Pelvic floor exercises and why all pregnant women should be doing them

(Original Article: https://www.hulldailymail.co.uk/news/health/pelvic-floor-exercises-pregnant-women-1469737 19th April 2018)

It’s a well known fact a woman’s body changes as she goes through pregnancy.

As your baby grows, your body stretches and your pelvic floor is weakened – which can lead to various problems. But despite the embarrassing symptoms – including leaking urine when coughing and sneezing – women are suffering in silence.

Wanting to help women, the Us Mums Hull team, run by Hull City Council‘s Healthy Lifestyles Team have held the city’s first ever pelvic health workshop to try and reduce the stigma around the problems women are facing.

It is just one of several workshops, events, walks and exercise sessions the team – which is funded by Sport England – is holding throughout the city in an attempt to help women keep fit, active and social during pregnancy and beyond.

Leila Lapse-Berga from Us Mums said: “Pelvic health is so important and hasn’t been spoken about enough. We at Us Mums think we are in a good position to talk about that.

“Many women say to us they would like to do exercises, but they don’t know how, and they don’t want to openly talk about it.

“We have seen how pelvic floor related issues can affect a woman’s mental and physical health, yet we can help to fix it.

“So after a mum came to me in one of our sessions and told me her problems, we decided to launch these workshops to try and get women talking about it.”

During the free session, which was held at Hull Arena, Diane Mawer, clinical lead for physiotherapy in obstetrics, based at Hull Women and Children’s Hospital, talked to new mums about everything they need to know about their pelvic floor. Here’s what she had to say.

What is the pelvic floor?

The pelvic floor refers to the muscles at the bottom of the pelvis. They are the muscles responsible for holding things up in the pelvis. (The uterus, bladder and rectum). These muscles help with sexual function, bowel functions, wee functions and birth.

When women get pregnant, it’s often the first time we think about our pelvic floor, as our body changes.

When is a good time to start exercising your pelvic floor?

During pregnancy. Women who exercise their pelvic floor during pregnancy have a stronger pelvic floor then those who don’t.

What can I do to strengthen my pelvic floor?

Exercise

We allow women 24 hours off after birth to rest the muscle, but after this time, women should start exercising their pelvic floor.

We want women to start using these muscles again and not be afraid of it being sore or hurting. It may take a while before it starts to feel better, but that doesn’t mean the exercises aren’t working.

Rest

Women are told after they’ve had a baby to rest, and there is a very good reason for this, your pelvic floor needs to recover.

Your pelvic floor objects if you push it too hard, so think about what you are doing, are you on your feet, taking long walks, doing the vacuuming too soon? If you don’t give it a chance to recover, this is when you risk a prolapse.

Diet

If you’re not eating properly, this can affect your pelvic floor.

Women need to look at their diet and fluids intake. For example, too many fizzy drinks and drinks with caffeine will irritate your bladder.

Also, being constipated will weaken your pelvic floor.”

How do I exercise my pelvic floor?

You need to be thinking about squeezing and lifting, as if you are desperate for a wee.

You are squeezing and lifting inside, and holding this for up to ten seconds. You need to keep breathing whilst doing this.

I try to pull up slowly and smoothly and bring it down smoothly and slowly. Others think about bringing it up in a lift, and up and up again.

These exercises are for your slow twitch fibres, they are going to help stop you from going to the toilet so often, and women should do three groups of ten a day.

You also need to exercise your fast switch fibres – these are the ones to work to stop you leaking when you cough, sneeze and lift things.

With these you need to squeeze up and let go, and also do three groups of ten of these aswell.

Women need to do these at the front, middle and back. To make it easier to do the back women should stand with their feet facing inwards.

What can happen if my pelvic floor doesn’t work properly?

Urinary Incontinence (UI)

This is known as an involuntary loss of urine. It is distressing and socially disruptive. Many women delay health treatment for this for many years due to being embarrassed.

Many women believe it is “inevitable” after childbirth, and not be aware there are treatment options. It has been estimated that UI affects more than 20 per cent of people aged 40 and over, equivalent to five million people in the UK.

A common form of problem is where women can’t even sneeze or cough without leaking urine. The reflex which stops you leaking, which closes the bladder neck, isn’t always under control when women have just had a baby.

Pelvic Organ Prolapse

The pelvic floor holds in place the uterus, bladder and rectum. If these support structures are weakened by over-stretching, the pelvic organs can bulge (prolapse) from their natural position into the vagina. Sometimes a prolapse may be large enough to protrude outside the vagina.

Prolapse is very common. It can cause a feeling of heaviness, and can cause bladder and bowel problems, and sexual activity may be affected.

Almost 50 per cent of women over the age of 50 suffer a prolapse. This is when the back passage and uterus sag down through the pelvic floor.

This can be temporary and is usually because women have done too much. It is correctable by doing pelvic floor exercises.

Urgency

Women will get that feeling of ‘I need to go to the loo now’, and they won’t be able to hold it. We can retrain our bladders though and solve this problem.

Frequency

Women with weak pelvic floors will find themselves going to the toilet too often. Going often in pregnancy is normal, but it’s not normal to go so often once the baby is born.

Common questions answered by Diane Mawer

Q) “I’m an older mum, struggling with my pelvic floor, even though I’ve done my exercises. Is there anything else I can try? I had my baby five weeks ago.

A) “You could pull up every time you cough and sneeze, or bend over to help make it stronger. You could also look at your diet, are you drinking too many fizzy drinks, and alcohol can also irritate your bladder. But five weeks is not a long time. Women put pressure – society doesn’t help because we see women exercising and ‘getting back out there’ very soon after having a baby. But actually you do need to rest your pelvic floor after birth.

Q) What can I do if I’ve got a problem with my pelvic floor?

A) “You can ask your GP to refer you via the incontinence service to women’s health physio.

Q) Do pelvic floor over-the-counter devices work?

A) We are all looking for a quick fix, but I would suggest doing the exercises first.

Q) How long will it take to see an improvement?

A) Women should expect to see a difference quite quickly. If you are looking to see improvements, see if you can hold the squeeze for a bit longer. But like everything, you’ve got to keep doing it.

Q) How can I remember to do my exercises?

A) There are apps you can download that ping when it’s time to exercise. But actually I find it best to get into a routine. For example you might do it when you’re sat crawling in traffic, I personally do it when I’m waiting in a queue in a shop. It’s not a massive commitment, and when you get feedback that it’s working, you know they are working and so it becomes as familiar as cleaning your teeth. The point is, we can do these exercises wherever we want, without anyone even knowing we’re doing them.

 

(Original Article: https://www.hulldailymail.co.uk/news/health/pelvic-floor-exercises-pregnant-women-1469737 19th April 2018)