Feel Good

The biggest risks to pelvic floor problems and how to avoid them

Don’t just rely on haemorrhoid cream and incontinence pants – Roseanna Grace shares how pelvic floor physiotherapy can change our lives down below.

Written by Becky Hardy

Published 12.01.2023

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For some reason – and we don’t really know why – talking about our pelvic health has become taboo.

Reasons this is ridiculous:

Everyone has a pelvic floor, (yep, even men).
Pelvic floors are literally part of our bodies. Much like an arm or a foot.
Pelvic floor problems are common – 1 in 3 women will have some incontinence in their lifetime, for example.

We at High Life North have had enough. We’re going to talk about pelvic health whether you like it or not.

And we’ve found an expert in pelvic floor physiotherapy to chat with, too. Meet Rosie Conway of Roseanna Grace Physiotherapy.

See, our pelvic floor muscles support the bladder, bowel, uterus, pelvic girdle and lumbar spine. When fully functional, they assist in pregnancy and childbirth, prevent incontinence and the prolapse of organs, and are an important part of sexual function and pleasure. So, we reckon it’s important we all know a little more about this hero group of muscles.

Because the pelvic floor can easily be weakened.

What’s more, we could be accidentally weakening our pelvic floor without experiencing any symptoms.

Which is why we’ve asked Rosie to break down the 9 biggest risks to our pelvic floor – from lifestyle choices to recurring health issues – to help us all nip pelvic floor problems in the bud.

HIGH-IMPACT EXERCISE

Exercises such as HIIT training, running, CrossFit, dance, aerobics, Zumba, some strength training and skipping – along with sports like netball and football – all increase intra-abdominal pressure.

When we increase this pressure, we put extra demand onto our pelvic floor muscles. So, it’s essential that these muscles already have the strength and functionality to cope.

If our pelvic floor muscles are too stretched, weak or have a loss of flexibility to counteract this extra pressure, we’re likely to see:

Urinary leakage
Pelvic organ prolapse
Haemorrhoids

Some presentation of pelvic floor dysfunction is second to high tone in the muscle (which is the opposite to a weak muscle group). This can often result in:

Pain
Urinary incontinence

Apart from anything else, both these scenarios can affect your form in the gym. So, if you’re participating in any of these exercises and haven’t had your pelvic floor assessed already, it may be good idea to check in with a specialist physiotherapist to avoid any dysfunction down the line.

Rosie’s top tip: It’s worth noting that symptoms are the last thing to show when there’s a problem with your pelvic floor. You may have had misbehaving muscles for a long time before you experience any pain or leakage. So, a top tip would always be to get these assessed pre-emptively through pelvic floor physiotherapyand reduce any potential risk of dysfunction in the future.

PLANNING A PREGNANCY

We all want to get into our prime before trying to conceive a baby.

Maybe that’s by increasing our water intake or reducing how much alcohol we drink; maybe it’s eating a healthier, more balanced diet or reaching for the multi-vitamins and folic acid.

What most of us don’t do, though, is check that our bodies are properly conditioned for pregnancy.

We don’t make sure we’ve optimised our gluteal and core strength, posture, adductor strength and our pelvic floor.

Two of the five biggest risk factors for pelvic floor problems happens during pregnancy and childbirth, so you can easily reduce your risk by nipping any dysfunction in the bud before getting pregnant – or during your pregnancy.

For example: If you have weaker gluteal muscle bulks (or bottom cheeks!), then as your pelvis tilts to accommodate a baby growing, you may over-recruit your core and increase the load onto your pelvic floor muscles. This can onset symptoms of weakness that, otherwise, could have been greatly reduced.

USING A FOOTSTOOL ON THE LOO

We know from previous articles that constipation is a risk factor for pelvic floor weakness and dysfunction.

Every time you strain, your pelvic floor is put under a far greater load which, ultimately, can weaken your muscles over time.

Maybe you don’t consider yourself ‘constipated’, but if you’re straining regularly on the toilet, then it’s a risk factor.

