Your Pelvic floor: is it taking the hit?

Part of our new blog take over from Niamh Morrin, Baby and I@babyandi.herts



Introduction


Although the pelvic floor can be troublesome for anyone no matter their age or sex it can become a particularly troublesome part of the body for athletic females (Rebuildo, Faigenbaum and Chulvi-Medrana, 2021), dancers (Thyssen et al. 2002) and maternal women (Faubion et al. 2012). Evidence suggests that female athletes are three times more likely to experience pelvic floor dysfunction as compared to their male counterparts – throw the pre and postnatal journey on top of that; the maternal female dancer, is most certainly at risk of encountering pelvic floor dysfunction (PFD).


The pelvic floor can be particularly vulnerable during the journey to motherhood. Reasons that pregnancy and childbirth can influence pelvic floor function include:

1) A growing bump and widening pelvis will put stress and strain onto the pelvic floor muscles.

2) A long pushing phase or experiencing a tear can directly affect pelvic floor function

3) The overall postural changes and muscle imbalances that can occur during pregnancy can affect the function of the pelvic floor.


Pelvic floor dysfunction is NOT normal and should not be brushed under the carpet as a postnatal issue that’s part and parcel of becoming a mum.

Understanding the basic anatomy and function of pelvic floor, training it in the right way and getting support if needed should be part of every female dancers pre and postnatal journey. What’s frustrating, is that despite its very important functions, the pelvic floor isn’t an area of our body that we can readily see or even feel entirely comfortable talking about. Important functions include:

1) Spine and pelvis stability and support

2) Breathing and posture

3) Pelvic organ support

4) Continence (Urinary and faecal)

5) Sexual activity


Anatomy Basics


The pelvic floor muscles are a group of muscles that together form a hammock at the base of the pelvis (Figure 1). If we were able to look down into the bowl of our pelvis (Figure 1) we would see that the pelvic floor muscles span the entire pelvis cavity – muscles attach to the pubic bone at the front, the coccyx and sacrum at the back and the ischial tuberosities/sitz bones at the sides.

Figure 1: View of the pelvic floor muscles

There are a number of muscles that make up the entire pelvic floor, some superficial and some deep. The superficial muscles provide the squeeze which help with continence and the deep layer supports our pelvic organs (bladder, bowel, uterus). There is also a right and left side and a front and back to the pelvic floor. The right or left side can function or become dysfunctional independent of the other side, the same goes for the front and back and deep and superficial layers. In theory when contracting our pelvic floor we want our pelvic floor muscles to fire as a cohesive unit – just like our primary core muscles (internal and external obliques, transverse abdominus and rectus abdominal muscles). Also, similar to our core muscles, whilst we can consciously contract them, the pelvic floor should fire automatically to provide stability to the pelvis during movement.


Signs of dysfunction


Pelvic floor dysfunction (PFD) is a non-specific term that can encompass a wide variety of conditions. If a pre or postnatal dancer is experiencing PFD they might notice one or more of the following symptoms.

  • Urinary or faecal leakage; this could occur with jumps, coughing, sneezing, or lifting (stress incontinence)

  • Experiencing a very strong and uncontrollable urge to go (urge incontinence).

  • Pelvic pressure or the sensation of something falling out of your vagina

  • Urinary or bowel frequency/urgency (Having to “go” more often than every 2-4 hours during the day or getting up more than once in the night

  • Pain with urination or bowel movements

  • Incomplete bladder emptying (having to “go” again or dribbling a few minutes after urinating)

  • Pelvic pain (pain in the pelvic floor, lower abdominal, coccyx, pelvic region including urethral, bladder and anal pain)

  • Constipation

  • Painful menstruation

  • Painful intercourse


Training the pelvic floor