By Anna Geraets, Pelvic Health Physio
There is this muscle we have that we typically don’t think about, until there is a problem (leaking, pain), or we’re considering vaginal childbirth.
So, first, what is this elusive muscle?
To make things as simple as possible, our pelvic floor has 2 layers. The superficial layer (closer to the surface), and the deep layer. They work together but also serve different functions.
Levator Ani, aka “Levators”: This is our deeper layer. It’s main action is to lift and lower. It is like a hammock that sits at the base of our perineum and works to support our pelvic floor organs. It is very important for placing pressure on the urethra during straining (cough, sneeze, lifting) to keep us continent.
Bulbocavernosus/Bulbospongiosus, aka “Bulbo”: This is the more superficial layer and has circular fibres which work in a similar way to pursing our lips. It is typically the muscle that receives the most stretch during vaginal deliveries, and typically the muscle that causes a sensation of blocking for women who experience vaginismus.
Both of these layers are important, and when you are doing “kegals” ideally you can identify both the squeeze (bulbo) and the lift (levators).
However, that doesn’t answer the question of this blog.
Kegals. AKA pelvic floor exercises. I think it’s important that every woman is able to identify their pelvic floor muscle and choose to activate and relax them at will. This coordination is important in order to use the pelvic floor to support the pelvic organs during a cough, sneeze, and activity. It is just as important that they relax when we are voiding, opening bowels, delivering a baby, or achieving penetration (such as using a moon cup, tampon, or intercourse).
Sometimes the pelvic floor is “hypertonic”, where it has become short and tight. These women may experience leaking.
See the difference?
Pelvic floor exercises will address a weak pelvic floor. It may not, however, address your leaking. To do this you need to have a specific diagnosis as to WHY you are leaking. Your pelvic floor muscles may be too weak to put pressure on the urethra to keep you continent (the urethra is the hose where urine leaves the body). Or, they may be compensating for an overactive bladder that is sporadically squeezing so hard that urine starts coming down the urethra, and the pelvic floor is working overtime to keep the urethra closed.
So, I encourage all women to learn where their pelvic floor is and how to turn it on and off. However; if you have leaking, and you have been doing pelvic floor exercises effectively and are still leaking, perhaps strength isn’t the problem.
A pelvic and womens health physio will help to teach pelvic floor exercises, check you are doing them correctly, and provide strengthening programs for weak pelvic floors. However, pelvic floor exercises are but one tool in a very extensive tool kit that we have to help women with pelvic floor dysfunction. Before we open the tool box, we need to get a good diagnosis so our treatment can be effective and relevant to your presenting concerns.
Leaking? See a pelvic health physio so you can address this effectively today.
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