A Deeper Dive into the Wonder Down Under Understanding the Pelvic Floor

Many women become acquainted with terms like Kegels and pelvic floor during pregnancy or after childbirth, often in an effort to prevent issues such as urinary incontinence as they age. However, the significance of the pelvic floor in women's health extends far beyond these specific life stages, accompanying them through every phase of life. The pelvic floor serves as a cornerstone of wellness, providing support and balance, yet it can also be affected by the emotional and physical challenges that women encounter throughout their lifespan. By fostering an understanding and connection to this remarkable part of the female body, many of the issues associated with fear, shame and pain can be addressed to ultimately restore balance.

The pelvic floor encompasses a multitude of functions, but let's begin by identifying its location. It consists of a group of muscles situated at the base of the pelvic bones, akin to a hammock between the abdomen and the legs. Unlike muscles that are easily palpable externally, the pelvic floor muscles are internal, making them challenging to visualise and pinpoint. However, this internal structure provides crucial support to the base of the trunk, playing a vital biomechanical role in the loading and offloading of the lower back, hips and upper body. Additionally, as the foundation of the core muscles, the pelvic floor contributes significantly to balance, posture and the transmission of pressure through the trunk during movement and breathing. Like other muscles, it contracts and relaxes dynamically, akin to a bicep or quadricep. A simple way to conceptualise its location is to place your hand between your legs, over the genital area, while sitting down – that's essentially your pelvic floor.

One of the remarkable aspects of the pelvic floor is its role as the foundation for three essential organs within the pelvic cavity: the bladder at the front, the uterus in the middle and the rectum at the back. It supports functions such as continence, correct voiding, sexual function, childbirth, menstruation and even emotional stability.

Given the multitude of tasks it performs, certain symptoms may indicate that the pelvic floor requires attention. These symptoms often arise when the muscles are either overworked or underactive, resulting in weakness, limited mobility and discomfort.

Common issues include:

• Urinary leakage when coughing, sneezing or running
• Chronic constipation or faecal incontinence
• Tailbone pain while sitting
• Persistent hip, lower back or pelvic pain
• Pelvic pain during pregnancy
• Discomfort or pain during tampon insertion or sexual intercourse
• Sensation of heaviness or dragging in the anus or vagina

It's crucial to emphasise that these symptoms can occur at any stage of a woman's life and are not limited to pregnancy or menopause. Pelvic floor dysfunction can arise from various factors, including pregnancy, injury, poor biomechanics and emotional or physical trauma.

The good news is that there are numerous interventions available to promote healing and rehabilitation, extending beyond simple Kegel exercises. Begin by educating yourself about the body and understanding the underlying issues. Working with a physiotherapist specialising in women's health can be immensely beneficial. Much like addressing any other muscular dysfunction, physiotherapy can alleviate pain and enhance function. Pelvic physiotherapists can provide guidance on understanding bodily functions, gaining control and facilitating healing. And yes, Kegels are part of the equation – but it's crucial to perform them correctly, focusing not on stopping urination but on controlling the pelvic floor muscles, like when controlling the release of wind.

I often liken the pelvic floor to an untapped superpower for women. So why not unlock yours?

ABOUT THE AUTHOR

Kirsten Nel is a physiotherapist with a special interest in women’s and pelvic health. Visit www.andherphysio.co.za or follow @and.her.physiotherapy for more.