The mystery of the pelvic floor

It exists and as long as it does not cause problems, it is tolerated: The pelvic floor. Instead of laughing about the old exercises, we should rather deal with this muscle group so that it stays fit and so that neither sports nor good sex stand in the way of well-being in one’s own body and a good portion of self-confidence.

Pelvic Floor ABC

Treatment & Training

In principle, a distinction is made between two types of treatment:

External: In individual sessions, the external pelvic floor is treated directly. The therapist works with her hands mainly on the outer muscles, which can be felt around the ischial tuberosities.

Internal: These are internal therapies, where the specialist treats the pelvic floor inside the vagina itself. This technique allows the therapist to directly palpate the internal part of the pelvic floor and release tension or activate muscles that cannot be palpated from the outside.

In case of pelvic floor disorders, this treatment approach is very efficient, because not only tissue disorders are removed, but also pelvic floor awareness is greatly improved.

Additional training like classical pelvic floor exercises increases the efficiency of the treatment as the exercises are performed by the woman with improved pelvic perception. Pelvic floor trainers such as elvie or Smart Ball UNO can be used in addition.

Bladder problems

Stress incontinence is the involuntary leakage of urine when coughing, sneezing, laughing, running, jumping. Drops are enough! Urge incontinence is when you experience a sudden intense urge to urinate, followed by involuntary voiding that can be difficult to control. Irritable bladder, on the other hand, exists when there is a sudden strong urge to urinate that can be controlled, but there is often not much urine in the bladder. In many cases, however, mixed incontinence occurs.

Hormones

In the second half of the cycle, as well as with menopause, many women experience pelvic floor weakness. This is due, among other things, to the decrease in estrogen, which leads to tissue weakness as well as tissue loss. If this is accompanied by organ prolapse or heavy bleeding, the pelvic floor is severely stressed.

Menopause

With increasing age, the sex hormone estrogen decreases and the so-called menopause occurs. This hormonal change leads not only to sleep disturbances, hot flashes and depressive moods, but also to connective tissue weakness and a decrease in muscle volume. This change leads to increased organ prolapse, continence problems due to weaker muscles, and pain during sexual intercourse.

What can you do? Keep your pelvic floor healthy. A healthy pelvic floor can contract and relax well. If this is the case, its activity promotes blood circulation. This in turn promises a better supply of blood to the tissues. Here the circle closes, because you can tense and perceive a well supplied tissue better.

Lowering of organs

Organ descent is the protrusion of the affected organ, such as often the bladder, uterus or rectum into the vagina. If the bladder, uterus, or rectum sinks into the vagina and the pelvic floor is not strong enough, numerous symptoms may result:

• Pain during sexual intercourse
• Back pain, especially depending on the menstrual cycle
• Feeling of heaviness in and between the legs
• Bladder infections: If the urethra is kinked due to the lowering, there may be an increased incidence of bladder infections due to the residual urine.
• Pain during defecation: If the uterus presses on the rectum or anal canal, it can lead to both constipation and pain during defecation.

Common causes of descent of the organs are:

• Pelvic floor weakness due to overuse or misuse of the pelvic floor.
• Weakness of the connective tissue (often associated with menopause due to the decrease in estrogen
• Births
• Operations
• Chronic constipation
• Obesity
• Age
• Heavy physical work
• Chronic bronchitis

This results in involuntary leakage of urine when laughing, coughing, sneezing or jumping. In more severe cases, even walking, climbing stairs and carrying loads becomes impossible. The bladder is not always to blame. If the uterus sinks, it can press on the bladder, which can also lead to involuntary urine leakage.

What can you do? Exercise your pelvic floor. The muscles of the pelvic floor, like all muscles, can be trained and are the solution to counteract the descent. Here, the regularity of the exercises and good execution plays an important role. If you don’t know elvie yet, learn more about probably one of the smallest exercise bikes in the world here. If the position of an organ is not optimal due to the lowering, this can be corrected by specific manipulations by a trained therapist, whereby the training can and even should be continued.

Pregnancy

Pregnancies change a lot: hormones, weight, stress on the ligaments and additional pressure on the pelvic floor, weakening it. Already during pregnancy you can train your pelvic floor: both tension and, very important, relaxation.

Pelvic floor problems due to pregnancy and/or childbirth are quite normal. Childbirth increases the likelihood of pelvic floor weakness: months of stress on the pelvic floor due to weight gain and the position of the baby but also the birth process. Weight and size of the child, general condition and age of the mother, duration of birth and birth interventions additionally play a major role in the condition of the pelvic floor after birth.

In the case of a vaginal birth with birth injuries (episiotomy, perineal tear), it is essential to treat the scars, as they can cause pain and/or affect muscle activity.

In the case of a C-section, the deep abdominal muscles may be impaired in function due to the incision or scars. Scar tissue or adhesions may develop to the point of obstructing the bladder. Pain when urinating or a permanent need to urinate can be signs of adhesions.

When should everything return to normal? You can tense the pelvic floor immediately after birth to feel how it is doing. As a rule of thumb, 6-8 weeks after birth you should be able to sneeze, laugh and cough without losing urine.

What can you do? Rest, relief and treatment: With the help of rest and relief (bed rest) as well as rapid pelvic floor strengthening, discomfort can subside to a certain extent on its own within the first few weeks. If this is not the case, treatment is necessary and possible.

Specially trained physiotherapists and osteopaths release tensions and scars through local treatments. Also, a correct perception of your pelvic floor for a successful strengthening is made possible. In addition, it is very important to exercise the pelvic floor regularly.

Sleep

When we are exhausted, both muscle strength and muscle coordination diminish. This also applies to the pelvic floor! For this reason, enough sleep is a prerequisite for a functional pelvic floor.

Sex

A healthy pelvic floor, which can be well contracted and relaxed, has a great influence on sexual sensation, specifically on arousal and orgasm. With a little humor, intimate moments can also be used for pelvic floor awareness and strengthening. Success guaranteed!

Sport

Basically, sports are very good for the pelvic floor. However, it is important to have good pelvic floor awareness while doing so. After pregnancies or with existing pelvic floor weakness, the training of the pelvic floor strength must be adapted. If this is not taken into account, it can quickly lead to overstraining and cause or intensify symptoms. The correct guidance of a competent trainer is crucial for successful and safe training.

Stress

Stress is bad for our pelvic floor! The pelvic floor muscles, like any other muscle group, can become tense and the muscles can no longer work as efficiently. This can result in slowed or weakened responses. A quick sneeze can “go down the drain.” Under stress, we alter our natural breathing, which can increase abdominal pressure and directly increase pressure on the pelvic floor. If you suffer from a weak pelvic floor, this can quickly lead to strain and cause symptoms of bladder weakness.

What can you do? The most important thing: take your time ! Try to regularly take a break from the daily grind and replace your “to do list” with a “DONE list”. This way you immediately reduce stress so you can breathe easier. In addition, you can write down 5 gratitude points every day. This simple exercise will quickly make you aware of how lucky you are.