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5 secrets to improving pelvic floor function

<p><em><strong>Dr Kate Gregorevic is a geriatrician with a research interest in health and lifestyle factors that are associated with healthy ageing and recovery from illness.</strong></em></p> <p>The vagina is both for fun and function. Childbirth (whether vaginal or caesarean) is an incredible achievement, but due to human babies having relatively oversized heads and the female pelvis being relatively narrow to allow us to walk upright, many women experience trauma to the pelvic floor. In addition the hormones of pregnancy and menopause can also increase the stress on the pelvic floor muscles and contribute to pelvic floor dysfunction, which can result in incontinence, constipation and <span style="text-decoration: underline;"><strong><a href="https://www.physio-pedia.com/Low_Back_Pain_and_Pelvic_Floor_Disorders" target="_blank">even back pain.</a></strong></span></p> <p>Some women, particularly those who have experienced vaginal birth, may have a vaginal prolapse. This occurs when the tissues of the vagina become weakened and some of the surrounding structures bulge into the vagina. This is extremely common, affecting up to forty per cent of all women who have had a vaginal birth. When I was a medical student, we were taught that after menopause, prolapse would invariably get worse, but now we know that with the right strategies, a prolapse may even improve. These are some simple lifestyle steps that can have a big impact on pelvic floor function:</p> <p><strong>1. Learn to do your pelvic floor exercises PROPERLY</strong></p> <p>The pelvic floor is a string of muscles that goes from your tailbone to your pubic bone, and so doing pelvic floor exercises involves <a href="http://stableandstrong.com.au/exactly-activate-pelvic-floor-correctly-caution-real-talk-ahead/" target="_blank"><strong><span style="text-decoration: underline;">drawing up the muscles around the rectum, vagina and urethra</span></strong></a>. The next step is to activate the deep core muscles in the abdomen. Over time, you can then build up to co-ordinating all muscles at the same time.</p> <p><strong>2. Once you’re doing your exercises properly, get upright</strong></p> <p>Many women do their pelvic floor exercises while they are sitting. This is a good way to start practicing, but the pelvic floor also needs to be active when you are upright doing day-to-day activities. This involves progressing to getting upright, and even to making sure your pelvic floor is engaged when you exercise. A good rule is that if you can’t engage your pelvic floor while doing an exercise, you need to take a break. An exercise physiologist or women’s health physiotherapist can be a great help in this stage.</p> <p><strong>3. Avoid constipation</strong></p> <p>Constipation is passing infrequent or difficult to pass stools. This can lead to straining on the toilet, which can actually worsen a prolapse. A diet high in fibre is key to improving constipation because it makes the faeces bulkier and softer, so easier to pass. Fibre is the indigestible part of plant-based foods, like fruit, vegetables and wholegrains. Not only is this good for protecting your pelvic floor, but diets high in fibre are actually linked to better overall health and a <span style="text-decoration: underline;"><strong><a href="http://www.oversixty.com.au/health/body/2017/01/why-a-healthy-gut-is-important-in-older-age/http:/www.oversixty.com.au/health/body/2017/01/why-a-healthy-gut-is-important-in-older-age/" target="_blank">more diverse gut microbiome</a></strong></span>.</p> <p><strong>4. Use the correct POOsition</strong></p> <p>The optimal position for defaecation is actually crouching, not sitting. When we sit upright, a loop of muscle naturally kinks our rectum, meaning that we have to strain more to poo. By placing a stool under your feet and leaning forward, you can get the optimal angle and avoid straining and the pressure on your pelvic floor.</p> <p><strong>5. Get professional help</strong></p> <p>It is worth seeking out a physiotherapist or exercise physiologist with a specialisation in women’s health.  It can feel embarrassing to discuss such personal issues with someone, but women who enter this profession are experts at their job and making their clients feel at ease. They can help you develop a personalised management plan to focus on your specific needs.</p> <p>Even with the right lifestyle measures, some women may still require surgery for a symptomatic prolapse or incontinence, but these lifestyle measures are still important to optimise outcomes. One of the most important lessons to come from the <a href="http://www.abc.net.au/news/2017-11-30/controversial-vaginal-mesh-implants-banned-for-pelvic-prolapse/9209940" target="_blank"><strong><span style="text-decoration: underline;">vaginal mesh scandal</span></strong></a> is to highlight how important it is to talk about these common and treatable conditions.</p> <p>Speaking about this with other women, many will have shared the experience of pelvic floor dysfunction. Poor pelvic floor function is not inevitable with age. Even decades post-partum, with the right exercises and lifestyle measures, continence and sexual function can improve significantly. Whether your goal is avoiding prolapse surgery or running with the grandchildren, taking these steps to optimise pelvic floor function can make a huge contribution to living your best life.</p> <p><em>For the latest research on ageing well, follow Kate on Instagram <span style="text-decoration: underline;"><strong><a href="https://www.instagram.com/drkate_gregorevic/" target="_blank">@drkate_gregorevic</a></strong></span>.</em></p>

