Pelvic floor… What you CAN do to improve it
Pelvic floor is not something we think about every day… and yet plays a vital role in the prevention and management of issues around incontinence and pelvic floor weakness… Tory Toogood a Pelvic Rehabilitation Consultant / Physiotherapist, shares more about what we can each do to be better…
We met Tory just before she began her presentation with Fitness Professionals around the topic of providing better support during exercise for the pelvic floor… We began chatting and found out so much more… Tory was an Australian representative rower, spending 6 years at the peak of her sport and representing the country at the 1996 Olympic Games.
Fifteen years after finishing her rowing career, years filled with study, work, and family, Tory felt the need to set some fitness goals again. She was touched by the story of Jodi Lee and her battle with bowel cancer, and felt that the messages that the Jodi Lee Foundation is sharing with the community were worth supporting. She decided to start running, with the aim of competing in the New York Marathon within a year. That amazing event in 2011 created a bigger project for Tory – a project to run a marathon on each of the 7 continents and raise money for the Jodi Lee Foundation. She has only 1 marathon left now, in South America, having run marathons in Tanzania, China, The Netherlands and even Antarctica!”
Thank you Tory for sharing what you do and the valuable video that shows how we can strengthen our pelvic floor at home…
|Your Name||Tory Toogood|
|City of Residence||Adelaide, South Australia|
|Occupation or Experience||Women’s Health Physiotherapist|
|Web Links||www.vitalcore.com.au torytooogod.com.au|
|Your Passions/Interests||Wellbeing, health and fitness – and how we can use knowledge to empower ourselves|
What is the Pelvic Floor and what is its role in the body?
The ‘pelvic floor’ is the muscular base of the abdomen – a layer of muscles that support the pelvic organs. These muscles attach to the bony pelvis – they reach from your coccyx (the tip of your tail bone) to your sitting bones at the sides and to the back of the pubic bone, at the front, like a muscular trampoline. Strong pelvic floor muscles give us control over the bladder and bowel, together with the sphincters. They provide support to the organs that lie on it. When the pelvic floor muscles are contracted, the internal organs are lifted and the sphincters tighten the openings of the vagina, anus and urethra. The pelvic floor muscles also have a role in sexual arousal and in core stability. Relaxing the pelvic floor allows passage of urine and faeces.
What types of things put stress on the pelvic floor and what is the impact of this on the body?
Common causes of a weakened pelvic floor include pregnancy and childbirth, obesity, the straining of chronic constipation, and the strain of a chronic cough. Unfortunately, high impact and/or high load exercise can also cause damage to these structures. This will include repetitive heavy lifting, for work or leisure, and even a previous back injury can have an impact on pelvic floor function. Weakness of the pelvic floor muscles can mean the pelvic organs (bladder, bowel and in women, the uterus) are not well supported (which could lead to prolapse) and you may have trouble controlling the release of urine, faeces (poo) or flatus (wind).
What can people personally do to improve pelvic floor strength and continence in general?
The first thing is to seek treatment for any constipation or chronic coughing! Never strain on the toilet, ever. You should be able to feel a squeeze and lift of your pelvic floor muscles when you do it voluntarily – this is the same action as stopping yourself from doing a wee. It is not a squeeze of your buttocks, or of your tummy. You should be able to keep breathing normally, and your shoulders should be relaxed. You could sometimes – no more than once a day – try to stop the flow of urine when you are voiding to check that you are using the correct muscles. Once you have stopped the flow, relax and finish your void like usual, then practice squeezing and lifting again now that you have found the right muscular action! You don’t need to practice it on the toilet anymore. Try to progress to holding the squeeze for up to 10 seconds, repeat 10 times with a 10 second rest in between each squeeze. Also perform a series of short quick ‘pulses’, but also remember to relax fully after the series.
For those undergoing surgery or treatments that affect continence… when is the best time to seek professional help?
The best time to seek professional help for continence is as soon as you are aware you have an issue! You should be able to feel a squeeze and lift of your pelvic floor – if you can’t, a conversation with a professional on the Continence Helpline would be a good place to start. They may recommend you seeing a continence nurse or Women’s Health Physio for an assessment. Certainly, if you experience any involuntary loss of urine, faeces or flatus, you should seek assessment and treatment from a professional. If you have any pelvic floor pain, you should see a Women’s Health Physio. You don’t need a referral – see the contacts at the bottom of the page.
For better quality of life outcomes… what is available or valuable to know to better manage pelvic floor weakness or incontinence?
The Continence Foundation of Australia is a valuable resource. They have a very easy to navigate website www.continence.org.au that is worth exploring for far more information as well as a free helpline (1800 33 00 66) staffed 8am-8pm AEST, Monday to Friday. They can give you information on funding schemes, local professionals to be able to assess and treat you and can provide you with many different informative brochures free of charge. The Australian Physiotherapy Association also has a ‘Find a Physio’ function, where you can search by specialty (Continence and Women’s Health), State and location. www.physiotherapy.asn.au
What other message would you like to give in relation to this topic?
The wonderful thing is, we can treat and improve quality of life for most people with continence issues by addressing strength and control of the muscles and often making a few behavioural changes – perhaps with toileting, perhaps with exercise, perhaps with the amount of water you drink! Many pelvic floor disorders – continence, pain, prolapse, constipation – can be treated without medication or surgery and can improve at any age. Please contact the Continence Foundation or myself for more information.