I have pelvic floor issues, but I haven’t had a baby?
When we talk about pelvic floor issues or dysfunction – this covers wide topics including incontinence, prolapse and pain. These topics can happen on their own or in conjunction with each other and affect each other. This blog is going to focus on incontinence and prolapse in regards to women who are having issues – but haven’t yet had babies. Unfortunately, falling pregnant and having a baby isn’t the only path that can lead to pelvic floor dysfunction.
Have you ever been doing a body attack class and felt leaking of urine and totally freaked out? Have you ever upped your weight in the clean and press and then felt “funny” or a bulge down there. These are signs of pelvic floor dysfunction – and they are signs that your pelvic floor muscles are unable to handle the load that you are placing on them.
When we do exercises, or lift things, or push a trolley (all sorts of life activities), we create intra-abdominal pressure. This pressure changes depending on how heavy or difficult the activity is. Higher difficulty exercise = higher intra-abdominal pressure. The structures that control this pressure include our diaphragm, pelvic floor, transverse abdominus muscles and multifidus muscles (in the lower back). Depending on the strength and coordination of these muscles, some people can control the pressure of a really difficult exercise (eg women in the olympics performing a snatch) really well. If there is less strength or co-ordination, some people can notice issues at much lower pressures (eg bending down to pick something up off the floor like a pen).Higher difficulty exercise = higher intra-abdominal pressure. #performbetter @pogophysio Click To Tweet
There are some factors that can put you at risk of pelvic floor dysfuction. These factors are not related to being pregnant or giving birth so we call them non-obstetric risk factors. These include:
- Chronic cough
- High impact exercise
If you are constipated and have to force a bowel motion, this puts a pressure downward on your pelvic floor muscles and ligaments. If this is a consistent thing for you, there are multiple times per day/week that you are putting that downward pressure on your pelvic floor. Multiple this over weeks/years for some people and that is increased strain on your ligaments.
A higher BMI/weight means there is a heavier pressure on your pelvic floor muscles and ligaments at all times that you are standing, walking, sitting. Weight loss and lowering your BMI can be a great way to reduce some pressure on your pelvic floor if you are overweight.
Coughing increases intra-abdominal pressure. People who have chronic cough includes those with asthma, chronic bronchitis, cystic fibrosis and more. Smokers can also have a chronic cough. The frequent increases in intra-abdominal pressure force a pressure downwards on the pelvic floor.
High impact exercise
Exercise that include heavy lifting eg weight lifting and crossfit or sports with high impact landing eg gymnastics can put high pressure loads on your pelvic floor. Especially if you are holding your breath or fatigued.
How can you manage the above symptoms
See you GP or dietician
- Your GP can give you medication to help with constipation
- a dietician can look at your diet
See a physiotherapist
- Your physiotherapist with a special interest in pelvic floor can perform an assessment to check for prolapse
- Your physiotherapist can go through the risk factors for prolapse with you and show you ways you can reduce these in your every day life
- Your physiotherapist can give you specific exercises for your pelvic floor depending on your goals
Emily Georgopolous (APAM)
Featured in the Top 50 Physical Therapy Blog
Click here to book an appointment with Emily.