ADVICE: I had the last of my kids seven years ago, but I'm still having problems with my pelvic floor. Is there any way I can tighten up those muscles this long after the fact?
Yes, you can fix your pelvic floor years after kids – the pelvic floor is a muscle and just like any other you can train it to get stronger and function better.
It's important to note the pelvic floor doesn't work in isolation – if you think of your "core" like a balloon, you have the pelvic floor on the bottom, the diaphragm at the top, your transverse abdominis which wraps around your waist like a corset and your multifidus (a deep spinal muscle) at the back. If you put pressure on one part of this balloon you will get increased pressure on the other parts. So, holding on to your abs (the front part) will push either up or down, and the weakest area will give way.
What is often considered a pelvic floor "weakness" may actually be an overactive pelvic floor (switched "on" continuously) or just poor communication between the muscles that need to work together. A pelvic floor physiotherapist will be able to help determine what your problem is and provide solutions.
In the meantime, some things that may help to improve pelvic floor function:
The pelvic floor is not meant to be "on" all the time. When it's operating optimally, we breathe in, the diaphragm moves down and the pelvic floor relaxes. As we breathe out, the diaphragm moves up and the floor contracts. This should all work together, and we can learn to co-ordinate the two by focusing on breathing in/relaxing (think about widening your sit bones) and breathing out/contracting.
While Kegel exercises, or pelvic floor contractions, and Kegel balls are useful for helping you isolate or "find" your pelvic floor muscles, the use of the balls will encourage sustained contraction of the pelvic floor. What we want to do is promote the integration of pelvic floor function with the rest of the body, or in other words, contraction and relaxation of the muscles with movement.
Often during pregnancy the lower back develops greater curve to accommodate the growing baby, the ribs are pushed forward of the hips and the position of the core musculature is affected. In this position, the pelvic floor can't relax and contract fully when breathing, which can impact strength in the area. Often after pregnancy women will maintain this posture, so correcting this alignment and encouraging the hips to position under the ribs can also help with pelvic floor function.
Poor diet or inadequate nutrition affects muscle elasticity. Ensure you have a nutritious diet with plenty of fresh fruit and vegetables, good protein and fats which can also help with muscle function. Also note that at different times of the menstrual cycle, a woman's hormones will also influence muscle elasticity.
Continuously trying to squeeze your pelvic floor "on" is great for isolating the muscles, but not for improving pelvic floor function. Like any other muscle, it needs to be trained to switch on and off with movement to function efficiently. If you have concerns about your pelvic floor function, contact a specialist pelvic floor physio in your area.
Raewyn Ng is a Movement and Health Coach at mybod.co.nz. Send her your body and exercise related questions to email@example.com with Dear Rae in the subject line.