Getting to Know Your Pelvic Floor // Caring For Your Pelvic Floor

Now now we should all know a bit more about what the pelvic floor is and what it’s meant to do - if you missed last week’s post, make sure to head back and give it a read - but what can we do to make sure that our pelvic floor functions as it should, particularly before, during, and after pregnancy, a time when the pelvic floor undergoes a lot of strain. In today’s post, Candice discusses 8 really simple things that you can do to take care of your pelvic floor. I’ve linked to some extra resources after some of the tips for more information. Enjoy!


Before we dive into today’s post, let’s do a quick recap on the pelvic floor. In the last post on Pelvic Floor Basics, we discussed that this hammock like structure is responsible for maintaining and controlling continence, supporting the pelvic organs, and playing a role in sexual function. In addition to this, it forms a part of the vaginal canal through which a baby being born would pass. I am sure that we can all agree that your pelvic floor is quite important and deserves a little TLC! In this post we will be looking at:

 
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1. Seek the help of a professional if you have any uncertainties or concerns

Seek out the help of a Pelvic Physiotherapist, Gynaecologist, Urogynecologist or other health professional that specialises in this area. I would personally encourage a check-up both during pregnancy and 6 weeks postpartum as a means to best care for your pelvic floor.  

2. Deep breathing / Relaxing

Deep belly breathing is underrated and has a gentle stretch affect on your pelvic floor, which is great for stimulation, improving blood flow, awareness and general relaxation. You can do this as follows:

  1. First get into a comfortable position

  2. Inhale (relax everything!) and allow your ribs and belly to rise as you draw air in (but do not push your belly out!)

  3. Exhale and let go

  4. Repeat x 10, throughout the day

3. Maintain general Fitness

I am sure you have heard this many times before! Maintaining fitness and finding a healthy balance is incredibly important for you, including your pelvic floor. Think back to your ‘functional unit’ (discussed in my first post) and you will agree that maintenance of your surrounding musculature is vital.

4. Cultivating Good Toilet Habits 

Let’s go in the order nature calls. We want to force the matter but we need to get the job done properly. A general rule is to NOT PUSH or strain, and empty your bladder and bowels fully. 

  • When urinating: Firstly, remember that your bladder is a muscle, so when you need to go, make sure to sit, relax and allow it to do its work. Do NOT push urine out. If you relax properly and don't rush, your bladder will empty fully (and the good news is that no residual urine = less chance of contracting a UTI)

  • When passing a bowel movement: Firstly, remember NOT TO PUSH - get yourself a ‘squatty potty’ or similar (you can always prop your feet up on a low stool or box), breathe, and relax your pelvic floor. Secondly, don't rush, make sure to get the job done properly, and do your best not to delay the urge to go for > 20mins.

5. Antenatal classes & Preparing for Birth

Pregnancy, labour and childbirth have a significant impact on your body, including your pelvic floor. You don't need to be a google doctor, there are many experienced professionals out there that are enthusiastic and passionate about guiding you through your child bearing years. 

6. No straining!

Do I need to say it again, NO PUSHING! I am not just referring to toilet habits - also be mindful when picking up children, weight lifting, doing strenuous exercise, carrying shopping, and pushing furniture. These activities may cause you to hold your breath and bear down. Don't do it. The increase in intra-abdominal pressure puts strain on your pelvic floor, and this strain may cause you to leak, exacerbate a prolapse or compromise a weak pelvic floor. Rather gently engage your pelvic floor (see ‘How to Kegel’ below) and breathe while performing these activities.

7. Clean Machine (avoid vaginal washes - warm water will do)

Your vagina is self-cleaning, so you do not need scented cleansing gels/wipes/douches to ‘freshen’ up your lady bits. Cervical mucus (which can be clear, white, or cream in colour) is normal and does not need to be scrubbed away! There is naturally occurring ‘good bacteria’ (lactobacillus) that live within the vagina, which maintains a healthy acidic environment. The use of washes will disturb this balance therefore encouraging infections or thrush. All you need to do to keep yourself clean is to gently wash around your external genetalia (labia majora/minora) with warm water!

8. Kegels

Please note how breathing and relaxing where mentioned first. Many patients don't realize that what they really need is to relax and let go their pelvic musculature before they begin to focus on strength. 

How to Kegel:

  • Start in a comfortable position (ie. sidelying or sitting) 

  • Take a relaxed breath, let go any tension in your pelvic floor.

  • Step 1: Inhale (let it all go), exhale and close the back passage as if you are trying to stop wind, inhale and let go (repeat x3)

  • Step 2: Inhale (relax), exhale contract the back passage, bring that feeling forward as if you are trying to stop urine, inhale and let go (repeat x 3)

  • Step 3: Inhale (relax), exhale contract the back passage, bring that feeling forward as if you are trying to stop urine, now lift as if you are trying to suck a milkshake up through a straw (with your vagina), inhale and let go (repeat x 3)

 

Step 3, contracting back, front & lift is a kegel. Well done! Now you need to master the awareness of what you are trying to achieve so that you can progress by incorporating it into your daily function! 

Progressions:

  • Inhale (relax), exhale (contract) x 10, 4 times a day (until you get the just of it)

  • Contract and hold that tension, breathe x 10, repeat 10, 4 times a day (you may need to start with 2 breaths)

  • Incorporate in varied positions and activities (contact and breathe an s you; sit-stand, step up, climb stairs, walk to car)

  • Incorporate in exercise (please seek assistance - squats, bridges, lunges)

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Candice is a Physiotherapist based in Durban with a special interest in Women's Health and Pelvic Health, a relatively new and growing field of Physiotherapy. In an effort to improve awareness of Pelvic Physio as well as educate and empower women with pelvic health concerns, Candice is known for addressing many of the taboo topics in this area. Rather than ‘brushing it under the rug’ or giggling over pelvic floor symptoms in conversation, she highlights that there are professionals trained in conservative treatment. She has an Instagram page @umhlangaphysioforwomen and ran a series of ‘Wonderful Women’ Events in 2018 which aimed to normalise conversations and address pelvic floor dysfunction in an empowering and engaging setting. These platforms allow women to interact with herself as well as other professionals within the field. When Candice isn't dancing around in front of a crowd explaining the ins and outs of a pelvis she is based at a Physiotherapy practice in Umhlanga, Durban, South Africa. This is where she assesses and treats any patients that may come her way with concerns relating to the pelvis.

You can keep in touch with her work on: