Category: Exercise

Do Men Have Pelvic Floor Muscles?

Post author By Melanie Platt
Post date September 20, 2023

Do Men Have Pelvic Floor Muscles?

Why yes they do! Who would have thought men have pelvic floor muscles. They have similar roles to that in women but with the anatomy being different it adds another level of complexity.

Pelvic floor health is important for men’s overall health and well-being just as it is for women, however, it is often overlooked or not discussed. This is something we want to change, bring to the surface and make it a comfortable topic for men to discuss. To provide help to the thousands of men who are suffering and give them a solution from the comfort of their home.

The pelvic floor muscles play a vital role in many functions, including controlling the bladder and bowel, supporting the abdominal and pelvic organs, and contributing to sexual function. Eg erectile dysfunction, orgasm intensity.

An estimated 30% of men visiting the doctor in Australia have urinary incontinence yet more than two thirds don’t discuss it with their health care provider. What’s more frustrating is it’s a treatable condition. The first treatment option recommend is pelvic floor strengthening and control exercises.

Do men have pelvic floor muscles? It’s still a question I get asked often from both men and women. I am just as surprised they ask it, as they are surprised to learn that yes men do have pelvic floor muscles and here are some ways you can get your muscles working for you to improve your pelvic floor health.

Maintaining your pelvic floor health:

Strengthen your pelvic floor muscles: The pelvic floor muscles can be weakened or switched off by a variety of factors, including age, obesity, and certain medical conditions. Strengthening the pelvic floor muscles can help improve bladder and bowel control, and may also improve sexual function. A program like ours here at Perfect Pelvic Floor goes through the statges of teaching you how to find your pelvic floor using the 3 different actions to engage it. Strengthening your muscles with a daily program and learning control of your muscles through functional exercises. (See our Men’s Program)
Maintain a healthy weight: Being overweight or obese can put additional pressure on the pelvic floor muscles, leading to problems such as incontinence. Maintaining a healthy weight through a balanced diet and regular physical activity can help reduce the risk of pelvic floor issues.
Avoid constipation: Constipation can put unnecessary strain on the pelvic floor muscles. To avoid constipation, it is important to eat a high-fibre diet, stay hydrated, and participate in regular exercise.
Improving sexual function: The pelvic floor muscles play a role in sexual function and performance, and strengthening these muscles can lead to improved sexual function in men. Who wouldn’t want that!
Avoid heavy lifting without proper technique and core activation. Lifting heavy objects can put extra strain on the pelvic floor muscles, leading to weakness and other problems. Ensure you know how to activate your pelvis floor muscles – get started on our (Willie Wiggles)

Prostate and the Pelvic Floor Muscles

The prostate is a small gland sitting below the bladder in men and is roughly the size of a walnut. It is not uncommon for it to grow in size as men age. It surrounds the urethra which is the tract that transports your urine and semen out of your body.

Sometimes with an enlarged prostate, or having prostate cancer treatment you can have difficulty urinating.

The prostate also helps to regulate your urine flow. As men haven’t really had to rely on their pelvic floor muscles as their first line of defence against urinary incontinence, it’s not uncommon for them to have difficulties activating the pelvic floor muscles. Typically I see men bracing all of their abdominal muscles and buttock muscles instead of their pelvic floor muscles initially.

Unsure where to start?

Men are also less likely to see a health professional about urinary incontinence hence I wanted to give them an opportunity to improve their symptoms from home with our Men’s Pelvic Floor Exercise Program app.

Here are some of our starter exercises you will find in our Men’s Pelvic Floor Exercise Program.

Pelvic Floor Exercises:

Willie Wiggles – The easies & simplest way to start activating your pelvic floor muscles by thinking about your “Nuts to Your Guts”. Get our Free Guide below.
Stopping your fart – This is a very basic version to get your muscles activated. The pelvic floor muscles are more intricate than this which is explained in our men’s exercise guide which you receive with out program. However this is a good one to start with for men who can imagine what this would feel like.
Breathing – start activation your diaphragm. Most men tend to clench their whole abdomen when they are trying to do different exercises. This exercise gets you to breathe deeply into the base of your lungs slowly and exhale slowly. Your diaphragm has a big relationship with your pelvic floor muscles in maintaining pressure in your abdominal cavity.

If you loved these but need a little more guidance we have instructional videos in our App. Simple, effective and easy to follow. Grab your free trial today.

