What are pelvic floor muscles?
These elusive internal muscles are actually a group of sheet-like muscles. They start at your pubic bone at the front of your body to the base of the spine at the back and create a bowl-like structure for your bladder, uterus, vagina and rectum to sit on. But it doesn’t stop there, they also work with the abdominal and back muscles to stabilise and support the spine.
When they are weakened through childbirth or the menopause they don’t function as they should which can mean you are unable to control your bowel movements properly and you may suffer leakage. The pelvic floor muscles also support sexual pleasure so you may notice a loss in sensation during sex too. But despite these muscles being so important an increasing number of women (and men!) are living with the side effects of a weak pelvic floor.
“The statistics are 1 in 3 women suffering but I believe the actual figure is higher than this,” says expert Jane Wake. “A common scenario is that, after childbirth, women initially have issues but they seem to go away so no one’s worries too much about it. What I get is women coming to me after exercising the wrong way or years and years later after pregnancy, often when they are either perimenopausal or menopausal, with huge issues.”
It’s time to break the taboo and talk about health more honestly
With so many women able to benefit from help with improving their pelvic floor it’s amazing we hear so little about the issue. “We talk so ridiculously British around the subject!” says Jane. “We can’t even say the word vagina without people bursting into fits of embarrassed laughter – we really need to get a grip.” Pelvic floor muscle fitness can be affected by several things – not just having a baby – including being overweight, years of straining on the toilet, lifting heavy weights in the gym, ongoing constipation and ageing.
Finding your pelvic floor muscles is key
Many women who wish to improve their pelvic floor situations believe Pilates is the only answer. But while Pilates is certainly proven to be a very effective solution, for a lot of women even finding their pelvic floor muscles in the first place is tricky. “Understanding how to find and feel your pelvic floor, how to lift and relax it is key,” says Jane. “It can be very hard and this is the reason why, for many women, exercises don’t work. It’s also hard to stick to an exercise programme. We all know what that’s like with any exercise programme. You’ve got to be dedicated. I’ve come up with loads of different ways to help women but they all often need my constant support.” Some research suggests that, after being told how to do the relevant exercises, only half of women manage to contract their pelvic floor muscles correctly. A quarter are doing nothing at all and a quarter in the research actually straining downwards, which can make problems worse.
Luckily there are devices available now to help identify which muscles we need to work and give them some initial strength so you can mobilise them during more traditional exercises. Vaginal weights are small tampon-shaped weights, which increase in weight and are inserted into the vagina and kept in place by contracting the pelvic floor. They’ve been popular in France for years now and are routinely prescribed by doctors for women after childbirth – along with instructions and a schedule for when to use them.
It’s also possible to measure the electrical output of the muscles using vaginal probes. You can locate the pelvic floor muscles and activate them from the outside using neuromuscular electrical stimulation too. INNOVO shorts include electrodes on key areas to target the nerves which directly connect to the pelvic floor. “Multi path technology is very specific and well researched to ensure it targets the right muscles,” explains Jane. “One of the biggest ways they can help is connection and consistency. It not only makes sure you are doing your pelvic floor exercises correctly but makes it much easier to do it regularly. What’s more, once my clients have used it, they find it easier to then contract their pelvic floor on their own. It’s also non-invasive and so easy to use.”
Supporting your pelvic floor through nutrition
Believe it or not there are ways of supporting your pelvic floor health and strength through nutrition, although these should be used along with, rather than instead of, physical exercise. Magnesium is an important mineral for proper muscle and nerve function, and can also ease incontinent worries, as it reduces bladder muscle spasms and enables the bladder to fully empty upon urination. Magnesium has also been proven to relieve constipation due to its laxative effect; it draws water into the stools, easing any tension, and making them softer and easier to pass helping the pelvic floor as straining can weaken it. If you suffer from incontinence or constipation, then you should ask your medical practitioner if they think you should incorporate magnesium-rich foods into your diet, such as potatoes, bananas, wholegrains, beans and nuts.
Similarly making sure you stay hydrated is important. “Drinking plenty of water will hydrate your body and flush out toxins, keeping your colon intact,” says naturopathic nutritionist, Amy Morris from Water for Health. “Dehydration can lead to bowel dysfunction, primarily: constipation, and constipation can play a huge role in contributing to a weakened pelvic floor. You should avoid caffeinated beverages, as they are a diuretic and bladder irritant, and can cause the bladder and any part of the pelvic to become overactive. Bladder irritation can also lead to chronic bladder infections, incontinence, and difficulty urinating, so it’s always best to stick to water.”
If you drink lots of juice or fruits which are high in citric acid, such as oranges, lemons, grapefruit and cranberries, this can cause irritation and worsen bladder control. Opt for fruit and vegetables that are low in acid, such as bananas, avocados, peas and apples, as they will provide the body with vital nutrients including fibre, without causing irritation to the pelvic floor.
Also check you are getting enough vitamin D – a vitamin which is needed through supplementation in the UK winter months – as recent studies have shown that women who have high levels of vitamin D, are less at risk of having a weakened pelvic floor. “Vitamin D affects skeletal muscle strength and function, and insufficiency is linked to poor muscle strength and loss of muscle mass,” explains Amy. “Vitamin D has been shown to increase skeletal muscle efficiency at adequate levels, as vitamin receptors are present in our muscles and therefore have a direct effect on our pelvic floor muscles. I recommend taking a vitamin D supplement to ensure your vitamin D levels are in the healthy range, especially during the colder months but it can also be found in foods including oily fish, raw milk and eggs.”
Help is out there, it’s just we aren’t talking about it as much as we should!