Regardless of age or whether or not she has a baby, all women should know their pelvic floor. Athlete and coach The hole Baz moffat answers some frequently asked need-to-know questions
When elite athlete and mother of two Baz Moffat decided to become a women’s health coach at age 38, she felt embarrassed that she didn’t know what the pelvic floor was or what it was supposed to do.
He vaguely knew he was in the lower area, like most of us, but that was it.
That’s why Healthista caught up with Baz and asked him some frequently asked questions about the pelvic floor …
The pelvic floor (FP) is a group of muscles and ligaments that attach within your pelvis, suspended like a hammock, connecting your pubic bone in the front and your coccyx in the back. Essentially, your PF is there to keep your guts from falling out!
Your PF is there to keep your guts from falling out!
It is quite simple but ridiculously complex at the same time, mainly because it is such a private, sensitive and vulnerable part of a woman.
This is all we need to know: Women’s health physiotherapists and gynecologists need to know a lot more about pelvic floor anatomy, but for everyone else it is enough.
What should I do?
Like all muscles, the FP must be able to contract and relax and it must have a good range of motion.
This is a key point because most of all what you hear about the pelvic floor if they have a problem with it is that they have to do “more work”, but that’s just an oversimplification.
Like any part of the body that does not function as it should, the solution is rarely ready-to-use or standardized. The athletic pelvic floor is no different.
Your pelvic floor should be able to:
Let it all fall – If you didn’t have a pelvic floor, your bowel, bladder, bowel, and uterus would be on the floor. This sounds basic, but it’s really that simple – the pelvic floor is there to support everything.
Keep you dry – Your pelvic floor must be able to prevent urine, gas or stool from leaking. Which means that if you’re playing impact sports, like netball, sprints, or trampoline, your pelvic floor should be much stronger than for someone who does a little gymnastics or whose exercise choice is walking.
We know that female athletes have much higher rates of urinary incontinence (they cannot hold their urine). Although it is annoying, not enough is known about why.
Relax in the bathroom – your pelvic floor should be able to relax enough when on the toilet so that you can completely empty your bladder and bowels (more on this later).
How does it work?
Ten years ago, the language surrounding the pelvic floor was about grasping, squeezing and holding and having stability, which implied that if female athletes were not stable, they were unstable, which is not a useful phrase.
We now know that the optimal state for the nucleus is to be coordinated and balanced and not to be statically strong.
It is designed to move with your breath and resist pressure from above.
The PF is a fundamental part of this balanced core, it must be as strong, mobile and coordinated as the rest of the unit. It is also important to note that the pelvic floor is not designed to stay in for a long time.
You cannot go for a run and maintain your FP at all times. You can’t do a vinyasa flow sequence and keep your PF high, it just doesn’t work like that.
It is designed to move with your breath and resist pressure from above (laughing, coughing, sneezing, holding your breath) and from below (running, jumping).
A balanced core
The pelvic floor works with your deep core, coordinating with your back, abdominal muscles, and diaphragm. They all work in harmony, making for a dynamically strong core.
Let’s start with the pelvic floor and diaphragm connection first. They are both dome-shaped muscles and must work together most of the time.
If you are doing very heavy lifts or jumps that require you to hold your breath, then you use your core very differently, but the rest of the time your diaphragm and pelvic floor must work together.
The diaphragm drops, allowing the lungs to fill with air, which makes perfect sense, and if you take a couple of conscious breaths now, you will feel it.
It is what we call a balanced core: everything works together.
Inhale: the lungs fill and the diaphragm has fallen out. The pelvic floor will also relax as the internal organs move slightly downward; you don’t make an effort to do this, it should just be happening.
As you exhale, the diaphragm begins to rise, expelling the air from the lungs and the pelvic floor accompanies it, a little. It contracts at the same level as the diaphragm.
This is how the deep core should work most of the time. It is what we call a balanced core: everything works together. It is a piston that moves up and down, inhale down, exhale and lift.
And now that we know our entire system is connected, it should come as no surprise that the other muscles in your core get involved as well, including the trans abs (transverse abdominis, the formal name) and the deep back muscles.
the other muscles in your core get involved as well, including your trans abs.
As we inhale, our tummy should be nice, smooth, and relaxed, and it should expand slightly, along with the lower back. (These are all really subtle movements that you won’t notice unless you focus your attention on them.)
The piston has moved down. And when we begin to exhale, the diaphragm and FP rise and the lower back and abs contract slightly – they don’t grab, hold, or crunch, they just contract and support our core. This is what we call dynamic support.
What are the symptoms that your pelvic floor may not work as well?
Getting wet, back pain, painful sex, struggling to insert or hold tampons, feeling of heaviness, pelvic pain, inability to control the wind, and bowel incontinence – quite a daunting list.
It takes women seven years, on average, to talk to their GP if they have some of these symptoms.
Women take seven years, on average, to talk to their GP if they are suffering
My advice is to see your GP sooner rather than later. Some women may be concerned about the surgery option, but don’t worry, there is no way you should discuss the surgery option without first trying more conservative approaches such as physical therapy with a women’s health professional.
These things can be difficult to talk about, so if you think you are going to bottle it up, write down your concerns, be as specific as possible, and give it to your GP.
I just drip a little and only when I’m running, can’t I just ignore this?
No, you cannot ignore this. Well you can, but our advice is that you shouldn’t. Leaks are a sign that your body is not effectively handling what it is asking it to do.
Unfortunately, unlike our teeth, we cannot replace our pelvic floor, so we need it to last as long as possible and the sooner the better, although it is never too late.
Is there a quick fix besides pelvic floor exercises?
Sorry no. You will find many products and procedures that claim to be “the solution,” but there is no magic formula when it comes to your pelvic floor.
It does many fundamental things and needs our daily attention.
How often do I need to do my exercises and how do I do them?
If you have no problems, once a day every day is a good place to start.
Use the NHS Squeezy app and make sure you have a starter guide on how to do your exercises correctly, whether it’s from a women’s health practitioner, a trained trainer, or a Pilates teacher who can guide you.
Do men have FP?
Yes, they sure do. But they don’t have a vagina, no babies, or go through menopause, all of which make the female pelvic floor a bit more susceptible to “trouble.”
Baz moffat it is The Well Trainer, providing support for women’s health, well-being and performance based on the science of the female body.
Twitter: @thewellhq / Instagram: @thewell_hq
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