Resources & Links:

Prostate Cancer Foundation Australia

Continence Foundation Australia

Tags incontinence, men's health, men's pelvic floor, pelvic floor, pelvic floor exercises for men, prostate cancer

Education Exercise

Can Pelvic Floor Dysfunction Be Cured?

Post author By Melanie Platt
Post date July 18, 2023

Can Pelvic Floor Dysfunction Be Cured?

It’s probably a question you have asked yourself when you’re in the depths of despair – embracing yet another leak with a cough or a sneeze. Afraid to laugh too hard because you know you’ll wet yourself or you’ve given up on running or jumping for life. The trampoline is your sworn enemy.

You’ve probably heard of this term pelvic floor dysfunction and asking what exactly does that mean? Essentially, it’s when your pelvic floor muscles aren’t working properly. They are’t doing the job they are supposed to do. It’s very common and can affect people of all ages and gender but it doesn’t have to be the “normal”.

Here are some factors that put you at a higher risk of developing pelvic floor dysfunction:

Being overweight puts additional pressure on the pelvic floor muscles, and sometimes they don’t have the strength or control to counter the effects.
Pregnancy and childbirth can weaken and stretch the pelvic floor muscles as well as the surrounding ligaments and soft tissue, leading to pelvic floor dysfunction.
Aging – As we age, like any muscles the pelvic floor muscles and surrounding soft tissue can weaken and have less elasticity, increasing the risk of dysfunction.
Constipation – Straining for a bowel movement especially chronically can weaken the pelvic floor muscles and lead to dysfunction.
Chronic coughing can put pressure on the pelvic floor muscles, leading to dysfunction.
Engaging in high-impact activities, such as running or jumping, can put additional strain on the pelvic floor muscles and increase the risk of dysfunction un less you know how to adequately activate your muscles prior to jumping or sneezing. We do have a solution for peezing to get you back to running and jumping as you wish. Get our “Ditch your Peezing Guide“.
Previous pelvic surgery: Any surgery that involves the pelvic area can cause trauma, scar tissue and can weaken the pelvic floor muscles increasing the risk of pelvic floor dysfunction.
Genetic predisposition: Some people may have a genetic predisposition to weak pelvic floor muscles, which increases the risk of dysfunction. Which is why we love a good high quality liquid marine type 1 and 3 collagen supplement like the “Collagen Elixir” Mel swears by.

One of the biggest risk facts is the increase in intra-abdominal pressure acting downwards inside your body that the pelvic floor muscles have to counter with their strength and co-ordination. This increased pressure over time is what can cause disruptions in the pelvic floor muscles connection, strength and sometimes in the muscles being able to relax as well.

So can it be cured?

Essentially Yes. Minimising your risk factors will absolutely help but also learning how to activate your pelvic floor muscles.

Learning to activate them prior to sneezing or coughing and getting them strong enough to work and support your core with exercise, yes even with jumping.

The research still suggests the first line of treatment to be a pelvic floor exercise program. One like ours here at Perfect Pelvic Floor starts with simple static exercises and diaphragm breathing to help you find your muscles with lots of cues I’m sure you’ll find one that works for you. As everyone is different.

Then progressing to movement based exercises with pelvic floor and core control. And finally through to functional exercises with your pelvic floor and core working with you as you know how to control your muscles.

Also consider a high quality liquid marine collagen that is based on type 1 and 3 collagen to help with soft tissue and muscle repair. (Read More on Collagen)

There are other options including pessary if you’re feeling the dysfunction has structural component of a prolapse which your nurse or women’s health physiotherapist can fit you for the correct pessary. (Read More on Pessaries)

Get started with our easiest and first exercise the “Vagina Winks“.

Tags peezing, pelvic floor dysfunction, pelvic floor exercises, vagina winks

Education Exercise

Vagina Winks

Post author By Melanie Platt
Post date May 15, 2023

The Vagina Winks - a Real Girl's New Diamond

You’re probably still questioning what in the world is a vagina wink? You’re not alone there.

Some might say Vagina Winks are just Kegels. I say they are way more than that. They are the new girl’s best friend.

Let me explain…

When we’re trying to teach someone how to connect to their pelvic floor muscles and get them activated we use different cues to help you visualise what’s going on. This in turn helps you connect to your own pelvic floor muscles.

Vagina Winks as a term started from one of these sessions with a client of mine. She was struggling to connect to her pelvic floor muscles and I was going through the list of cues that I use at times and just said you know “like your vagina is winking”. And she got it. After a lot of laughing from us both. And now I use it all the time. I love it even more because it makes people smile or laugh and we could all do with a little more of that in life.

