Lindsay Baker, Physiotherapist The Joint, Physiotherapy + Sports, Injury Centre
1 in 3 women will be affected by incontinence or prolapse in their lifetime. 1 in 20 men will be affected by incontinence. On average, women live with symptoms of pelvic floor dysfunction for 7 to 10 years before talking to a health care professional about it. That time frame is likely at least as long for men having similar issues.
So let’s talk about it.
Here are some common misconceptions about the pelvic floor:
1. Kegels will fix everything.
First, not all pelvic floor problems happen because the pelvic floor is weak. Sometimes the issue is a pelvic floor that can’t relax properly. Secondly, many people don’t do a Kegel correctly with verbal instruction alone. You can’t see it and it can be difficult to know exactly what your pelvic floor is doing. And third, even if you’re contracting and relaxing your pelvic floor properly, it has to happen at the right time. The pelvic floor muscles need to co-ordinate with the other muscles of your core – your diaphragm, transversus abdominus, and multifidus – to move, breath, and maintain continence.
2. Only women can get pelvic floor dysfunction.
Although less common, men can have pelvic floor dysfunction too. It often presents as pain(chronic pelvic pain syndrome or chronic prostatitis) or sexual dysfunction. These conditions are often complex, and so is the treatment, but Pelvic Floor Physiotherapy can help. As difficult as it is for many women to talk about pelvic floor problems, it can be even more difficult for men.
3. Only women who have had children get pelvic floor dysfunction.
There is a surprisingly high rate of incontinence in young female athletes (up to 50% in gymnastics and ballet). It’s often related to holding too much tension in the pelvic floor and deep core muscles. Retraining movement patterns can not only help prevent incontinence, but can also improve movement efficiency and performance.
4. Only women who have had vaginal deliveries get pelvic floor dysfunction.
Pregnancy itself increases the risk of pelvic floor dysfunction by causing the muscles and ligaments in and around the pelvic floor to lengthen. Women who have had C-sections are just as likely to have pelvic floor dysfunction as women who have had uncomplicated vaginal deliveries. It’s important to be mindful of your pelvic floor after a C-section too.
5. It’s normal to pee a little if I’m lifting heavy, sprinting, or jumping.
Absolutely not. Just because something is common does not mean it’s normal. It is never normal to pee when you don’t intend to. If you do, you are losing control of a vital part of your body, you are losing your form, you are maxing out. Please stop. See a Pelvic Floor Physiotherapist who can help you break down and modify your exercise of choice, then build you back up again. If your symptoms can’t be managed through physiotherapy alone, we will refer you back to your doctor to discuss other medical and/or surgical options. But rest assured, it’s not normal and it can lead to bigger problems down the road.
6. I have a prolapse/diastasis/incontinence, so I’ll never be able to lift/run/jump again.
While it isn’t a good idea to push through and ignore your pelvic floor, it’s not always necessary to completely give up activity that you love either. A lot of advice around pelvic floor dysfunction focuses on what not to do, but there’s nearly always a way to make gradual progress towards returning to things like running and weight lifting without compromising your pelvic floor.
7. If I ignore it, it’ll go away on its own.
Issues like incontinence and prolapse often worsen with time, especially around menopause. Hormonal changes, particularly dropping estrogen levels, affect connective tissue and make it less elastic. It is common for women to have a minor problem that becomes significantly worse as menopause approaches. Overloading the pelvic floor over and over with improper technique can also make problems worse over time. Dealing with it sooner rather than later is always a good idea.
8. I’ve had this problem for so long, there’s no point in addressing it now.
It’s never too late to work on strength and co-ordination of any muscle group and the pelvic floor is no exception. Whether you’re 15 or 95, Pelvic Floor Physiotherapy can help.
If you have any issues with incontinence, pelvic pain, prolapse, diastasis, or exercising during or after pregnancy, talk to your doctor or contact The Joint Physiotherapy + Sports Injury Centre at 250.331.1200 or email Lindsay Baker at firstname.lastname@example.org for more information.