Pelvic Floor Muscles - A topic for EVERYONE!

As a doula I like to attend as many secessions and classes possible so I have the most up-to-date information for my clients. A while ago the Women's Health Clinic (WHC), which operates out of Winnipeg's new birthing centre, offered a class on pelvic floor muscle (PFM) health. PMF is a huge topic in the birthing world so I was most definitely there. A large part of the class was a refresher for me but there were also many new things I learnt. Most moms and moms-to-be have lots of questions on this topic so I thought I would share some information with those who care to learn.  Although, as it turns out, it is not only mams and preggos that should be learning about PMF, this is a topic that affects EVERYONE. Yes, that means you too gentlemen.

All the information that follows comes from my doula training and the information presented at the PFM health class provided by the Women's Health Clinic (WHC) and their informational brochures and handouts. Much of this information can be found on their site www.womenshealthclinic.org. More great information can also be found here www.pelvichealthsolutions.ca 
This information should not be used to replace a visit with your health care provider.

What are the PFM? The PFM are muscles that originate from the tailbone and insert onto the pubic bone forming a sling that fills the bowl of the pelvis. These muscles not only create a muscular hammock but they also form an intricate network that weaves around and throughout the pelvic organs. The PFM serve five major functions which include supporting the pelvic organs (bladder, uterus, vagina, rectum), they also act as the sphincters to control the passage of urine, stool and gas. The PFM assists in respiration through interactions with the diaphragm while also working with the abdominal and core muscles to help stabilize the trunk and spine to improve posture. As if that wasn't enough, the PFM play a significant roll in sexual function and enhanced pleasure. How does that grab ya?!


There are two types of PFM dysfunction: Hypotonicity (Weak pelvic floor muscles) which can contribute to stress incontinence (aka: peeing yourself when you cough, sneeze, run or jump ect.), urge incontinence (feeling like you need to go all the time) both of which are NOT a normal part of aging, pelvic organ prolapse (yes, this can happen), uncontrollable passing of gas or stool (you know who you are), and a feeling of pelvis/sacroiliac instability. Conversely, Hypertonicity (Tight pelvic floor muscles) contributes to urinary and fecal urgency, urge Incontinence, chronic pelvic pain, constipation, dyspareunia, vaginismus, vulvodynia, pudendal neuralgia, interstitial cystitis and chronic prostatits. Both weak or overly tight PF muscles can also cause hip, pelvic or low back pain and stiffness or fatigue. 

One of the most shocking things I learnt in this class was the population percentage of those with some form of PFM dysfunction. 96% of the population is affected by at least one aspect of PFM dysfunction and 87% show 2 or more symptoms! That is nearly every one! 

Causes of unhealthy PF muscles are plenty. Many things can lead to either weak or tight PF muscles like pregnancy and childbirth, hormonal changes (as in menopause), chronic constipation and straining, chronic coughing (like smokers cough), surgery, recurring UTIs, poor posture, excess weight and lack of exercise are but a few. Some PFM dysfunction symptoms like urge incontinence are made worse by consuming food/drinks that cause irritation to the bladder. For example, the following list worsen symptoms in most people: Coffee, caffeinated tea and sodas (some medications also contain caffeine), alcohol, chocolate and smoking. Some people's symptoms also worsen with the consumption of the following: acidic foods (including tomato and tomato products), citrus fruits and juices, artificial sweeteners, spicy foods, milk and milk products, sugar and honey for some, corn syrup and cranberry juice. I know this last one seems weird considering that cranberry is used to cleanse the kidneys and is good for bladder infections, but it is best to consume cranberry extract. Also, concentrated urine (which happens when we don't drink enough fluids - which most people don't) can irritate the bladder and result in greater symptoms of urgency and frequency. Further, I personally know many of you out there who refuse to use the bathroom anywhere but in the comfort of your own home or, when forced to use a public washroom, hover over the toilet seat in order to avoid any contact with said toilet. Both of these actions (or lack of action I should say) can also wreak havoc on those oh so important PF muscles. Holding in your pee or bowel movement regularly can cause PFM issues while hovering counteracts what you are trying to do by tightening everything up instead of releasing. Also, terrifyingly, propylene glycol and other chemicals found in many soaps, shampoos, perfumes ect, can weaken the muscles which absorb these chemical through your skin. Gross!!     

Fortunately, most PFM disorders can be corrected although it may take time and work. Whenever the topic of PFM comes out the first thought is usually 'kegels' or PF exercises (I'll let you look up how to do kegels). Although these are extremely important and crucial in strengthening PF muscles they may not be the answer to all forms of PFM dysfunctions or symptoms. For those with symptoms caused by tight PFM, Kegels would be the last thing you would want to do. It is important to maintain a balance of taught and firm pelvic floor muscles without being overly tight or too weak. Thankfully there is PF physiotherapy available for those who need it. The Incontinence & Pelvic Pain Clinic (IPPC), a division of the Nova Physiotherapy & Sports Fitness Clinic, is run out of the medical arts building and specializes in PFM therapy. Another local physiotherapist that specializes in PFM is Donna Sarna. Also, the WHC has a pelvic pain nurse, Lynn Crocker-Loat who helps women with pelvic issues.

So please be kind to these muscles that serve so many purposes. Keep healthy, drink lots of water, eat well, exercise, do go to the bathroom once when you feel the need and don't hold it forever. Just sit on that dang toilet seat (you can clean it first if you so desire) instead of hovering and try not to strain so much. Do exercise your PFM if they are not overly tight and do see a physiotherapist if you are experiencing unwanted symptoms (you don't have to live with them!). 

Thank you for visiting and taking the time to read! Please leave comments and tips for other readers if you so feel the urge.   

Happy Summer Guys!!