Do you want to stop your leakage, learn how to activate and control your pelvic floor muscles and have the best sex ever? Then you’re in the right place…

Vagina winks are also the start of our functional pelvic floor programs. It is the easiest exercise to start with to get your brain connecting to your muscles. Fast pulses of your muscles to get them activated to your 100% and to relax them 100%. Don’t worry so much about the breathing with vagina winks – because they are fast just let your breath rise and fall naturally.

Grab the Do you need Vagina Winks Guide to see if they are the missing link for you!

Because we’re using the word vagina it helps stop women from just clenching their buttocks to get their pelvic floor muscles working. That’s not an effective pelvic floor strategy. Vagina winks allow you to visualise what’s going on which impacts your brain and muscle connection the most.

So how do they help with sex? Well you might also feel a little aroused after doing these exercises. That’s very normal and using the pelvic floor muscles like this in a fast acting pulse you are sending blood flow to your clitoris to enhance your arousal levels. This is another reason why I like giving this exercise to women who are having pain or trouble with sex. To enhance arousal but also to teach them how to relax their muscles in preparation for sex.

So why did I call them Vagina Winks?

Well I like a little fun in life and I wanted something that you would remember. Everyone is over doing their “kegels” at traffic lights and not getting results. Vagina winks are effective, easy and quick especially when you do them as part of our functional pelvic floor programs.

If you’re struggling to get the connection between your brain and your muscles here are some other cues I use to help women:

Pursing your lips
Curling your toes
Imagining a straw is inserted in your vagina and you’re holding onto it and pulling it inside
Holding onto a tampon
Feeling like you’re stopping yourself urinating. (Don’t practice with actually stopping your urine just the feeling of it)
Putting a hand on top of your vagina to get the feel of your front passage
Stopping a fart from coming out – use this one after you have got the initial front passage feeling first etc.

Vagina winks are super easy, simple, and they take no time at all.

If you’ve been struggling to activate your pelvic floor muscles or just want an easy fun exercise grab our Vagina Winks Guide and check out our Vagina Winks Express Course.

P.s There’s also something for the men in your life but obviously it won’t be their vagina that’s winking… Read More

Tags incontinence, kegel, leakage, pelvicfloorexercise, pelvicfloorhealth, vaginawink

Education Exercise Post Natal

Core Exercises to Reduce Your Abdominal Separation

Post author By Melanie Platt
Post date January 10, 2022

Core Exercises to Reduce your Abdominal Separation

Wow what happened to my stomach? It looks like it’s split in half and not working. I feel bulging coming out when I stand up, it’s flabby and it feels so weak! I feel horrible.
Does this sound like you?
It’s very common after pregnancy, It’s called Diastasis Rectus Abdominis (DRA) or abdominal separation. Where the tummy muscles have stretched and the fascia has separated leaving you feeling weak and flabby.
Here’s what you can you do about it!Abdominal Separation

DRA: This is where the fascia (I like to think of it as a piece of glad wrap over the top and in between your muscles holding them all together) and connective tissue between your Rectus Abdominis (6 pack muscles) has stretched and weakened leaving a gap between your muscles.
Add in the skin over the top stretching and it looks and feels like a mess. Don’t worry! It doesn’t have to be this way.

So why is this a problem?

Core exercises to reduce your abdominal separation, especially an exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle) is working and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our New Mum Program which is so important given your best chance of recovering these muscles is within the first 8 weeks after birth.
Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy for the first few weeks.
Be careful lifting your baby – try to use your pelvic floor muscles and TA as best you can.
Wear recovery support shorts – we love the SRC Recovery Shorts to give you that extra compression and support in your early phase.
Ease back into exercise slowly with gentle walking and a pelvic floor strength and recovery program first.

So even though you might feel like there is nothing you can do, there certainly is. Start with pelvic floor exercises to reduce your abdominal separation, then build up your core muscles through our New Mum Program. Remember the best chance at closing your abdominal separation is within the 1st 8 weeks of having your baby using core exercises.

Want to find out how strong your pelvic floor is?
Take your quiz

Typical Sit ups or crunches! This is a no no as it increases your intra-abdominal pressure and your stomach muscles and pelvic floor aren’t ready to cope with that. It can make your bulging worse and harder to recover from. Modified head lifts can be ok under the guidance of your Physiotherapist.
Planks without sufficient Pelvic Floor and TA strengthening first.
Bracing your stomach muscles – this can increase the bulge from within.
High impact sport without inner core and pelvic floor strengthening first.

