To sum up for those who still may not relate to the problem: She pees her pants when she picks up the pace.
Ladies often joke about cough pee, sneeze pee, jumping jack pee, trampoline pee, and other bladder challenges. But full-blown incontinence is no laughing matter. I’m a firm believer that a strong pelvic floor is the answer to incontinence. A strong pelvic floor not only makes the difference between wet and dry running shorts, but can also keep high intensity exercises, such as running, pain free by reducing pregnancy related pain, such as hip and lower back pain.
Many women assume it’s childbirth that causes incontinence, but In fact pregnancy itself may put strain on the bladder, thus highlighting that a c-section won’t necessarily save you.
So firstly, what are your pelvic floor muscles?
The PF muscles run between the sacrum (the triangular bone at the base of the spine) and the pubic bone (the bottom-front of the pelvis). Ideally you want the PF to be long, supple, and taut, to generate long-term forces that hold up your organs, as well as have enough motor skill to open and close your bathroom muscles as needed. When the PF is too tight, it can pull the sacrum out of alignment, bringing it forward, into the bowl of the pelvis (which tends to happen during pregnancy and child birth). Which means bye-bye strong PF muscles, Hello Pelvic Floor Hammock. And the last time I checked hammocks are for vacation and have not promoted the notion of long-term force generation for some time. I cannot stress enough the importance of keeping your pelvic floor muscles strong and healthy.
First things first…Finding your Pelvic floor!
Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
Squeeze the ring of muscle around the back passage as if you are trying to stop yourself from farting in front of your hunky crush. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Try not to squeeze your buttocks.
When sitting on the toilet to have a wee, try to stop the stream of urine, then start it again. Do this to learn which muscles are the right ones to use – but only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.
If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right.
Now that we’ve located our pelvic floor muscles… lets get squeezing!
1) Squeeze and draw in the muscles around your back passage and your vagina at the same time. Lift them UP inside. You should have a sense of “lift” each time you squeeze your pelvic floor muscles. Try to hold them strong and tight as you count to 10. Now, let them go and relax. You should have a distinct feeling of “letting go”.
Repeat “squeeze and lift” and let go. It is best to rest for about 4 seconds in between each lift up of the muscles. If you can’t hold for 10, just hold for as long as you can. Your endurance will improve over time and with practice holding for 10 seconds will get easier.
Repeat this “squeeze and lift” as many times as you can, up to a limit of 8 to 12 squeezes.
Try to do three sets of 8 to 12 squeezes each, with a rest in between.
2) Your pelvic floor muscles also need to react quickly to sudden stresses from coughing, laughing or exercise that puts pressure on the bladder. So practise some quick contractions, drawing in the pelvic floor and holding it for just one second before relaxing. Try to achieve a strong muscle tightening with up to ten quick contractions in succession.
Aim to do a set of slow contractions (exercise 1) followed by a set of quick contractions (exercise 2) 3-4 times each day. It takes time for exercise to make muscles stronger. You are unlikely to notice any improvement for several weeks – so stick at it! You will need to exercise regularly for at least 3 months before the muscles gain their full strength.
These pelvic floor exercises can be done while lying down, sitting or standing.
Top Tip: Remembering to do your pelvic floor exercises is harder than doing the actual exercises. The best thing to do is to get into a habit of doing your exercises and to incorporate them into your activities of daily living, for example, squeeze when you’re doing the dishes, squeeze when you’re changing your babies nappy, squeeze when the adverts are on the tele, squeeze when you’re brushing your teeth. These are activities that you engage in daily, so doing your squeezes whilst doing these activities will ensure you are doing your exercises regularly and daily. Remember: you can exercise your pelvic floor muscles wherever you are – nobody will know what you are doing!
So just some final words from me… EASY PEEZY DON’T FORGET TO SQUEEZY!!