If I told you it is possible to move your tailbone by contracting your pelvic muscles, would you believe me? Indeed, not many people know about the existence of these muscles in the pelvis called “the pelvic floor.” To contract your pelvic floor, imagine picking up a ping pong ball with your anus (or with your vagina if you are a woman) and draw it up towards your nose. Now, release the ball and bring it back down onto the chair. Did you feel the muscles around your anus and/or vagina contracting and releasing? In theory, if you do it right, no one should be able to tell, by looking at you, that you are contracting your pelvic floor. Your legs and buttocks should stay relaxed and you should keep breathing normally as you contract.
So … sorry, but why are we talking about this?
Well, because it turns out that a healthy pelvic floor is quite a handy thing to have. As a matter of fact, it plays an essential role in keeping you dry. When it contracts, it closes the urethral and anal sphincters, allowing you to hold urine and feces until you can find a bathroom. When it releases, it allows you to urinate and have a bowel movement. Not only that, but the pelvic floor also contributes to your lower-back and pelvic stability, it supports your bladder, rectum, prostate and uterus, and it is involved in orgasm. In summary, we should clearly have a moment of gratitude for our pelvic floor, right now!
But what happens when these muscles do not work properly?
Due to their involvement in so many body functions, a variety of symptoms can occur. You may start losing urine or stool when you do not want to, for example. You may experience pelvic or low-back pain, or feel like “something is falling out” through your vagina or anus.
Urinary issues could occur, such as urgency (a strong feeling that you should urinate right now), frequency (urinating more than five to seven times a day, which is the normal frequency), pain with urination, or inability to fully empty your bladder. In regards to sexual function, people with pelvic floor disorders may report pain with intercourse or with orgasm. And do not think these issues only happen to older people! Indeed, pelvic-floor disorders can be experienced by any gender, at any age.
Okay, okay, I get it Sophie! It sounds like pelvic health is a thing, and I should do something to prevent these not-looking-so-fun symptoms … but how?
1. Maintain a healthy weight
I know, I know, this is getting old. However, maintaining a healthy weight is not only good for your general health, but also for your pelvic floor. As we saw, these muscles are literally the “floor” of everything over your hips. for every pound we put on, our pelvic floor has to carry it every day. Over time, we can easily imagine that this extra load can wear our pelvic muscles out, leading to symptoms.
2. Maintain good bladder habits
Avoid going to the washroom “just in case.” As a pelvic health physiotherapist, I often have clients consulting for overactive bladder issues (frequent urination). The first thing they say is, “I have always had a small bladder.”
The truth is, most of the time, people develop a small bladder capacity from bad bladder habits. If you always go to the bathroom “just in case” and you do not wait for your bladder to send you a signal, you are basically training your bladder to never stretch completely. Over the years, the bladder gets smaller and smaller. Leaving for work or going for errands? Avoid visiting the washroom before leaving; instead, wait for your bladder to send you a signal.
Obviously, this is just one part of the equation. Other factors may contribute to overactive bladders, such as pelvic-floor tension, presence of bladder irritants in the diet, etc. Consult with a professional for proper guidance on how to treat your symptoms.
3. Avoid constipation
As pelvic health physiotherapists, chronic constipation is definitely a beast that we want our patients to fight if they present with pelvic-floor disorders. By having feces accumulating in the rectum for an extended period of time, the rectum may become looser and loses its sensitivity. When the sensitivity is lost, no signal is sent to the brain that you should go for a bowel movement, and fecal incontinence may occur. In women, constipation and straining on the toilet could cause a pelvic-organ prolapse, a condition where the bladder, uterus or rectum descends into the vagina and can trigger symptoms like vaginal heaviness and incontinence.
Things you can do …
Do not postpone your bowel movement when you get a signal that you should go. By postponing, feces get harder and harder, as the rectum extracts the water from your stool.
Try and increase your water intake. If you are not a fan of straight water, be creative and eat more fruit with high water content, or add some flavour to your water to make it tastier.
Squat to poop! Squatting during bowel movements releases the pubo-rectalis muscle around the rectum, allowing a smooth and effective bowel movement without straining. Haven’t you noticed how easy it is to poop when you are out in the backcountry? Meanwhile, for your in-town days, use a stool under your feet to keep your knees higher than your hips. I strongly encourage you to watch the “Squatty Potty” video on YouTube for a good laugh and an educational experience. The Squatty Potty can be purchased at Canadian Tire.
4. Practice contracting and releasing your pelvic floor.
Ten to 12 pelvic-floor contractions a day help keep the pelvic health physio away! However, make sure you do it right and you release the pelvic floor properly after contracting it. Otherwise, you may develop pelvic floor tensions which can lead to pelvic floor symptoms. In doubt or if you have any symptoms, consult with a pelvic health physiotherapist.
Now that you know the basics about the pelvic floor, I challenge you to share this new knowledge at your next potluck! But I’m warning you … you may get awkward looks or be tagged as a weirdo (personal experience talking here). But hey … pelvic health is a thing, and it should be talked about! You never know who you could help.
About the Author: Sophie Villeneuve is a registered pelvic health physiotherapist in the Yukon and the owner of Physio Borealis, a physiotherapy clinic strictly focused on pelvic health. Passionate about teaching, Sophie offers education workshops, on rotation, about various topics related to pelvic health. You can find more on her website,
www.physioborealis.com.
