Why are Pelvic Floor Muscle (PFM) exercises important?
It is estimated that as high as 1:3 women in their lifetime, may develop signs or symptoms associated with PFM weakness and or dysfunction. As these muscles are not cosmetic and affect our outward body’s appearance, they are often overlooked and forgotten until a problem presents. Exercising these muscles early and consistently in life may prevent you from leakage, pelvic pain and or prolapse later in life. So, start now, it is never too late!
Why is it important to check your Pelvic Floor Muscles (PFM) before planning a pregnancy?
The pelvic floor muscles are a group of muscles found in the floor (the base) of your pelvis (the bottom of your torso). They provide a ‘hammock floor’ like structure to support your organs such as the bladder, uterus (or prostate in men) and rectum.
The pelvic floor muscles give you the ability to control the release of urine (wee), faeces (poo) and flatus (wind) and to delay emptying until it is convenient. When you contract the pelvic floor muscles, they lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Preventing leakage and hence incontinence. They also provide the supporting base for the core abdominal and diaphragm muscles to work from and support your spine and torso.
With relatively simple exercises known as ‘Kegel Exercises’ you can strengthen the pelvic floor muscles providing a good strong base of support of your pelvic organs, as well as a stronger muscular support for your growing baby in pregnancy and the increasing effects of hormones on your body while pregnant.
By checking your pelvic floor muscles and having them objectively graded (on a strength scale), you then have a base line to work from and a better understanding, if you are doing your Kegel exercises correctly. During a pelvic floor muscle assessment, any concerns of a weak, an inactive, a poorly functioning pelvic floor (dysfunctional pelvic floor) and or signs of a pelvic organ prolapse, can be identified, and treated, prior to pregnancy. Simply knowing your pelvic floor muscle health, can provide you with emotional and physical support, reassurance, and an opportunity to enter pregnancy fitter and stronger.
Where possible ALL women should have their pelvic floor muscles checked prior to, during and most definitely after birth.
When should you check your pelvic floor muscles and how often in your pregnancy?
There is no set week or month in your pregnancy that you should check your pelvic floor muscles, however I would recommend if you have not had your pelvic floor muscles assessed prior to pregnancy, then I would suggest after the first trimester using Real Time Ultrasound and or vaginal assessment to have your pelvic floor muscles assessed for function and strength. A personalised pelvic floor muscle program can then be given to you to do daily to strengthen your pelvic floor muscles and or correct any dysfunctional pelvic floor muscle signs. Regular checks may be required every 4-6 weeks if the client is having any pelvic floor concerns – leakage or tightening (spasm).
If there is pelvic floor muscle spasm / tightness identified, then releasing of these pelvic floor muscles, prior to delivery may assist in relaxation of these muscles, making a vaginal delivery slightly more comfortable. Release can be started any time from 37 weeks subject to the doctor’s clearance to do so and ensuring no medical condition would prevent release of the pelvic floor muscles such as Placenta Previa – a low lying placenta which may be positioned across the birth canal or cervix area.
Can your pelvic floor muscles be affected even with a C- Section?
Yes, your pelvic floor muscles can be affected even with a C - section but not because you have had a C - section but purely due to the pregnancy itself. Factors such as: the weight of your developing baby, more than one developing baby (twins, triplets), multiple births, the position of the baby in uterus, pregnancy hormones such as progesterone, your pre pregnancy pelvic floor muscle fitness, as well as your pregnancy fitness and weight, and finally the genetic makeup of your collagen and tissues may all be factors that affect the pelvic floor muscles. In the C -section the pelvic floor muscles are not cut through, the uterus (a muscle) is cut through and several layers of tissue, fat, skin. Not the Pelvic floor muscles. So, it is the pre- pregnancy, preganacy and birth journey combined that affect the pelvic floor muscles not necessarily the type of delivery – vaginal or C section.
How Do I get to see how my Pelvic floor Muscles work?
We can see the pelvic floor muscles in action due to the availability and use of Real Time Ultrasound Imagery (RTUS). This involves placing a small convex shaped sound head, with gel on surface over the skin, in the pelvic supra pubic area and viewing the pelvic floor muscles, and other pelvic gridle organs such as the uterus, and bladder. All that is required is a semi to full bladder, as ultrasound uses sound waves that bounces off water and convey an image of the surrounding tissue. An empty bladder would make the tissue and organs difficulty to see.
So please come in with a semi to full bladder as you can empty your bladder after the ultrasound, which only takes approximately 5 - 10 minutes. The use of RTUS imagery is painless and extremely exciting, as well as motivating, as you are literally looking inside your own body in real lifetime!
It is none invasive and offered with no additional charges, as part of the assessment and treatment.