The pelvic floor is a sling of muscles within the pelvis that, just like any other muscle in the body, gets strong when we exercise it the right away. Yet also like our other muscles, it becomes weaker over time and with certain habits.
So, picking up one of the best pelvic floor trainers is a good idea for anyone experiencing difficulties in this area, though they remain unfortunately very common. New research commissioned by Intimina reveals that almost one in 10 women experience pelvic floor leaks every day - a number that rises to six in 10 among those who've given birth. In the years after childbirth, it only becomes more common as lowering oestrogen levels linked to the onset of perimenopause symptoms weakens the pelvic floor further.
Yet, many of us are damaging our pelvic floor muscles without knowing it. Simple daily habits, like bathroom routines and certain types of exercise, can have a bigger impact on the pelvic floor than you might think. Here, gynaecologist Dr Susanna Unsworth shares the pelvic floor mistakes she often sees - and how to avoid them.
1. Stopping urine flow mid-stream
When learning how to use a pelvic floor trainer or practice kegel exercises, you may have been told to practice clenching your pelvic floor muscles by stopping the flow of urine on and off as you use the loo. "In the past, this was often seen as a way of testing your pelvic floor and even recommend to exercise the muscles," says Dr Unsworth, who is also the in-house expert at Intimina.
"However, this is not recommended as it can cause issues with the bladder," she explains. "When you pass urine, the bladder muscle contracts and the pelvic floor muscles relax. If you contract your pelvic floor midstream regularly, it can result in the bladder relaxing, assuming it has been emptied, and lead to bladder dysfunction. [This, in turn] can contribute to ongoing problems, such as urgency and an overactive bladder, potentially causing incontinence issues."
2. Going to the loo ‘just in case’
It's a habit that stems from childhood when our parents told us to always use the loo before leaving the house. But in adulthood, it may be making your pelvic floor issues worse.
"It's okay to do it occasionally - especially before an event where you know you can't be excused easily - but if it becomes a regular habit, it can lead to problems with bladder function," says Dr Unsworth. "Repeated bladder contraction when it's not full is 'teaching' the bladder to empty smaller volumes [of urine]. This can lead to feeling an urgent need to pass urine even when the bladder is only partly full, resulting in more frequent trips to the toilet and a chance of incontinence if you can't get to a toilet in time."
If you regularly wake up in the middle of the night and can't go back to sleep without using the loo, this could be your problem too.
3. Hovering over the toilet
Most of us will avoid a public toilet unless it's urgent and when we do go, we hover above the seat in a squat any personal trainer would be proud of. However, Dr Unsworth says: "This often leads to contraction of the core muscles, including the pelvic floor, which is the opposite of what we want when we pass urine."
It's unlikely that many of us do this often - but if you do, it's certainly something to consider. "We may need to contract our bladder more aggressively to allow ourselves to pee. This can contribute to issues like an overactive bladder and a higher chance of urinary tract infections. So much so, it's better to just sit on the seat - maybe with a bit of toilet paper placed over the seat if needed," she says.
4. Doing something else while going to the loo
There are two elements to passing urine, Dr Unsworth says: bladder contraction and pelvic floor relaxation. "Neither of these require excessive force and if you do overstrain, the balance between the two can be disrupted. Blowing your nose, holding your breath whilst trying to pass urine, or forcing a 'power wee' [if you're short on time, for example] can influence these contractions and lead to dysfunctional bladder symptoms."
5. Holding your bladder
Occasionally hanging on to use the loo at home rather than going when you're out and about isn't going to make a difference - but regularly holding your bladder can lead to issues with your pelvic floor.
"[If you do it for too long], it can lead to issues with poor bladder contraction and incomplete emptying," says Dr Unsworth.
6. Hanging around on the toilet
"As a parent, this is definitely something I've been guilty of! Sometimes sitting on the toilet is the only time you get some peace and quiet," says Dr Unsworth. "But, if you stay sitting for too long, it can lead to the pelvic floor staying relaxed for too long."
And like anything else, doing this too often can lead to pelvic floor dysfunction.
"So, allow 15-30 seconds after finishing to ensure your bladder has fully emptied and then get up. You can still hide in the bathroom for a little longer if you need the time out, but standing up will allow your pelvic floor to regain its usual level of tension preventing future problems," she says.
7. Some types of exercise
While regular exercise has many benefits for physical and mental health, if you are dealing with pelvic floor issues, you may want to stick to activities like yoga workouts, Pilates, walking, hiking, swimming, golf, and gym classes like step aerobics. These have a lower risk than others of putting extra pressure on your pelvic floor.
High-impact exercise (which includes anything where you jump up and down), intense core exercises, and any activities where you 'bear down' are among those to avoid. Such as:
- Running
- Weightlifting
- Endurance sports, e.g. triathlon
- Core exercises like crunches and squats
- Gymnastics
- Cycling, either indoor cycling or road cycling
Some experts will suggest cycling as a suitable low-impact exercise for those dealing with pelvic floor issues as the seat of the bike supposedly supports the pelvic floor. However, several studies outline a link between cycling and pelvic floor issues.
Loyola University Health System found that one in three female triathletes had an issue (urinary incontinence, bowel incontinence or pelvic organ prolapse) with their pelvic floor in the years following their training. Researchers from the Rural School of Public Health in Texas found links between cycling and pelvic floor issues based on where the handlebars are positioned.
However, there are also studies to show that pelvic floor issues as a result of exercise can be reversed, as revealed in the Harvard University journals. The studies suggested that pelvic floor exercises, such as kegels were the way forward, with "cure" rates of up to 80%.
