The Pelvic Floor Muscles – The most important muscles a woman has ...

 The muscles responsible for a woman's most intimate body functions are hidden away so deeply that they are often totally neglected. 

Prior to pregnancy and childbirth we take our pelvic floor muscles for granted and usually they work as they should. 

They form a hammock or sling between the tail bone and the pubic bone and have two main functions: support of the pelvic contents (bladder, bowel and uterus) and control of the three openings. 

These muscles are responsible for control of our most intimate body functions and if they are subjected to factors such as undue stress or stretch, the quality of their function is reduced. 

The most common symptom of weak pelvic floor muscles is Urinary Stress Incontinence  (wetting when you cough, sneeze, laugh, run or jump). Others include decreased control of wind from the anal sphincter and bowel emptying problems, urogenital prolapse, difficulty wearing tampons effectively, discomfort during intercourse and decreased sexual sensation. 

Childbirth is not the only factor which puts these muscles to the test, but it is a major one – especially following a quick or very long delivery, birth of one or more large babies, traumatic, difficult or instrumental deliveries. 

Other factors that can weaken or further stress these muscles include heavy lifting (including toddlers), carrying excessive weight, inappropriate or high impact exercise, constipation, chronic respiratory problems, hormonal status and ageing. 

Often a secondary problem of urinary frequency, often with urgency and nocturia develops following urinary stress incontinence. To avoid an embarrassing accident, women tend to go ‘just in case’ and before long their bladder is the boss, leading to toilet hopping by day and interrupted sleep at night. 

Unfortunately the pelvic floor muscles are well hidden and despite attempts to tighten ‘down there somewhere’ often there is little progress. Pelvic floor muscles need to be worked correctly and regularly and once acceptable strength and control is achieved, this needs to be kept by following an ongoing maintenance plan. 

To identify the pelvic floor muscles, squeeze all three openings shut, draw all together centrally and lift up inside, initially holding for two seconds, and then releasing slowly. No external movement of buttocks, abdominals or inner thighs should accompany this contraction. Repeat this contraction ten times per session and repeat these sessions ten times per day. 

In practice it is often difficult to be sure of correct technique and appropriate programme setting and progression on your own. There are also issues of bladder retraining, correct bowel evacuation technique and adjustments to daily lifestyle which may require professional input. 

For too long women have accepted these problems as an inevitable consequence of childbirth. They have not known who to talk to, or where to go for help. These symptoms have lead to limited physical participation, decreased confidence and self esteem, and reduced enjoyment in sexual liaisons. Inadequate strength, control and function of a woman's pelvic floor leads to a compromise in the quality of her life. 

BRENDA HOLLOWAY  - Women's Physiotherapist 

Brenda has been exclusively addressing problems relating to women's pelvic floor dysfunction since 1991.