Problems with the pelvic floor are rarely talked about and it is often regarded as a taboo subject.  However, many women can suffer from dysfunctions of the pelvic floor with symptoms such as incontinence or pelvic organ prolapse; the actual statistics are 1 in 3! 

Women’s Health Physiotherapist, Sarah Cross who works at Crystal Palace  Physiotherapy is keen to spread her knowledge and skills to help treat people with these problems. 

Unfortunately how to cope and manage these problems is not well known.  Thousands of women cope with symptoms of urinary incontinence and pelvic pain which can have huge effects on self-confidence and the ability to participate in normal activities of daily living.  Covering up symptoms of incontinence or treating it as the “norm” post-natally will not help.  There are often simple strategies and exercises that will fix it.

Let’s first discuss the anatomy of the pelvic floor.  These muscles act like a sling to support the pelvic organs (womb, bladder and bowel).  They attach to the base of your spine and span the underside of your pelvis to attach at your pubic bone.  They act to elevate the bladder to the correct position and to close the passages around the bladder and bowel until emptying is required upon when these muscles need to relax.

              

   

What can happen?

Weakness of the pelvic floor muscles can occur during pregnancy and following childbirth.  This can happen due to the load of the foetus bearing down onto the pelvic floor muscles causing a stretch of these muscles.  Additionally damage may occur to the pelvic floor muscles during childbirth where some women may have a tear or need to be cut to allow for the delivery of the baby.  Forceps and ventouse delivery can also cause trauma to the pelvic floor.  These muscles will heal following labour, however the full strength of these muscles may not just return without specific strengthening exercises.  A weakness in these muscles means that they will not act as a clamp effectively around the bladder and/or anus.  This can lead to symptoms of urinary or anal incontinence. 

Symptoms

Stress urinary incontinence is the most common symptom of pelvic floor malfunction.  This is a leakage of urine with activities of increased abdominal pressure such as coughing, sneezing, jumping and running.   Urgency urinary incontinence is if you leak when rushing to the toilet. Sometimes leaking can happen with little notice.  This may be due to bladder irritation or reduced control of the bladder.  People may also experience symptoms of anal incontinence reporting a leaking of faeces or a loss of control with wind.  Pelvic Organ Prolapse is when the organs of the pelvis are not well supported by the pelvic floor, they can drop down and bulge into the vagina. Symptoms of this include sensations of heaviness, dragging or a pressure forcing down, discomfort during sex, incontinence or a slow stream of urine. Additional symptoms of pelvic floor weakness could include: Reduced sensation and satisfaction during sex Constipation, straining and pain during bowel movements.

What can be done?

Firstly don’t suffer with your problems in silence! You should seek advice from either your GP or a women’s health physiotherapist.  They can assess your pelvic floor and ascertain the best line of treatment for you.  Pelvic floor exercises have been shown to be highly effective in treating these conditions; however it is important that you are doing them correctly.  This can be taught by your women’s health physiotherapist.  The evidence shows that these exercises can help up to 70% of people with these symptoms when guided by a specialist physiotherapist. The good news is that pelvic floor muscle exercises are easy to perform and can be done anywhere. Just a little time spent exercising them every day will help to restore their strength.

There are various tools that your physiotherapist may use to help you with these exercises such as muscle stimulators and biofeedback machines to help visualise the contraction.  It is vital that you stick with these exercises for a period of 3 months to gain the best results.  After following a course of treatment you should no longer have to rely on pads, limit your exercising or have a mad dash to the toilet   as soon as you open your front door!

Contact: 020 8778 9050 or e-mail Sarah at s.cross@cpsic.co.uk