Prioritise time to open your bowels. Make sure you take up to 10 minutes to defecate – this is the average amount of time it can take to fully empty our bowels.

Rosie’s top tip: Normal frequency is anything from three times a day to three times a week. If you’re not going this often, consider consulting a pelvic health physiotherapist; they can maximise your stool type and habits to reduce any risk to your pelvic floor. Ideally stool type would be a type 3 or 4 with regular bowel motions. Anything above or below can also be optimised to maximise your bowel – and therefore pelvic – health

POST-NATAL LIFE

Whether you have had your baby by forceps, caesarean section or suction, or you had a normal vaginal delivery, the biggest load your pelvic floor has ever held is a baby for nine months!

During pregnancy, our muscles stretch and thin – much like a hammock as baby is growing – and can likely weaken during pregnancy if you are not working these effectively to build muscle bulk throughout this stretching and thinning.

Rosie’s top tip: Remember – you don’t have to have symptoms to have dysfunction in these muscles, so prevention is key. Stop the onset of symptoms by booking in a post-natal check (even if this is a three-year post-natal check!). It’s never too late.

COUGHING

Chronic coughing loads your pelvic floor much like constipation.

It does this by increasing your intra-abdominal pressure, much like high impact exercise. Roseanna Grace has seen so many people post-COVID, or post chesty infections, as these have caused pelvic floor dysfunction.

If you have a dry cough, consider consulting your GP to see if this can be investigated or treated. Sometimes, this can be down to allergies or reactions which can easily be improved through treatment.

UTIS, FREQUENT THRUSH OR CYSTITIS

If you suffer with frequent thrush, urinary tract infections or cystitis – and by ‘frequent’, we mean more than twice per year – then consider seeing a specialist.

Sometimes, regular infection or irritation can affect the pelvic floor, which can contribute to the re-occurrence; your pelvic floor could be overly tense in response to your discomfort, for example, or if it’s too weak then it could be letting bacteria in.

Knowing what to do and how to treat this is vital for reducing future infections or irritation – which is where pelvic floor physiotherapy comes in.

ANY PELVIC SURGERY

If you’ve had any pelvic surgery – including hernia repairs, hysterectomies, bladder or prolapse repairs – then your muscles can be placed under extra pressure.

As organs are moved and, sometimes, removed, the change in anatomical position can onset symptoms of pelvic floor dysfunction.

Think of your pelvic floor muscles as a JENGA tower: the more pieces you take away, the more unstable the tower becomes.

So, before and after surgery, always see a pelvic health physiotherapist.

MENOPAUSE

Whether semi-, peri- or post-menopausal, the change in our hormonal balance that the change causes reduces the elasticity in all our soft-tissue structures.

This puts our pelvic floor muscles under more stress and highlights weaknesses that may not have been showing symptoms before.

Menopause can also slow down our gut’s transit time (which is called peristalsis), and, therefore, may increase the risk of straining or constipation on the loo.

By consulting a pelvic health physiotherapist, you can get advice and support on how to optimise your strength, as well as guidance on how to look after your bone health.

WEAK BLADDER

Finally, if you’re someone who thinks they have always had a ‘weak’ or a ‘small’ bladder, please come and see us!

The bladder is a muscle and muscles can be weak – but they can always be retrained and optimised, too.

Normal voiding habits on a two-litre intake should be every 3-4 hours and no more than once a night. If you’re going more frequently than this, consider booking into see Rosie’s team for some guidance and direction to gain back control of your bladder.

You don’t have to put up with unwanted bladder frequency or urgency. Pelvic floor physiotherapy really can help!

For more information about how Rosie and her team can help you reclaim your confidence and overcome your pelvic floor symptoms, visit the Roseanna Grace Physiotherapy website, or follow them on Facebook and Instagram.

Or pop into one of her two Jesmond clinics and say hello:

15a Clayton Road, Jesmond, Newcastle NE2 4RP

89 Holly Avenue, Jesmond, Newcastle NE2 2QB

Alternatively, Millie is the clinic receptionist and would welcome your call on 0191 281 6084 if you wanted some guidance and re-assurance before booking your consultation.