What can you do about it?

Core exercises to reduce your abdominal separation, especially an exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle) is working and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our New Mum Program which is so important given your best chance of recovering these muscles is within the first 8 weeks after birth.
Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy for the first few weeks.
Be careful lifting your baby – try to use your pelvic floor muscles and TA as best you can.
Wear recovery support shorts – we love the SRC Recovery Shorts to give you that extra compression and support in your early phase.
Ease back into exercise slowly with gentle walking and a pelvic floor strength and recovery program first.

Want to find out how strong your pelvic floor is?
Take your quiz

100% of women have some level of separation of the abdominal muscles in the third trimester. (Hilliard and Brown 1996, Diane Lee 2013)
For a lot of women with DRA their gap closes significantly between day 1 and 8 weeks post baby. However if their gap remains widened at 8 weeks and if left untreated the gap at 8 weeks remains the same at 1 year post baby. (Cauldron et al 2008, Liaw et al 2011)
66% of women with DRA were also found to have a pelvic floor dysfucntion Eg Incontinence, pelvic organ prolapse. (Spitznagle et al 2007)

What NOT to do!

Typical Sit ups or crunches! This is a no no as it increases your intra-abdominal pressure and your stomach muscles and pelvic floor aren’t ready to cope with that. It can make your bulging worse and harder to recover from. Modified head lifts can be ok under the guidance of your Physiotherapist.
Planks without sufficient Pelvic Floor and TA strengthening first.
Bracing your stomach muscles – this can increase the bulge from within.
High impact sport without inner core and pelvic floor strengthening first.

What can you do about it?

Core exercises to reduce your abdominal separation, especially an exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle) is working and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our New Mum Program which is so important given your best chance of recovering these muscles is within the first 8 weeks after birth.
Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy for the first few weeks.
Be careful lifting your baby – try to use your pelvic floor muscles and TA as best you can.
Wear recovery support shorts – we love the SRC Recovery Shorts to give you that extra compression and support in your early phase.
Ease back into exercise slowly with gentle walking and a pelvic floor strength and recovery program first.

Want to find out how strong your pelvic floor is?
Take your quiz

It can lead to weakness in the stomach muscles leaving you at risk of back pain and postural related pain.
It disrupts the lumbo-sacral support and muscle system. (lower back and pelvis area)
DRA and Pelvic Floor dysfunction often go together.
A thinner lining of the abdominal wall creates less support for your inner organs and can leave you at risk of a hernia of your bowels.

Alarming Facts:

100% of women have some level of separation of the abdominal muscles in the third trimester. (Hilliard and Brown 1996, Diane Lee 2013)
For a lot of women with DRA their gap closes significantly between day 1 and 8 weeks post baby. However if their gap remains widened at 8 weeks and if left untreated the gap at 8 weeks remains the same at 1 year post baby. (Cauldron et al 2008, Liaw et al 2011)
66% of women with DRA were also found to have a pelvic floor dysfucntion Eg Incontinence, pelvic organ prolapse. (Spitznagle et al 2007)

What NOT to do!

Typical Sit ups or crunches! This is a no no as it increases your intra-abdominal pressure and your stomach muscles and pelvic floor aren’t ready to cope with that. It can make your bulging worse and harder to recover from. Modified head lifts can be ok under the guidance of your Physiotherapist.
Planks without sufficient Pelvic Floor and TA strengthening first.
Bracing your stomach muscles – this can increase the bulge from within.
High impact sport without inner core and pelvic floor strengthening first.

What can you do about it?

Core exercises to reduce your abdominal separation, especially an exercise called a head lift which aims to ensure your pelvic floor muscles are switched on, your TA (deeper core muscle) is working and a slight head tilt to allow the outer abdominals to contract. Adding extra hand pressure to your muscles to push them closer together and down towards your spine. There is no bulging or doming from the tummy outwards! This is a key exercise of our New Mum Program which is so important given your best chance of recovering these muscles is within the first 8 weeks after birth.
Be careful with getting up from the chair or bed, use compression with a towel or your hands around your tummy for the first few weeks.
Be careful lifting your baby – try to use your pelvic floor muscles and TA as best you can.
Wear recovery support shorts – we love the SRC Recovery Shorts to give you that extra compression and support in your early phase.
Ease back into exercise slowly with gentle walking and a pelvic floor strength and recovery program first.

