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Why you shouldn't ignore your pelvic floor

Why you shouldn’t ignore your pelvic floor

Pelvic floor dysfunction affects 25% of women aged 30-70 around the world and if you have undergone an instrumental delivery this chance is increased even greater

Ever had a “whoops” moment when you laughed/coughed/sneezed or are you too scared to get on the trampoline with your children.

Pelvic floor dysfunction can cover anything from stress incontinence, heaviness down below or a prolapse.

Modern women’s health product marketing tells us it’s normal and just comes as part of the package of being a mum. Let’s not confuse common with normal.

If you leaked blood from your eye every time you coughed/ran/jumped would you ignore it? Would that be just gotten on with and part of the package of being a mum/ageing?

ANY level of dysfunction is not OK. ANY level of dysfunction does not have to be YOUR normal

What are the symptoms of Pelvic floor dysfunction?

  • The feeling that you need to have several bowel movements within a short period of time

  • The feeling that you cannot complete a bowel movement

  • Heaviness or pressure down below

  • Tissues protruding (prolapse)

  • Constipation

  • Frequent need to urinate

  • Urgency to urinate and feeling as though you are unable to wait

  • Painful urination

  • Pain in your lower back that cannot be explained by other causes

  • Ongoing pain in your pelvic region

  • Pain during sexual intercourse

What’s the pelvic floor’s function?

Let’s imagine a bucket – with a base, sides and a lid.

That’s essentially what your core unit looks like – the lid is the diaphragm, the sides the abdominal muscles and the base the pelvic floor.

In my previous post I spoke about how a mismanagement of intra-abdominal pressure can load against those 3 areas and exit the weakest points. If you imagined punching some holes on the bucket when pressured by the water it contains the bucket would leak from those weak points.

The pelvic floor’s function is to provide support for the pelvic organs (e.g. the bladder, intestines, and uterus) and maintain and allow for the continence of the urinary and anal sphincters. It facilitates birth and helps to maintain optimal intra-abdominal pressure

Essentially the pelvic floor acts as a sling or hammock to hold up the abdominal muscles – so chances are if your pelvic floor is weak your abdominal muscles will be impaired in their ability to work.

A weak pelvic floor

The period of pregnancy causes postural and alignment changes within the body which put the pelvic floor under more pressure. That coupled with the additional weight of a growing (and moving) uterus and baby/ies can take its toll on this underappreciated muscle.

You might find that suddenly you need to urinate with urgency or have incontinence during exercise

The pelvic floor is commonly thought of as an isolated muscle that is worked upon on its own.

Let’s take a bicep curl in the same train of thought – if you picked up a bottle of water with your hand and bicep curled it you would of course be working the bicep – but not alone. To perform this functional the triceps would need to support the flexion of the bicep, the shoulder and forearm acting as non-prime movers also. You simply couldn’t isolate the muscle totally.

The same is true of the pelvic floor – the abdominals, hips, glutes and back muscles all have a connection around the pelvis. If the pelvic floor strength is impaired then we could hazard a good guess that one or more of those areas are also impaired and potentially vice versa


If your pelvic floor muscles are particularly weakened or relaxed this can lead to prolapse. There are 5 types of prolapse;

  • Cystocele (bladder prolapse)

  • Enterocele (small bowel prolapse)

  • Rectocele (rectum prolapse)

  • Uterine (uterus prolapse)

  • Vaginal vault (where the upper portion of the vagina loses its normal shape and drops down into the vaginal canal or out from it)

These can occur singly or together – so for example you could have a double or triple prolapse

A prolapse is graded dependent on the level the organs position on a scale of 0-4.

Your women’s health physiotherapist is the best person to seek advice from to determine your grading and seek advice and treatment.

I believe that every women should have a post birth check up to determine your pelvic floor and core health regardless of whether you are symptomatic or not – please visit the Mummy MOT website for signposting to your nearest professional

Hypertensive pelvic floor

In some cases of pelvic floor dysfunction the pelvic floor is not only weak but also tight – if you imagine it as a hammock – under constant tension – the hammock would be weakened. This is a condition that is not always recognised when dealing with weakness in the pelvic floor and indeed it actually needs different management than a weak pelvic floor alone. Unlike pelvic floor disorders caused by relaxed muscles (urinary incontinence or prolapse) women who are affected by a non-relaxing pelvic floor may present with a broad range of non-specific symptoms such as constipation, pain during urination and sexual intercourse all of which require relaxation of the pelvic floor muscles.

So what should you be doing?

I would always suggest starting with a professional opinion on your pelvic floor and core health from a women’s health physiotherapist and starting a programme of progressive strengthening exercises (if appropriate as there is a slightly different approach to a hypertensive pelvic floor) that utilise full body movements. The common Kegel exercise (the feeling of stopping yourself going to the toilet mid flow) certainly has its place in pelvic floor rehab but in a recent study it was shown that a side lunge showed more pelvic floor response than a Kegel alone – that’s because it was assisted by all the other muscle groups surrounding it not only creating a stronger response (and therefore a faster rehab programme) but also means for more functional training – and for a busy mum getting an exercise than not only works to restore your pelvic floor but also regains your fitness and strength is ideal – because let’s face it time is short and results need to be high.

The Motherhood Movement’s programmes include full body workouts to restore your pelvic floor health from the early day’s right back to impact activities like being able to enjoy the trampoline with the kids

So let’s not keep quiet about it all anymore – let’s shed the taboo around talking about it and let’s move on from the “normalising” of stress incontinence.

If you leaked through your eyes post birth – would you ignore it?

DON’T ignore your pelvic health – it doesn’t have to be YOUR normal

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