To wee or not to wee…

Even as a physio and learning all about women’s health, prolapses, incontinence and the like, I only assumed this happened to older ladies, like >60 years old. It would never happen to me. I remember learning about kegels in class and believing I had pretty strong pelvic floor muscles. After all I was a good runner and had never ever had an issue with ‘dribbling’ shall we say whilst exercising. I kept up running upto week 32 of pregnancy. Even after the birth of my daughter (a healthy 9lb 9oz!) I naively thought things would be back to normal sooner than later. The doctors advice is 6 weeks until one starts exercising again, 12 weeks after a C-section. I got on the exercise bike after 4 weeks. Apart from a sore coccyx this was surprisingly comfortable. Comfortable may be the wrong word, but I mean fitness wise my legs and lungs coped. At 6 weeks I tried running. Oh lordy I remember my organs feeling like they were on a tumble dry cycle, plus my womb, uterus, vagina or whatever hanging by my knees! 6 weeks was too early for that, and basic daily kegels were a must!

By the time I was comfortably running 5km I was pregnant again with Moo, and generally too tired to run anyway. Power walking and pushing a toddler in a buggy was quite enough. Another 10lb vaginal birth = numbness down below for days. I made it my routine to do my kegels whilst waiting for my daughter to fall asleep every night. I was much more religious this time around, however I still needed a pad on a 15″ walk or when baby wearing. I would use no time and no energy as my excuse for not doing any proper aerobic exercise but really my body did not feel ready. Only at 9 months did I chance an outdoor jog, by which I mean walk 1 min jog 1min and was pleasantly surprised. Since then I believe that running will actually help strengthen my pelvic floor whereas some people think running is bad for it. This all depends on current state/strength of your muscles and exercises that are performed in the interim. Do your Kegels, end of!

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I didn’t last long on a trampoline – perhaps more because my nursing boobs couldn’t take it!

Benefits of Pelvic Floor Exercises

  • Help improve or maintain control of bladder and bowel function.
  • Improve or maintain strength and tone of pelvic floor muscles which support pelvic organs against gravity.
  • Help recover urinary control in men after prostate cancer surgery.

Key Points

  • Tighten only pelvic floor muscles.  Do not use abdominal, buttock or inner thigh muscles.
  • Breathe during exercises.
  • Choose a comfortable place and quiet time of day to perform these eg. lying in bed in the morning and evening.

Performing the Excercises

  • Find the right muscles: To contract the pelvic floor muscles, squeeze the same muscles you would use to cut off your urinary stream or prevent passing gas. You should not, however, perform the exercises by trying to stop your stream – use this technique only to identify the muscles.  If you are doing it correctly you will feel your genitals “drawing up and in”. Women can place a finger in the vagina and try to squeeze the surrounding muscles.
  • Perfect your technique: Like any exercise, it takes time and repetition for things to get better. It may take 3 or more months of regular exercise. Over-exercising can lead to fatigue. Try to do “10-10-3-3”
    • 10 sets of contractions
    • 10 seconds holding alternating with 10 seconds relaxing
    • 3 sets, 3 times a day
    • 3 months minimum trial

Resources

Soul Physiotherapy & Pelvic Floor Health – an excellent resource for specialized physiotherapy in Richmond

Dayan Physiotherapy and Pelvic Floor Clinic – an excellent resource for specialized physiotherapy in Vancouver

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