Toning your pelvic floor WELCOME
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1 Toning your pelvic floor WELCOME
2 Introductions Amelia Samuels, Physiotherapist, Active Rehabilitation Physiotherapy Supporting the Continence Foundation of Australia
3 Continence Foundation of Australia National peak body promoting bladder and bowel health
4 Today we will cover: What is your pelvic floor? Conditions related to your pelvic floor Looking after your pelvic floor Healthy bladder and bowel habits Where to get help
5 What Is The Pelvic Floor? The pelvic floor is a collection of muscles, nerves, blood vessels and fascia (support tissue) in the base of the pelvis The pelvic floor is the base of the group of muscles referred to as your core
6 The Pelvic Floor
7 The Pelvic Floor A Bird s Eye View
8
9 What does it do? Helps support the pelvic organs including bladder, bowel & uterus Forms part of the core of muscles needed for low back and pelvic stability Resists downwards pressure inside your abdomen during activities. eg. Cough, sneeze, lift, strong exercise
10 What does it do? Important for bladder and bowel control Supportive role during pregnancy Helps sexual sensation and orgasm
11 AGES AND STAGES OF THE PELVIC FLOOR
12 Ageing and The Pelvic Floor Further weakening of the muscles Chronic health conditions Diabetes Arthritis Heart disease Respiratory disease
13 Men and the Pelvic Floor Sport Work Weight gain Weakening of muscles In older age Prostate surgery Chronic health problems
14 Menopause and The Pelvic Floor Hormones: Oestrogen Weight gain Around the waist
15
16 Signs of Pelvic Floor Problems Accidentally leaking urine eg. when you laugh, cough, sneeze or exercise Having to hurry to the toilet or not making it there in time Constantly needing to go to the toilet Difficulty emptying your bowel or bladder Accidentally losing control of your bladder or bowel
17 Signs of Pelvic Floor Problems Accidentally passing wind Pelvic organ prolapse a bulge in the vagina a feeling of heaviness, discomfort, pulling, dragging or dropping Pain in your pelvic area Painful sex Poor sensation or leaking during sex
18 Conditions related to PF dysfunction Urinary incontinence Faecal incontinence Prolapse
19 Urinary Incontinence Stress incontinence = leakage during tasks with increased force Urge incontinence = the inability to hold with the need to void Mixed = a combination of both As we age, it seems to be a combination of factors that add up to incontinence rather than a clear single event
20 Stress Incontinence Inadequate closing pressure Urethral atrophy Weak or absent pelvic floor response
21 Urge Incontinence I need to go to the toilet...now! I can t hold on I know where every toilet is in.. I leak before I get to the toilet
22 Faecal Incontinence Can be more complex and worth medical investigation The gut system has its own nervous system and is therefore very complex It is possible to be constipated and have incontinence at the same time sneaky poos! A large amount of people need to learn how to pass without incorrect straining
23 Sneaky Poos = Overflow Incontinence
24 Pelvic Organ Prolapse Descent of intrapelvic organs such as the uterus, bladder, urethra and rectum due to deficiencies in the pelvic support system Often asymptomatic and develops over time Early symptoms: heaviness or weight in the vagina or rectum, changes to voiding, back or abdominal pain, obstructive constipation Incidence has been reported as high as 39.8%
25 Risk Factors for Prolapse Constipation Childbearing with increasing risk with multiple births Heavy lifting Repetitive lifting Poor pelvic floor control during high impact exercise Obesity Menopause Smoking Oestrogen Deficiencies Chronic coughing Prior surgery Collagen abnormalities and Myopathies
26 What do people do? To cope with incontinence, people tend to... Avoid aggravating activities decrease exercise Go frequently before activity and just-in-case Wear pads Don t drink enough Plan activity around toilet stops Stay at home Live in denial
27 Making Changes For the Better To prevent or improve bladder and bowel problems Develop healthy habits to stay in control Look after you pelvic floor Seek help
28 Healthy Habits to Stay In Control
29 Healthy Habit 1 Drink well To prevent bladder irritation & constipation
30 Healthy Habit 2 Eat well To keep your bowels regular To have a healthy body weight
31 Healthy Habit 3 Exercise Regularly To have a healthy body weight To prevent constipation
32 Healthy Habit 4 Practice good toilet habits To keep your bladder under your control To prevent constipation To protect your pelvic floor
33 Healthy Habit 5 Look after your pelvic floor To keep it strong for good bladder and bowel control
34 Looking after the pelvic floor Protection reduce the risk factors healthy bladder and bowel habits Activity exercise the pelvic floor muscles correctly use the pelvic floor during activities make sure your activity is not damaging your pelvic floor rehabilitation where needed
35 We need our pelvic floor muscles to: Support our pelvic organs against the pressure and load generated by activity Respond quickly and strongly Relax fully
36 Why do we need to do pelvic floor muscle exercises? Build awareness and co-ordination Brain finds your muscle Ability to isolate pelvic floor muscle Increase muscle tone and bulk Improves the speed of response
37 Where is YOUR pelvic floor? PUBIC BONE Imagine a diamond SIT BONE SIT BONE Sit up tall TAIL BONE Lean forward, hands on your knees Feel this diamond underneath you
38 Pelvic floor muscle exercises: Time to try! Pelvic floor contraction= Squeeze around bladder, vagina, and anus Lift inside, up higher into the pelvis
39 Pelvic floor muscle exercises: Men Pelvic floor contraction= Squeeze around anus Lift testicles, up higher into the pelvis Retract or shorten penis
40 Pelvic floor muscle exercises: Time to try! Use your imagination! Concentrate! Cues: Squeeze and lift Tighten and pull up Hold wind and urine at the same time
41 Pelvic floor muscle exercises: Time to try! Imagery: Elevator Picking up a silk scarf Zip Pea
42 Pelvic floor muscle exercises Isolation is the key to success Are your buttocks and thighs relaxed? Are you drawing in above your belly button? Are you holding your breath? Are you completely letting go?
43 The pelvic floor and the core
44 What is the correct amount? How strong? How long? How many? AIM = Muscle fatigue! How long can you hold the contraction for? How many repetitions can you do?
45 Seek further help if you are: Not sure if contracting your pelvic floor correctly Experiencing bladder or bowel problems Feeling a sensation of bulging, heaviness or fullness in the vagina Practicing pelvic floor exercises with no noticeable improvement for more than 6 weeks
46 If you are having trouble: National Continence Helpline Public sector: Continence Services (multidisciplinary) Private sector o Continence and Women s Health Physiotherapists
47 Other resources National Public Toilet Map Health Promotion Officer free community education session
48 QUESTIONS?
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