Men & Women’s Pelvic Floor
What is the pelvic floor?
The pelvic floor is a group of muscles, ligaments and connective tissues which line the pelvis and surround the openings to our bladder, bowel and in women, the vagina. They are like a sling or a hammock that attaches to our pubic bone at the front, and our coccyx (tailbone) at the back. The pelvic floor also forms part of “the core” – a flexible and dynamic cylinder inside our trunk, along with the diaphragm (breathing muscle), transverse abdominis (deepest tummy muscle) and multifidus (deep back muscle).
Both females AND males have a pelvic floor!
What does it do?
The pelvic floor has several functions which include
- Contracting to maintain storage of waste products from the bladder (urine) and bowel (stool/poo)
- Relaxing to allow evacuation of waste products
- Playing a role in sexual function for both men and women
- Providing a passage for the birth of a foetus
- Supporting abdominal and pelvic organs
- Assisting to control the pressure inside the abdomen
Symptoms of a pelvic floor problem
- Accidentally leaking urine when you laugh, cough, sneeze or exercise
- Sudden urge to empty your bladder or bowel and needing to rush to the toilet
- Not making it to the toilet in time
- Constantly needing to go to the toilet
- Difficulty emptying your bladder or bowel, or not feeling like you have fully emptied
- Accidently losing control of your bladder or bowel
- Women – this may a feeling of heaviness, dragging or discomfort in the vagina or lower back or felt as a bulge or a lump in the vagina
- Men – bulge in the rectum (back passage) or feeling like you need to empty your bowel when you don’t really need to go
- Pain in your pelvic area
- Pain with sex or difficulty using tampons
Who gets pelvic floor problems?
Anyone can suffer from pelvic floor problems; however, the following can increase the risk:
- Pregnancy and childbirth – especially with multiple births, forceps or vacuum, pushing for longer than 2 hours, tears or episiotomies, babies over 4kg
- Menopause – the hormonal changes of menopause can cause the pelvic floor muscles to become weaker and the vaginal tissues to become thinner and drier
- Being overweight or obese places excessive load and strain on the pelvic floor
- Gynaecological surgeries such as hysterectomy (removal of uterus), cancer surgeries or pelvic radiation
- Chronic constipation or straining to empty bladder or bowel
- Elite athletes and heavy lifters – high impact sports such as gymnastics or running, or people who lift heavy weights at gym or work
- Prostate enlargement (BPH) – blocks the passage of urine in men making it difficult to empty the bladder
- Post-prostate surgery – nerve damage during surgery can weaken the pelvic floor
What can I do about it?
PLENTY! Whilst pelvic floor problems are very common they are NEVER normal and no one should have to suffer in silence or “just put up with it”. Depending on the nature of your problem there are lots of different treatment options including lifestyle changes, strategies to control your urgency, modifications to your exercise regime, advice to maintain a healthy diet and body weight, learning how to properly empty your bowel and bladder without straining, medications and pelvic floor exercises.
There is overwhelming evidence that pelvic floor exercises are effective to help with certain pelvic floor problems, however, they are not always easy to do and getting the technique right is essential (there is almost no point in doing them if you aren’t doing them correctly!)
A Continence and Women’s Health Physiotherapist can teach you how to use these muscles correctly either by using an ultrasound or an internal examination. Training the pelvic floor takes time, patience and dedication!
Where to get help
If you are suffering from any pelvic floor problems there is plenty of places to get help. Continence and Women’s Health Physiotherapists have undergone additional university training and are qualified in the assessment and management of pelvic floor problems. They can help you to understand what is going on, why you have developed the problem and the best course of management for you.
Additionally, information is also available by visiting the Continence Foundation of Australia on www.continence.org.au or Pelvic Floor First www.pelvicfloorfirst.org.au or calling the National Continence Helpline on 1800 330 066.
Masters in Clinical Physiotherapy
Caris has a keen interest in pregnancy and Women’s Health issues. She is currently completing her Masters in Men’s & Women’s Health and Pelvic Health. Having danced herself for over 20 years, Caris has a particular interest in treating dancers and dance-related injuries. She has also worked for many years with Aussie Rules teams at both amateur and semi-professional levels.
With her dancing years behind her, she has transferred her love of movement to Clinical Pilates and runs both Studio and Mat classes at the clinic. When she’s not in the studio, she loves to travel and spend time with her loved ones and her two gorgeous Staffys.