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6 Ways to Protect Your Pelvic Floor

The pelvic floor is a group of structures including muscle, ligaments and fascia that form the “floor” of your pelvis and core, supporting your bladder, bowel, and uterus. Injury to the pelvic floor may result in prolapse or dropping of these organs, urinary or stool leakage, or pain in the pelvis, abdomen, hips or back. The pelvic floor is vulnerable to injury just as any other part of our body, especially because we use our pelvic floor during just about any physical activity. Protect your pelvic floor with these tips: 

  1. Exhale during lifting. It is common to develop a bad habit of holding your breath as you lift during exercise, work, and carrying out daily living activities such as lifting groceries or your child. Holding your breath during lifting provides a sense of stability or strength. However, this is a false stability and creates an excessive strain on the pelvic floor that over time will weaken it. When you exhale you reduce the pressure placed on your pelvic floor and appropriately transfer some of the work to the core muscles. 
  2. Avoid excessive coughing. Coughing creates a significant strain on your pelvic floor. When healthy, the pelvic floor assists with coughing but if it is subject to repetitive periods of coughing, it can fatigue.  Talk with your health care provider to determine the cause of your coughing and determine appropriate treatments to reduce your cough.
  3. Maintain a healthy body weight. Pay particular attention to the waist to hip ratio (WHR).  The World Health Organization recommends a WHR of .85 or less for women. To calculate yours, go to Omnicalculator: https://www.omnicalculator.com/health/waist-hip-ratio. Your pelvic floor was designed to effectively support a healthy body weight. Added weight, especially in the abdomen, places a prolonged strain on the pelvic floor eventually weakening the muscles.
  4. Avoid constipation. The pelvic floor assists with bowel movements. A healthy bowel  movement should consist of only a brief initial mild strain to position the stool in the anal canal. However, if you must overly strain to achieve a bowel movement, that pressure will weaken those muscles over time. Increasing your fiber and water intake may help. Talk to your pelvic health therapist on ways you can improve your bowel movements. 
  5. Exercise your pelvic floor and core. Strong, flexible and reactive pelvic floor and core muscles are necessary for full function of all daily activities including bladder, bowel and sexual health. You should incorporate pelvic floor and core exercise into your workout routine daily.  
  6. Rehabilitate other injuries. When another part of your body is injured, the body compensates to keep you going.  Because the pelvic floor and core are essential for movement of your body, any reduction of function in other parts of your body will result in overuse of the pelvic floor. Our body is designed to work in balance. Overuse of the pelvic floor can result in excessive tension leading to pain and/or difficulty emptying your bladder or bowel.

If you would like to have help in learning to protect your pelvic floor and improve your sexual health, seek out a pelvic health physical therapist at www.aptapelvichealth.org/ptlocator.

Written by: Kathleen Novicki, PT, DPT, PRPC. Kathleen is the Director of Pelvic Health Education and Program Development at Oxford Physical Therapy Centers.

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April-June 2021 Highlights from Journal of Women’s Health Physical Therapy (JWHPT)
Responsiveness of health-related quality of life patient-reported outcome measures in women receiving conservative treatment for urinary incontinence: a systematic review

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