The pelvic floor, consisting of muscles and ligaments at the base of the pelvis from the pubic bone to the coccyx, supports the bladder, bowel, and uterus. Experts state that daily maintenance of pelvic floor health is important for all genders and ages. Shan Morrison, a specialist physiotherapist, noted that 10% of men experience persistent pelvic pain.
Key Strategies for Pelvic Floor Health
Muscle Engagement and Relaxation
Strengthening involves locating and engaging the pelvic floor muscles. For women, this involves a two-part movement: a squeeze at the front (as if holding urine) and an anal squeeze (feeling like a lift). For men, the cue is to lift the testicles. Experts recommend 10 repetitions of 5-10 second holds.
Relaxation is also crucial. Angela James, a principal physiotherapist, cautions against constant clenching or over-engaging core muscles, which can lead to excessive tension and pain in the abdominal wall and pelvic floor.
"The Knack" Technique
Lisa Birmingham, a senior physiotherapist, suggests "the knack," which involves bracing pelvic floor muscles immediately before actions that increase abdominal pressure, such as coughing, sneezing, or laughing. This habit can be built by associating it with existing daily routines, like performing a hold when standing up after using the toilet.
Toilet Routine Practices
Daily toilet habits significantly affect pelvic floor function. Constipation and subsequent straining can weaken pelvic muscles over time. Resisting the urge to defecate can also cause constipation. Using a footstool during bowel movements can help mimic a natural squatting position and reduce straining. It is also advised to avoid going to the toilet "just in case."
Diet and Hydration
Dietary intake influences bowel and urinary function. Recommended daily intake includes five servings of vegetables, two servings of fruit, and at least a third of a cup of lentils or chickpeas for fiber. Chia seeds, berries, and flaxseeds are suggested for gut health. Regular fluid intake is also vital for optimal stool and bladder movements.
Movement and Exercise
Prolonged stillness is detrimental to pelvic floor muscles, which benefit from movement. Simple changes like taking stairs, getting off public transport early, and regularly changing sitting positions are recommended. A balanced movement regimen, including cardio, stretching, and strengthening, is advised. Heavy weight lifting is not reported to worsen symptoms like leakage or prolapse; it may increase strength in the area, even for individuals over 30.
Belly Breathing
Shallow chest breathing can affect pelvic floor function and increase body tension. Diaphragmatic (belly) breathing calms the nervous system, reduces muscle tension, and promotes healthy pelvic floor movement. Practicing slow, deep breathing into the belly, especially during stress, can make it a default pattern.
When to Seek Professional Help
Pelvic pain, whether internal or external and located between the navel and thighs, is not considered normal. Early intervention for pelvic pain or conditions like endometriosis is more effective than delaying care. For symptoms such as leakage or pain, consulting a specialized physiotherapist is recommended. Internal exams are not mandatory if a patient is uncomfortable.