Want to find out how strong your pelvic floor is?
Take your quiz

Tags abdominal separation, core exercises after birth, core exericses

Education Exercise Labour Post Natal Pregnancy

Pelvic Floor Muscles – All You Need to Know

Post author By Melanie Platt
Post date October 19, 2021

Everything you need to know about your Pelvic Floor Muscles

There is a lot of talk about pelvic floor muscles, pelvic floor exercises and kegels lately. Do you think your pelvic floor muscles are as important as everyone says they are?

Do you know what they do? Well that’s what I’m here to tell you about. To let you know everything about your pelvic floor muscles.

These muscles have so many roles and really important ones too:

Help keep your organs inside and lifted
Prevent and stop urinary incontinence
Supporting you during your pregnancy
They help guide your baby into your birth canal
Holding wee and poo in continuously without you even thinking about it
Helping you feel pleasure by arousing your clitoris and increasing the sensation of your orgasms

I’d say they are pretty important muscles! And ones I would want to know about! Wouldn’t you agree?

Especially considering most of this happens without you thinking about it. Pretty intuitive body we have!

Where are these muscles?

They are shaped like a hammock or a half moon running between your pubic bone at the front and your tailbone at the back around in a loop so when the muscles contract they shorten and close off the area. Obviously there is a lot of structures here from ligaments, bones, blood vessels, nerves and connective tissue but the muscles of the deep pelvic floor are:

Pubococcygeus (PC muscle)
Iliococcygeus
Coccygeus
Puborectalis – the muscles runs between the outer layer and the deep layer so it’s more like a middle layer but acts like a constrictor as an outer muscle does.

1, 2 and 4 make up your Levator Ani. Which is the lifting aspect of your pelvic floor muscles.

So where do things go wrong? Why do the muscles stop working well?

Pregnancy – just the physical load on your body and the anatomy of your pelvic floor is enough to cause issues. Worse if you’re not strong to start with.
Labour – You are at risk of major trauma like perineal tears with a forceps & vacuum delivery. Where instrument use is necessary, episiotomy will significantly reduce your risk of OASI (Obstetric Anal Sphincter Injury – 3rd/4th degree perineal tears) especially if it’s your 1st child and you are needing forceps. OASI is a significant risk factor for anal incontinence. Also just add in the generic trauma associated with labour to this area, the muscles take time to recover and get functioning again.
Genetically – your pelvic floor consists of muscles and connective tissue based on type I & III collagen fibres. These fibres can have a genetic weakness factor, so some people are more prone to weakness in their pelvic floor muscles without any other contributing factors. (Hence why I love collagen support – read more on collagen )
Weight training – heavy prolonged weight training without the appropriate engaging of your pelvic floor or correct technique for your pelvis puts you at a higher risk of having pelvic floor dysfunction.
Coughing – prolonged coughing can increase the pressure load acting downwards on the pelvic floor muscles, if the muscles can’t sustain it with strength or active engagement when coughing pelvic floor dysfunction can occur.
Bowel Straining – As above with the pressure pushing down on the muscles, they sometimes weaken and reduce their resting tone with the pressure against them periodically. Especially if this has been chronic constipation or straining.
Alcohol, caffeine & dehydration – they can make your urine more acidic which can make you need to urinate more frequently which can change the way the bladder works and how it interacts with the pelvic floor. (read more on the bladder)
Pain & Swelling – pelvic pain, back pain, endometriosis etc can make these muscles switch off or slow down like they aren’t quite getting the message from the brain. Not to mention to trauma of birth within the pelvis.

So how does it feel when your pelvic floor muscles aren’t working properly?

Leakage
More frequent urination
Urinating through the night
Feeling of not being able to hold on to your urine (don’t want to jump or run)
Back pain
Lack of sensation during sex
Pain with sex
Constipation
Feeling like everything is falling out down below (heavy feeling)
Feeling your stomach bulging out when you get up of the chair
Lack of pelvis stability (wobbly or not quite working right when you exercise)

Tips to keep your pelvic floor and vagina working well and feeling amazing!

