Pelvic floor muscles may not be visible like triceps or quads, but they are vital for everything from basic bathroom functions to sexual health to sitting and standing — and they benefit from a well-rounded fitness programme. Women’s bodies go through many changes as they age. One area of the body women may not focus on is the pelvis. The pelvic floor can undergo changes over time that increase the risk of many kinds of urine leaks, also known as urinary incontinence. The pelvic floor can lose its muscle tone and control over the bladder for a number of reasons, but most commonly as a result of pregnancy and childbirth, heavy sport and exercise regimes, menopause, natural ageing, and pelvic and prostate surgeries. The good news is there are steps women can take to address these changes and maintain a healthy pelvic floor according to the American Urogynaecology Association.
Pelvic Floor Problem: Pelvic floor muscles hold up your bladder. They also support the uterus and bowel (small and large intestine). “The pelvic floor can change for many reasons; the muscles can get weaker or tense up.” The bladder muscle should be relaxed when the bladder is filling, and the pelvic floor muscles should be tight. The pelvic floor muscles surround the urethra (the tube that urine passes through). When they tighten, they help prevent urine leakage.
Stress Urinary Incontinence (SUI): The pelvic muscles can get weak from pregnancy and childbirth. Being overweight and having low estrogen levels can also weaken pelvic floor muscles. Women with a weak pelvic floor may develop stress urinary incontinence (SUI). This happens when the pelvic floor muscles have stretched or weakened. Physical activity puts pressure on the bladder and can cause the bladder to leak. Leaking may happen with workouts, walking, bending, lifting or even sneezing, coughing and laughing. It can be a few drops of urine to a tablespoon or more. SUI can be mild, moderate or severe. For women with SUI, strengthening the pelvic floor muscles can help prevent leakage.
Overactive Bladder (OAB): Women with central obesity or overweight women develop tension in the Pelvic floor. This can lead to overactive bladder (OAB). With OAB, your brain tells your bladder to empty – even when it isn’t full. Or the bladder muscles are too active. They contract to pass urine before your bladder is full. The main symptom of OAB is the sudden urge to pass urine. You can’t control or ignore this “got to go” feeling. Another symptom is having to pass urine many times during the day and night. Learning to relax the pelvic floor muscles may help reduce these problems. Tension in the pelvic floor can also lead to pain during sex. If you have any of these symptoms, it’s best to seek medical attention from your doctor to point you in the right direction for treatment.
Treating weak pelvic floor with kegel exercise: “Kegel” exercises can strengthen your pelvic floor muscles. They will help keep your pelvic floor muscles firm, reducing problems with leakage. To make your pelvic floor muscles stronger, alternate between squeezing and relaxing them. Follow the below steps to help practice this technique.
- Squeeze your muscles for one second and hold.
- Relax your muscles for two seconds.
- Each time you squeeze and relax, it counts as one set.
- Complete five sets.
When you can do the exercises easily, increase to doing them ten times per day. When that gets easy, try to squeeze and hold the muscles for three seconds. Then relax the muscles for three seconds. As your pelvic floor muscles get stronger, try holding squeezes for about ten seconds. Relax between squeezes so your muscles can rest before squeezing again. You should do these exercises in three different positions. Do ten sets lying down, ten sitting and ten standing. You may want to do one set of 30 in the morning when you get up and another set of 30 at night. However, the exact time of day does not matter. What matters is that you get in the habit of doing the exercises every day.
Yoga Poses for Strong Pelvic Floor
- Hook Lying with Block
- Reclining bound Angle Pose
- Triangle Pose (Utthita trikonasan)
- Moutain Pose with block (Tadasan)
- Knee to chest (Apanasan or Pavanmuktasan)
- Cat-Cow (Marjaryasan bitilasan)
- Chair Pose (Utkatasan)
- Wide-leg squats or garland Pose (Chair Pose)
- Supported Legs Up the wall pose (Viparitkarni)
- Bridge Pose (Setubandhasan)
- Baddhakonasan
- Happy Baby (Anandbalasan)
Importance of Pelvic floor Health: The pelvic floor is “just as important in your daily life as your Achilles is for running, because we use it for everything”. Maintaining strong and healthy pelvic floor muscles is crucial for overall health and well-being. These muscles provide essential support for the pelvic organs, helping to maintain continence and prevent issues such as urinary and faecal incontinence. Additionally, strong pelvic floor muscles are essential for sexual function, contributing to arousal, sensation, and orgasm. By enhancing pelvic floor strength and coordination, individuals can improve sexual satisfaction and intimacy, thereby enhancing their overall quality of life Strong pelvic floor muscles contribute to core stability and posture, playing a vital role in maintaining balance and alignment throughout the body. Weak pelvic floor muscles, on the other hand, can lead to issues such as lower back pain, pelvic instability, and postural imbalances. Whether you’re a young woman planning to start a family, a new mother recovering from childbirth, or a postmenopausal woman experiencing changes in pelvic floor function, prioritising pelvic floor health can have significant benefits.
(Dr. Ashwini Anil Kumar Sirapanasetty is Obstetrics and Gynaecologist Surgeon)
