Let’s talk about the pelvic floor. Pelvic floor dysfunction, incontinence and prolapse effect millions of women in the UK. Although in the majority of cases women are effected, men also have a pelvic floor which can be impacted by imbalance, dysfunction and incontinence.
In fact statistics indicate that “Pelvic organ prolapse is common, and some degree of prolapse is seen in 50% of parous women.” (‘parous’ meaning women who have given birth) 
The pelvis houses an important group of muscles which is referred to as the pelvic floor. “The pelvic floor muscles provide foundational support for the intestines and bladder. They also help the anus function. In women, these muscles help push a baby through the vaginal opening during childbirth and support the uterus. These muscles are located on the inner portion of the pelvic bones.” 
The muscles of the pelvic floor are essential for correct function of the pelvis and lower back, are critical for posture and they support internal organs such as the bladder, intestines, rectum and in women the uterus etc
Primary issues that many women face due to dysfunction (often due to childbirth) are urinary stress incontinence, rectal incontinence, and prolapse. A pelvic organ prolapse is bulging of one or more of the pelvic organs into the vagina. These organs are the uterus, vagina, bowel and bladder. A prolapse can occur due to injury or poor tone in the muscle fibres. 
Research is ongoing concerning the pelvic floor area, but often it is thought that dysfunction can occur through childbirth, trauma, obesity, pelvic surgery, nerve damage and injury. 
There are exercises and self management techniques that can strengthen and tone the pelvic floor offering more stability, however it is essential to seek appropriate medical advice and diagnosis from GP or specialist if any of the following symptoms are present including urine leakage or urgency, constipation, bowel strains, discomfort during sexual intercourse, pressure in the pelvis and rectum region or muscle spasms in the pelvis.  *
It may be that injury and weakening of the pelvic floor muscles causes the above health issues but these muscles can also become too tight/active due to over exercise or emotional factors and some people may find it difficult to relax this area which can also cause problems with the bladder/bowel and can be a cause of lower back pain etc. Either way it is supportive and wise to become more familiar with the pelvis and how to exercise this area to support the back and posture as well as maintaining adequate support for the internal organs such as the bowel, rectum, vagina and bladder.
The symptoms can increase over time and it is important to have an assessment by a qualified health professional if there are any symptoms. We do not need to necessarily live with incontinence and pain and there maybe support out there and it is well worth looking into all the treatment options. It is also worth considering preventive exercises and self-care techniques concerning the pelvic floor.
So what can you do for your general wellbeing and pelvic health?
You can become familiar with your pelvis and pelvic floor area. This may not be an area of the body we usually pay much attention to. We may not be particularly conscious of how our body feels generally or in specific areas and becoming more familiar with your pelvic area, through body awareness exercise and implementing a simple pelvic floor exercise programme can be a great preventative maintenance programme. You can learn to not only strengthen your pelvic floor area but also relax it, picking up on whether is is overly tense or loose, this can also be supported through breathing and body awareness exercises.
Breath & Body Awareness Exercise:
Prepare a space to lie down that warm, comfortable and quiet. Make sure that your body is completely supported, by using pillows and blankets required. This will make it much easier to relax and focus. Settle your whole body down in lying position, arms open, by the sides of your body and allow your whole body to rest and relax. As you breathe gently in and out of your nose release any tension in your whole body.
Focus your awareness on the pelvic area. You can do this initially by focusing your mind’s attention on your pelvis. Think of the pelvic floor as a sling or basin that sits at the bottom of your pelvis or in the area in front of your bottom. As you breathe and focus you will gradually become more aware of this area and how it is feeling.
Does it feel tight and clenched? Or loose and floppy? Can you easily feel where it is or does it feel a bit empty down there? Feel any areas where you are holding tension, or whether you feel disconnected from this area or perhaps emotions and distractions come up as you observe.
If it helps lay your hands over your pelvic bones from your hips just below your belly button and feel your breath move into the pelvis. If you are finding it difficult to relax your pelvic floor it can sometimes be useful to focus on relaxing your tummy muscles as this often supports the pelvic floor to relax.
Keep relaxing with every out breath and keep connecting more and more with your pelvis and the pelvic floor. Just starting to get a sense of the pelvic floor area and how it feels can be very supportive. The more we are aware of our body in all areas the more responsive we can be as to how best we can support it. You can continue this practice with the pelvic floor but also other areas of the body, until you begin to build a deeper connection and responsive relationship with your body.
Where do you go from here?
Even if you do not have any major symptoms it may be useful to make your pelvic floor and its maintenance part of your everyday self-care plan.
If you would like to discuss the potential for remedial massage, physiotherapy, exercise programmes and home care advice concerning posture and pelvic floor balance, please give us a call as we can advise.
If required Andrew Mooney and Michelle Harford our physiotherapists can support with a pelvic floor programme or refer you on for further medical investigation /advice if required. Our treatments work in partnership with specialist medical care and we offer general advice concerning health and wellbeing.
You will find our clinic Inside Out Health & Wellbeing in Wadebridge, North Cornwall.
*Seek appropriate medical advice from your GP