In General:

No soaps/moisturisers with chemicals – can irritate and cause infections.
Pelvic Floor Exercises regularly – start with one of our pelvic floor and core programs see results within 2 weeks. (See programs)
No straining to urinate or do number 2’s – This puts extra pressure on your pelvic floor muscles by increasing your intra-abdominal pressure downwards. This can lead to a pelvic floor dysfunction or to a risk of prolapse. Instead lean forwards with your trunk, lift up your heels so you’re on your toes and relax your pelvic floor muscles.
Pelvic floor muscles activated when doing weights or lifting anything including your baby. This is where you reach a functional level of pelvic floor control. It will make you feel stronger and also protect you from a possible pelvic floor dysfunction or risk of prolapse.
Good quality collagen for type 1 and II fibres to help improve the quality of your muscles and ligaments surrounding your pelvic floor.

Pregnancy & Birth

Ice Pads after birth or Padsicles – to help with the healing process and reduce any swelling. Spray your pad with water and witch hazel (distilled – avoid any that have alcohol in them) if you like, fold the pad back up and freeze in a freezer bag. Let them thaw for a few minutes prior to use, then use up to 10 minutes every hour as needed in the first 24-36 hours after birth.
Warm compress during pregnancy – helps your vulva tissue relax prior to labour.
Perineal massage during the late stage of pregnancy (from 34 weeks) to reduce your risk and severity of 3rd & 4th degree perineal tears, reduce your risk of episiotomies & decrease your perineal pain after labour. Follow the instructions and use a natural based lubricant. (Read more)

Sex

Well lubricated before sex – as the pelvic floor muscles help with stimulation to the clitoris and can increase arousal. Try doing some pelvic floor exercises before having sex in particular the Vagina Wink. Other options include using a natural based lubricant. We love Olive & Bee Intimate Cream.
Urinate after sex – can help reduce the risk of urinary tract infections which due to the increase in frequency of urination and the acidity can affect your pelvic floor muscle function.

Do we always need to do pelvic floor exercises?

The simple answer is yes. But think of it like this, do you always need to eat well to feel good? Or put petrol in your car for it to work? Do you want your muscles to be functioning well when you’re into your 80’s and live a great life being able to exercise and move about like you want to?

It’s also best to have a pelvic floor exercise program that targets your muscles specifically so you can feel what it feels like to you when your pelvic floor muscles are working well. Everyone is different and everyone will feel it differently. Then you can add more functional movements so your body learns to use these muscles again without you thinking about it. Like our programs at PPF!

No matter where you are on your journey we have a program for you.

So what can you do?
Well for starters take this Pelvic Floor Test stop see if you need Vagina Winks. To prevent embarrassing leaks and improve your pelvic floor health.

Then try our 3 day trial on the PPF App and see for yourself. You’ll feel your muscles in 3 days and really see a difference in 2 weeks.

References:

Okeahialam NA, Wong KW, Jha S, Sultan AH, Thakar R. Mediolateral/lateral episiotomy with operative vaginal delivery and the risk reduction of obstetric anal sphincter injury (OASI): A systematic review and meta-analysis. Int Urogynecol J. 2022 Jun;33(6):1393-1405. doi: 10.1007/s00192-022-05145-1.

Dieb AS, Shoab AY, Nabil H, Gabr A, Abdallah AA, Shaban MM, Attia AH. Perineal massage and training reduce perineal trauma in pregnant women older than 35 years: a randomized controlled trial. Int Urogynecol J. 2020 Mar;31(3):613-619. doi: 10.1007/s00192-019-03937-6.

Abdelhakim AM, Eldesouky E, Elmagd IA, Mohammed A, Farag EA, Mohammed AE, Hamam KM, Hussein AS, Ali AS, Keshta NHA, Hamza M, Samy A, Abdel-Latif AA. Antenatal perineal massage benefits in reducing perineal trauma and postpartum morbidities: a systematic review and meta-analysis of randomized controlled trials. Int Urogynecol J. 2020 Sep;31(9):1735-1745. doi: 10.1007/s00192-020-04302-8.

Education Exercise Labour Pregnancy

Do Births Always Go to Plan?

Post author By Melanie Platt
Post date April 9, 2020

Rebecca Barr has recently joined our team at Perfect Pelvic Floor as our guest blogger. She has been a Physiotherapist for over 10 years with years of experience in pelvic floor retraining and incontinence. Here is her beautiful birth story and I just love her beautiful baby girls name Emmison.

After seeing those two lines appear, I knew I had to do another test just to make sure. This time the digital pregnancy stick which told me I was 1 – 2 weeks pregnant!

I had feelings of excitement and elation, which quickly turned to slightly frightened and nervous about the long nine months ahead. I was healthy and fit, what could possibly go wrong?! After the initial nerves, I did sail through most of my pregnancy without a worry. Even my obstetrician made a comment asking if I had done this before!! He had never seen a first time mum so relaxed. Each appointment he would ultrasound scan me and say yes baby is perfect, and measuring well.

