The pelvic floor and physiotherapy.

Incontinence and the pelvic floor:

The pelvic floor is a group of muscles that sit in your pelvis. The pelvic floor attaches to the front of your pubic bone all the way to the coccyx and attaches to the sides of your pelvis by your two sit bones. 

The pelvic floor forms the basis of physiotherapy intervention for conditions such as urinary and bowel incontinence and prolapse. These conditions can be seen pre and postnatally. 

There are 3 different types of urinary incontinence and these are: 

  • Stress urinary incontinence – involuntary loss of urine on effort or physical exertion e.g. sporting activities, or coughing and sneezing.
  • Urgency urinary incontinence – involuntary leakage with reporting of a sudden, compelling desire to void.
  • Mixed urinary incontinence – components of both stress and urgency incontinence. 
  • Overflow incontinence – feels like not completely emptying when going to the bathroom. 

The pelvic floor has the ability to contract and relax like any other muscles in the body. However, it is a bit more challenging as you can’t see these muscles as they are internal. 

Cues for pelvic floor muscle activation: 

There are lots of cues that we can use to help with activating your pelvic floor to reduce urinary incontinence. Thinking about squeezing certain points of the pelvic floor together such as front to back and progressing from there. Other cues can also be used which include squeezing the back passage or stopping urine. It’s important to note that some cues work for some people while others do not. It’s important to have an individualised approach when finding out which cue you respond best to. 

Positions for pelvic floor: 

Typically we begin pelvic floor muscle training in sitting. There are techniques we can use to help increase the ease of getting a contraction such as placing your elbows on your knees or sitting on a towel or swiss ball. From this, we can progress the positions in which you can activate your pelvic floor. 

Pelvic Floor Exercises: 

Firstly we begin with holding the pelvic floor contractions as long as you can and increase these holds to 10 seconds x10. We need to make sure that you are not holding your breath or overly activating other muscles. Once you have successfully completed this, we can move on to quick contractions up to 25, ensuring that you are completely relaxing between those contractions. We aim to complete these exercises 3x per day. 

If you feel as though you are experiencing incontinence related to your pregnancy, feel free to get in touch with one of the physiotherapists at Your Health Physio.