The pelvic floor is a part of the body that we often do not know well to identify but which is fundamental for our well-being. How can we keep it toned and healthy?
Don't store avocado like this: it's dangerous
The pelvic floor is a part of the body that we often do not know well to identify but which is fundamental for our well-being. How can we keep it toned and healthy? We asked Michela Bardino, midwife of Santagostino.
Many people underestimate an important fact: having a toned but also elastic pelvic floor has a series of benefits for different functions of our body, including sexuality. It is therefore important to capture any problems in time as well as refer to an expert to understand which are the best exercises or treatments to do for your specific situation.
We asked the midwife Michela Bardino for some advice who first explained what exactly is meant by pelvic floor:
It is a structure composed of muscles and ligaments that closes the pelvis at the bottom and supports the organs of the pelvis which in women are the bladder, uterus, vagina and rectum. It has a structural role, therefore of maintaining the correct anatomical relationship between these organs, supporting them, keeping them in place, and a functional role since it participates in complex functions such as urinary continence, fecal continence, evacuation, sexuality and also in childbirth plays a role.
Index
Is it important for both men and women?
Men also have it but there is a big anatomical difference because the presence of the vagina in the woman completely changes the muscular structure and the challenges that the pelvic floor has to endure, because a completely closed pelvic floor except the small opening for the the urethra and the rectum in the male works much more easily and is more solid than the female one which has a soft central opening. As a result, women are more prone to pelvic floor problems. It must also be said that the same symptom in man and woman can have completely different dynamics, for example urinary disorders, because the man has a prostate so the problem could be linked to that gland while in the woman it can depend on the pelvic floor.
How can we tell if we have a pelvic floor problem?
Women may suspect that they have symptoms related to pelvic floor dysfunction. The most classic symptoms are urinary incontinence (for example after a cough, a sneeze, a run, a jump) but also the opposite: difficulty in emptying the bladder, too frequent stimulation. Then problems with evacuation, constipation, stubborn hemorrhoids as well as the opposite, anal incontinence for example. There are also symptoms in the sexual sphere: poor perception, difficulty reaching orgasm but also pains during intercourse. So it's a bit difficult to evaluate yourself, to better frame the problem you need an obstetric visit after which you will decide on the most correct exercises or other treatments to solve that specific case.
Also consider that the pelvic floor can be malfunctioning and does not give symptoms for some time, this is the reason why in some countries in the postpartum, which strains the pelvic floor a lot, all women do an evaluation (even in the absence of symptoms ) and rehabilitation which is then personalized.
Can pelvic floor problems appear even before pregnancy? What sports are recommended?
Absolutely yes. In my clinical experience more than half of my patients are under 30 who have muscle stiffness. There are some more risky sports on the onset of pelvic floor problems. High impact sports such as intense fitness, rope jumping, volleyball and all other sports that involve repeated jumps. Sports in which you risk, if you are unaware, of having a very developed muscle tone but sometimes not counterbalanced by a work of elasticity. For example, let's talk about ballet and artistic gymnastics. This does not mean that these sports should not be done but that in addition to the tone of the muscles you must also work on relaxation.
Sports that teach us to listen to our body, to breathe and to learn to become aware of the natural movements we can do are good for the pelvic floor. Yoga and pilates for example.
Can the classic Kegel exercise be done at home?
The Kegel exercise, which involves contracting and relaxing the pelvic floor, is also the basis of rehabilitation with the professional. The problem with doing it at home is that women often believe they can do the correct movement and instead either use other (wrong) muscles or instead of contracting they do a pushing movement as if to evacuate. And it is not so trivial to realize this. So it can happen that doing this exercise the wrong way instead of improving the situation makes it worse.
Consider that 30% of women are unable to activate the correct muscles at first.
Even the contraction time and the relaxation time in Kegel exercise must be modulated on the type of training that the muscle needs, if your muscle is stiff you will probably have to contract very little and relax a lot, if instead the muscle is weak you will have to perform these contractions. with a certain number of sets and reps appropriate to your muscle.
How is this exercise practiced?
The first thing to do if you want to practice the exercise is to understand if you are able to activate the right muscles which are the ones that are able to tighten the vagina and the anus and block the stream of urine while we urinate. This is a test you can do to see if you are able to selectively activate those muscles without getting confused with your abs, glutes or legs. However, it is absolutely not necessary to train the muscle by stopping the urine every time we go to the bathroom, as someone still advises.
You can try to understand if you are able to slowly contract and relax the pelvic floor while lying down, with your legs bent, your back snug against the mat, your feet resting on the bed.
However, consider that it is not possible to recommend an absolute exercise that is always suitable for every situation. Just as for back pain, completely different exercises may be needed, so also for the pelvic floor.
What else can we do at home to keep our pelvic floor healthy?
It is important to try to identify all those movements and postures that create pressure from the inside on the pelvic floor: when we are sitting a little hunched over, the cough, the sneeze that squeeze from the inside down and create pressure. All these movements should be accompanied by a balancing pelvic floor contraction to protect that part and support the organs while avoiding excessive stress on those structures.
And in pregnancy?
Learn if you have control over the pelvic floor with the exercise recommended above and keep it in motion with repetitions in which you are careful to contract but above all to relax, because in pregnancy obviously the pelvic floor is very tired and tends to stiffen as a modality of compensation.
Then you don't have to be sedentary: it is good to walk, swim, stretch because this helps postural adaptation including that of the pelvic floor.
After childbirth, report early if symptoms related to malfunctioning of the pelvic floor appear, if there have been stitches or episiotomy, if you have intense and persistent pain beyond the first week. And two or three months after giving birth it is good for all women to do an evaluation.
