How to know if you have a weakened pelvic floor and how to strengthen it (be careful with the Chinese balls!)

The

thing is like Santa Barbara, we only remember it "when it thunders."

We are aware of its existence or, at least,

as Samantha said in 'Sex and the City', but we have no idea of

until, one bad day, we They say that we have weakened it and that, in the best of cases, we have to put our batteries together to avoid going through the operating room.

"The pelvic floor is still the great unknown. Even now that it's 'in', we still think it's something 'down there' and something to do with

but we're still not sure," explains Arantxa Saldise, an expert physiotherapist in Women's Intimate Health.

What, then, is that mysterious pelvic floor that is being talked about so much now?

"The

as such, is the set of fascias, muscles, ligaments, etc. that close the pelvis in its lower part. Frequently, we believe that it is a single muscle that cuts off the stream of pee when it really consists of about

and has a variety of functions," says Saldise.

As an expert in Female Intimate Health or Pelvic Floor, however, this specialist is more in favor of talking about the

"The management of abdominal pressures directly influence the pelvic floor and working the CALP is much more complete than focusing on the pelvic floor itself. Structures such as the

and

are also of special importance for the health of the pelvic floor and must be taken into account to improve problems or dysfunctions of the same".

PELVIC FLOOR FUNCTIONS

Indeed, one of its functions is "

, thanks to which it controls the sphincters which in turn control pee, gas and feces".

According to the National Incontinence Observatory (ONI), 25% of women aged 35 and over suffer from incontinence and the percentage rises to 50% over 65 years of age.

"In other words, we are talking about one in four women, from the age of 35, and one in two, from the age of 65, suffers or will suffer

.

Although they live in silence due to the shame that, even today, they continue to generate, "around

at some point in their lives and most will resign themselves, due to ignorance or shame, without knowing that

.

But there is still more: "almost 30% of women suffer from

, which, it should be noted, is one of the most frequent causes of prolapses."

Beyond this very important function of continence, the pelvic floor performs an essential sexual task, "since it controls sensitivity and orgasms, among others."

This means that

"Of course, if our pelvic floor is stronger and more toned, our vagina will not be distended or open and our orgasms will be better, easier to achieve and more pleasurable. If these orgasms are produced by penetration, our partner will also feel more pleasure when feel a stronger and more toned pelvic floor.

Beyond intensifying our pleasure, the pelvic floor is also responsible for "

pelvic organs and influencing the balance of the upper and lower parts of the body."

In addition, it plays "an important role in

, helping the baby's head to come out if the tone of the pelvic floor is adequate and favoring the well-known ejection reflex."

HOW IT AFFECTS PREGNANCY

It escapes no one that, during pregnancy, a variety of

, which adapts to the creation of a new life and is gradually modified to favor the birth process.

Some of these changes

which prepares like the rest of the body for childbirth.

Which are?

Arantxa Saldise details them for us:

-

"As the baby and the maternal uterus grow, the weight and pressure on the pelvic floor increase. Therefore, pregnant women are recommended to acquire good lifestyle habits so as not to gain weight and gain more weight than necessary."

-Increased levels of estrogen and progesterone:

"These hormonal changes make the muscles and ligaments of our body much more lax. This makes it possible for our abdomen to distend without problem and for the muscles of the pelvis to adapt during childbirth but it makes the pelvic floor weak.

-Increased curves of the spine

: "It produces an alteration in the center of gravity of the pregnant woman that causes the pressures to go more towards the anterior area of ​​the pelvic floor (weaker and with less musculature) than to the posterior" .

- Constipation:

"Many pregnant women suffer will cause the pelvic floor to weaken more with each defecation push, increasing the risk of internal organs descending."

- Abdominal diastasis:

"Between 40 and 80% of women suffer, already in the postpartum period,

(separation of the recti from the abdomen)".

SIGNS THAT WE HAVE A WEAK PELVIC FLOOR

The weakening of the pelvic floor can manifest itself in various ways.

Some of the most common alarm signs, according to this physiotherapist, are:

Urinary incontinence

: ""The involuntary loss of urine when coughing, sneezing, laughing, running, jumping or lifting heavy objects can be a sign that the pelvic floor is weakened.

Even if this happens occasionally or is just a drop.

Pain or discomfort during sex

: "Weakening of the pelvic floor can cause these muscles to not contract properly, which can cause pain during sex."