At 37 weeks when I went in for another routine check, the obstetrician wasn’t so quick to say what I had been hearing from him at every other appointment. Instead he said he would like me to have a different scan to measure size and weight more accurately. Off I went to have this scan and returned to him telling me I had low amniotic fluid levels. Not too low to have anything done right away, but low enough to be closely monitored to ensure my baby was still growing.

Over the next two weeks I was a lot more aware of my precious little bubs movements. There used to be a lot of kicks when I would drink a cold glass of water, and as soon as I would get into bed to relax after a long day on my feet, I would usually feel the summersaults inside me. This had certainly started to reduce and I was quite anxious about what bub was doing in there!! The hospital were fantastic when I rang to say I felt there was reduced movement. I was told I could go in as much as I want and have a CTG whenever I felt I needed reassurance. A CTG is a Cardiotocography which monitors both the foetal heart rate and the contractions of the uterus.

My obstetrician decided at 39 weeks that I would be induced, which was a relief to be honest, as everyday I felt like I was overanalysing my baby’s movements or lack there of!

So the induction day came around quickly and it was lucky I was super organised and had my bags packed ready to go! My husband and I went in to hospital and I was first given the gel which helps to bring on contractions and soften the cervix. My waters would then be broken the next morning if nothing happened spontaneously. Overnight I felt mild contractions at no regular intervals, surprisingly I did get a good nights sleep! The midwives were in getting me up early and took me around to the birthing suite where I was to have my waters broken and then get comfortable for a long day ahead of me.

Once my waters were broken the contractions started almost immediately. What I thought were contractions overnight were measly little cramps, this was the real deal! I was able to walk around and there was a fitball in the room which I could use to hug and lean forwards onto during the strong contractions. My husband was very supportive and was following me around the room helping to massage my back but it got to the point where nothing I or he could do would help the intense pain! I then opted for an epidural and alas, I was able to function again!!

Having an epidural was great, I could lie down and relax after all those exhausting contractions. It did however prolong the active labour, although the obstetrician was in regularly checking my progress. I got to 8cm dilation when the obstetrician said my baby had turned posterior. Bummer! I was so close. He organised a theatre room and said we could try turning baby with forceps or vacuum. I was not keen on either of these methods as I had done my research and knew particularly forceps was quite damaging to my baby and my pelvic floor muscles. I had discussed this with the obstetrician during a previous appointment and he knew I did not want this method in my birthing plan. So I then consented to an emergency caesarean.

Within 10 minutes I was down being prepped in the theatre room. I could see on the monitor that baby’s heart rate was dropping, however all the staff seemed so relaxed and positive for me. The caesarean section was the quickest part of the whole experience, I just remember seeing my beautiful baby girl passed over the drape so that I could cuddle her straight away. My husband then cut her umbilical cord and seeing her being held in his arms I knew we had unconditional love for her.

Rebecca Bar has been a Physiotherapist for over 10 years and has post graduate qualifications in Women’s & Men’s Health and lives in Victoria Australia.
She has a keen interest in helping people improve their quality of life and loves spending her time playing tennis, hanging out by the beach and spending time with her beautiful daughter.

Education Exercise Post Natal Pregnancy

Pelvic Floor Facts You Need to Know!

Post author By Melanie Platt
Post date February 3, 2020

When talking about your pelvic floor muscles what are the essentials you need to know?
These small and sometimes seemingly insignificant muscles do a whole lot that you probably don’t even know about and wouldn’t even realise.

Reality is you can thank these muscles for pleasure and avoiding embarrassment!These important muscles form a sling like support system at the base of your pelvis. They work on some level without you even knowing it which is why sometimes they stop working as well as they should. Hence we need as strengthening program to get the working well but also learn to switch them off when needed.

