the rise and fall of the pelvic floor....to strengthen or lengthen???

It's widely accepted by most pregnant ladies and new mums that pelvic floor exercises are a good idea, with the expectation that our pelvic floor muscles weaken during pregnancy and as a result of stretching during childbirth.

It also seems pretty much accepted that not doing them, or not doing them as often as we should, is the reason we leak when laughing a bit too hard or when having a sneezing fit. And why the sight of a trampoline makes us feel a bit anxious for our underwear. But there can be more to it than just poor muscle strength.

Did you know the pelvic floor can be over-active or too tight? And that this can contribute to incontinence, pelvic pain, constipation, abdominal pain, tailbone pain (coccydinia), and pain during sex. In these situations, pelvic floor strengthening exercises have the potential to actually be unhelpful.

The pelvic floor is just another muscle, and like any muscle it can either be strong or weak, and over-stretched/lengthened or short/tight. If you can have tight hamstrings, why not a tight pelvic floor?

There are a number of factors that could contribute to an overloaded pelvic floor becoming too tight:

1. Trauma sustained during birth. If you experienced a tear or a had an episiotomy during labour, the area will heal as any soft tissue would by forming scar tissue. This new tissue is inelastic and inflexible resulting in parts of the pelvic floor becoming too tight. If one area of the pelvic floor has experienced soft tissue trauma and remains weakened by this, the other areas may need to 'over-work' to compensate for this. These over-working muscles will become too taught and give rise to muscle pain.

2. Muscle imbalance. During pregnancy we often find important stability muscles on the outside of the pelvis get lazy, becoming weak, and fail to provide the much needed stability to the pelvic joints. The pelvic floor compensates for this by working harder to offer the pelvis stability.

3. Over-exercising. We are led to believe that pelvic floor exercises are the cure-all for bladder symptoms. We are often told to do the exercises multiple times a day. If we over-do it, the muscles have the potential to be over-worked. It's also worth appreciating that when you work your lower tummy muscles your pelvic floor is activated. So if you constantly try to hold your tummy in post-baby, inevitably you are going to over-work the pelvic floor too.

4. Back pain. Research has shown that low back pain can inhibit our spinal stabilising muscles from working well, and that the pelvic floor functions in a different way in people with back pain. There is a really strong association between low back pain and pelvic floor dysfunction.

5. Stress/anxiety. Most of us can relate to having tension in the shoulder muscles when we are stressed or anxious. The pelvic floor can also hold tension as an automatic response to the stresses we experience during day to day life. Think of a frightened, stressed animal putting its tail between its legs - its the same muscles used to do this, we just don't have a tail. Constant stress, which we don't find an outlet for, can thus contribute to over-tensing and shortening of the pelvic floor muscles.

Wondering if your pelvic floor is over-active? If you are experiencing any of the problems mentioned above, and can relate to any of the risk factors mentioned then it is certainly possible. An effective way to determine if your pelvic floor muscles are over-working, giving rise to pelvic floor dysfunction is to be examined by a specialist Physiotherapist. A Women's Health Physiotherapist is trained to perform a vaginal examination which will allow them to feel any tension in the muscles, feel how the muscles work, gauge their strength and give you feedback and guidance on exercise technique.

There are treatment options for overactivity of these muscles and advice that can be given to provide an effective resolution of your symptoms. Pelvic pain, damp pants and painful sex are not an inevitable part of becoming a mother and are treatable conditions for which you can seek help.

St Judes Clinic in Leighton Buzzard are delighted to offer a postnatal women's health physiotherapy service, whether you have recently had a baby or your children are older, with Women's Health Physiotherapist Jo Dyson. This is a fantastic way to start your recovery from pregnancy, enabling you to reconnect with your pelvic floor muscles, tone your deep abdominals and improve bladder function having carried and delivered your baby. Your assessment will involve a back/pelvis assessment, internal pelvic floor muscle examination (if indicated, and only with your consent), examination for abdominal separation and a postural evaluation.

Having identified the nature of your problems Jo can use her extensive experience in Pilates tuition alongside pelvic floor rehabilitation to help close any abdominal separation, strengthen a weak or release a tight pelvic floor and therefore pave the way for you to return to your usual activities or sport follow the birth of your baby. If you would like more information about our postnatal wellness checks you can have a FREE 10 minute chat appointment (in person or by phone) with Jo Dyson to discuss your individual circumstances.

Contact Jo Dyson at St Judes Clinic on 01525 377751

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Mother Nurture Pilates | Physiotherapist led Antenatal and Postnatal Pilates classes | Leighton Buzzard, Bedfordshire

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