Wildflower Journal - Entry 1 | Do I really have a weak pelvic floor?

Let's be totally honest - this is the day old question that I hear in clinic, public and day to day. The pelvic floor is a muscle, and isn't simply 'on' or 'off'

If you have ever experienced bladder leakage, pelvic pain or discomfort during sex, you may have been told:

"You need to strengthen your pelvic floor."

And sometimes.. strengthening IS exactly what is needed - but the pelvic floor is more complicated than simply being "weak or strong".

Your pelvic floor needs to be able to contract, relax, coordinate and respond with the rest of your body. It needs to be involved with coughing, sneezing, laughing, exercising, lifting and more - but it also needs to let go when you breathe, empty your bladder and bowel and also provide function during intercourse (sex).

So can a pelvic floor be too 'tight'?

The bottom line. Yes. I dislike using the word tight to describe the pelvic floor but we often find that this is the most accessible information available.

When we talk about 'tight', we are often referring to overactivity in the muscles, or difficulty relaxing ("switching off")!

We often see symptoms such as pelvic pain, pain during intercourse, difficulty emptying bladder and bowels - but can also see leakage and difficulty holding urine alongside this.

This doesn't mean the pelvic floor is "too strong" - it can suggest that the pelvic floor isn't coordinating in the way your body needs it to.

What if I'm experiencing leakage?

Thats where things can become particularly interesting.

Urinary leakage can have different contributing factors. Pelvic floor muscle training can be effective for urinary incontinence, but the programme should be tailored to the individual and their ability to both contract and relax the muscles.

So doing hundreds of squeezes every day isn't necesarily the answer for everyone.

Your pelvic floor is part of a bigger picture.

At Wildflower Physiotherapy, I do not believe in giving everyone the same exercise sheet and sending them on their way.

Your symptoms, lifestyle, exercise, pregnancy history, hormonal changes, breathing, bladder/bowel habits and goals can all form part of the assessment.

The aim is not simply to make your pelvic floor stronger.

It's to help it work well for you.

If you are unsure whether your pelvic floor is weak, overactive or simply struggling to coordinate, a pelvic health assessment can help you understand what's going on.

You do not have to guess.