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Yoga moves for strengthening pelvic floor muscles

<p><strong><em>Tracy Adshead is a yoga teacher specialising in yoga for seniors. She is passionate about bringing healing and healthy ageing to the community.</em></strong></p> <p>If you’ve ever had an “oops” moment when you’ve laughed or coughed, you’ll know about the “personal discomfort that can arise from a weak pelvic floor. Women who have had children are more likely to experience urine leakage, together with anyone who is overweight. While some people choose to just live with it there are some simple chair yoga practices that everyone can do to strengthen these important muscles.</p> <p>The pelvic floor looks like a hammock – a sling of muscles, ligaments and sheet-like tissues that stretch from the front to the back of the pelvis. It supports the bladder and bowel, giving you control over the elimination process. The pelvic floor tends to get weaker with increasing age, after an injury (such as a fall) or with constant straining to empty the bowels. Luckily, it is possible to make these muscles strong again, like other muscles in the body, just 5 minutes of exercising each day can make a big difference.</p> <p><strong>How to locate the pelvic floor muscles:</strong></p> <ul> <li>Lie down on your back on a reasonably firm surface, like the floor or bed.</li> <li>Bend your knees and place the soles of your feet flat on the floor about hip width apart.</li> <li>Take a deep breath in, as you exhale lift your head and shoulder off the floor look towards your knees. Now, like blowing-out birthday candles exhale through pursed lips, blow the air out forcefully.</li> <li>As you exhale, notice the muscles that are contracting in the pelvis – this is the pelvic floor.</li> </ul> <p><strong>Here’s how to do a pelvic floor exercise:</strong></p> <ol> <li>Sit on a chair, keep your back upright, shoulders back. Relax your hands into your lap. Place your knees about hip width apart.</li> <li>Squeeze and lift your pelvic floor muscles (this should feel like you are trying to stop yourself from passing water). As you hold these muscles lift you right knee of the floor as best you can.</li> <li>Exhale, relax the right foot to the floor. Relax the pelvic floor. Repeat this 4 more times.</li> <li>Switch to the left foot, repeat this practice 5 times.</li> </ol> <p><strong>For best results do every day</strong></p> <ul> <li>Don’t hold your breath while doing this practice</li> <li>Only contract the pelvic floor muscles</li> <li>Don’t overdo it – little and often is best!</li> </ul> <p>Depending on your medical history and prior treatments you may wish to consult a doctor before starting a new type of exercise.</p> <p>What kind of exercise do you like to do at home? Let us know on the comments below.</p> <p><strong>Related links:</strong></p> <p><a href="/health/body/2016/06/yoga-exercises-for-neck-and-shoulders/"><em><strong><span style="text-decoration: underline;">Three yoga exercises to relieve neck and shoulder stress</span></strong></em></a></p> <p><a href="/news/news/2016/05/easy-exercise-all-over60s-should-be-doing-to-improve-balance/"><strong><em><span style="text-decoration: underline;">3 easy exercise all over60s should be doing to improve balance</span></em></strong></a></p> <p><a href="/health/body/2016/05/how-to-improve-your-balance-with-yoga/"><strong><em><span style="text-decoration: underline;">How to improve your balance with yoga</span></em></strong></a></p>

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