Here are some must know Pelvic Floor facts:

The pelvic floor muscles are made up of Pubococcygeus, Iliococcygeus, Coccygeus & Puborectalis. They sound really long and complicated but make up our superficial and deep layers of the muscles.
Pelvic floor exercises are the same as “doing your Kegels” ( kegels is just the American term. You have no idea how many times i’m asked this)
When pelvic floor muscles are tightened or contracted you get a closing and a lifting sensation of the vaginal walls.
They are important to us throughout our whole life especially as a woman. During pregnancy, the post partum period and onwards.
The muscles play a role in starting and stopping the flow of urine based on a contraction of the detrusor muscles. For more see our bladder blog
Men have pelvic floor muscles too. Surprise, surprise They are important for avoiding the post urinating drip. They can also have issues when the prostate becomes enlarged and presses on the nerves innovating the pelvic floor muscles.
They provide support your pelvic organs from below. Vital for any kind of exercise especially jumping & running. Also anything that causes an increase in intra abdominal pressure Eg coughing, sneezing & laughing.
They play a role with sexual sensation. The pelvic floor muscles help the clitoris become enlarged with contraction and can increase the sensation of an orgasm when contracted at the same time.
Assist in baby delivery. The pelvic floor muscles help guide the baby’s head into the birthing canal when the time is ready.
They are just like any other muscles in the body. They have blood flow, you can strengthen them, relax them and they can become tight and cause other issues.
Slow twitch and fast twitch fibres. Which work like any other muscles, slow to perform endurance type activities and fast to stop the flow of urine quickly.
Pain and swelling can inhibit your muscle control. The same as a lot of muscles in the body when we have pain and swelling it can interfere with the function of your muscles.

So many reasons to be thankful for these muscles! And if you don’t think you know how to activate them or wondering how strong you are? Take our Pelvic Floor Quiz below and find out.

Education Exercise Labour Post Natal

5 Essentials for New Mums

Post author By Melanie Platt
Post date December 12, 2019

As a new mum, you generally forget about yourself and look after everyone else. Hands down it’s about survival. However, I’m here to remind you the 1st 8 weeks are by far the best time for your body to recover!
Research has shown the best recovery gains in your stomach muscle separation and function are within the 1st 8 weeks. Don’t freak out, there are very easy and gentle exercises that you can do at home within this time frame, none of which put your body at risk.
Read on for 5 easy things to do:

1. Work on your pelvic floor from day one! This is so vital and important. Make sure your pelvic floor muscles are working, strong and able to hold everything in. You can start activating your pelvic floor muscles 24 hours after giving birth, regardless of the way you gave birth. Remember you may not be able to feel much happening down there and it may hurt. Keep going slowly and start to connect the pathway from your brain to your muscles by trying daily.

2. Have your abdominal separation checked and go slow. Don’t even think about an abdominal crunch until your separation has been checked multiple times by health professionals and you feel strong within your pelvic floor. You have a window of 8 weeks post baby to really work on getting your separation as close together as it will go. See someone early and start gentle exercises early.

3. Start gentle lower tummy exercises. Transversus abdominis especially, this is a great muscle providing lower back, pelvis and stomach support. Start gently by lying on your back and trying to slowing draw your belly button to your spine without tilting/moving your bottom/pelvis or spine. This is a great one to help activate those deeper muscles to help with your abdominal separation. If you have a separation add gentle compressions with your hands to close the muscles together.

4. If you are keen to get back into running, surfing or more high impact exercise build up to it once your pelvic floor and deep stomach muscles are strong. You need to start by by building a base and this can be done with general walking. Move onto pilates, yoga and more dynamic exercises as you feel stronger, again ensuring your pelvic floor is working during your other exercises. Your hormones are still changing which means your muscles can’t possible be at their maximum strength until 3 months post baby so don’t even think about running or any high impact exercise before this time.

5. I’m all for women getting back into exercise and sport and reaching some kick arse goals but that takes time. This is the time to focus on strength, not weight loss or pre baby body etc. There is no such thing! Your body has gone through something amazing and is like nothing else you will ever go through. You can’t possible expect your body to be like it was. That’s way too much pressure on yourself. Relax, be kind to yourself and take away the pressure. Aim for strength and posture. The weight loss will come later.

I have seen some clients feel good and think their pelvic floor is strong and go back to the gym at 6 weeks post partum and end up with a prolapse. The inside takes time to recover and heal. Focus on healthy choices and gentle movement. My general rule is no running until you can hold your pelvic floor on for 10 full breaths while walking and even then not before 3 months post partum.

Hot tip: TAKE YOUR TIME! Your body needs nutrients to support you and your baby. Be healthy, eat good nutritious food and go slow getting back into exercise. Remember it can take a year to recover from pregnancy and labour. Be patient and kind to yourself, you’re a mum now.

There is help! Join our new mum recovery program and get all the exercises you need for your 1st 12 weeks.

10 exercises/week that are super gentle and don’t take up much of your precious time.

New Mum Recovery Program