Difficulty reaching orgasm

: "Like the previous section, if there is no muscle contraction and/or the vagina is very distended (open) it may be more difficult to reach orgasm or even not at all. Being difficult to feel pleasure in the relationships".

Feeling of heaviness

in the pelvis: "A feeling of heaviness or pressure in the pelvis may be a sign of pelvic floor weakness."

Pelvic organ prolapse

: "The weakening of the pelvic floor can cause the pelvic organs, such as the uterus, bladder or rectum, to fall into the vagina. There is usually a sensation as if there is something in the vagina or even feel, see or touch a

depending on the degree of the prolapse.

Difficulty holding back gas or stool

: "A decrease in pelvic floor strength and tone can also lead to involuntary loss of gas or stool."

Arantxa Saldise recommends that "if you experience any of these alarm signs, it is important that you

in the pelvic floor or your family doctor to receive the appropriate referral, diagnosis and treatment indicated as appropriate".

What's more, "even if there are no symptoms, even if we don't feel there is a problem, even if it's a young woman, it

."

In addition, "depending on the problem or symptom of the woman, it is possible that it should

and not only by Physiotherapy specialized in Female Intimate Health or Pelvic Floor. There are many patients and the treatments that go hand in hand and we rely on different professionals such as

among others. Each one has their plot and depending on the problem we will refer to one or the other or we will work together".

In the case of pregnancy, he adds, "the most appropriate thing would be

, etc. And, according to this assessment,

for home exercises or habits to change and will indicate which

should be followed and when if necessary".

If everything is fine, "the usual thing is that they are given instructions to go home and they are evaluated again from week 34-35".

In case of finding "

, whether it is a hypertonic diaphragm, ribs with little mobility, lower back or pelvic pain, increased tone of the pelvic floor or pain among others, it is very possible that you will be advised to return to the consultation to perform physiotherapeutic treatment when the professional sees fit".

With this assessment, "we can recommend whether or not to perform Kegel exercises, for example, or whether you should take special care with your posture or your abdomen."

This is, obviously, a

: "It is clear that a pregnant woman at week 20 with a hypotonic (soft) pelvic floor will not follow the same guidelines as another with a hypertonic pelvic floor who even feels pain during sexual intercourse ".

Thinking that, she continues, "doing four Kegel exercises or a few minutes of hypopressives is enough (especially if we don't do them correctly and if we don't know exactly what we need for ourselves) is not only not enough, but it can counterproductive. In general,

and we are the main responsible for it".

IS IT JUST 'A WOMEN THING'?

"No, it's not something exclusive to women. What happens is that male pelvic floor problems are different and tend to appear at a

than in women."

including

:

Age:

"As men age, the pelvic floor muscles can become weak, which can cause urinary incontinence problems."

Prostate Surgery:

"Prostate surgery can weaken the pelvic floor muscles and cause urinary incontinence problems."

Sedentary lifestyle

: "Lack of physical activity can weaken the pelvic floor muscles."

Chronic constipation:

"Constant straining to have a bowel movement can weaken the pelvic floor muscles."

Injuries or trauma:

"Injuries to the pelvic area can weaken the pelvic floor muscles."

Sport:

"Practicing certain sports excessively, such as cycling."

To strengthen the male pelvic floor, "exercises and treatments can be performed, just like the female pelvic floor. If you experience pelvic floor weakness, it is important to see a physical therapist or specialized doctor for diagnosis

."

MOST FREQUENT MISTAKES ON THE PELVIC FLOOR

"Honestly, says this specialist, I think we have been

. How many times do we listen to mothers or have we heard ourselves phrases like: "Come on, pee quickly, we're in a hurry"; "if not the poop comes out, push a little, honey"; "you have to pee before you go out or go to sleep"; "don't take that thing that is poop" and, like that, a long etcetera. Perhaps, it seems silly but, with that kind of education, we are creating habits that over time can cause problems and dysfunctions of the pelvic floor".

These are, in his opinion, the five most frequent mistakes we make:

1. "To pee

, even if we don't feel like it, because we go to class, go to the doctor, leave the house, go on a trip or sleep, for example."

2. "Perform the

. Many years ago, it was recommended to cut the stream while peeing several times to strengthen the pelvic floor. Not only does it not achieve that, but if it is done over time it can generate dysfunctions of the same ".

3. "Use the

to strengthen the pelvic floor without the prior assessment of a professional. The Chinese balls tone the pelvic floor, but if we suffer from urinary incontinence or some other dysfunction, it is very possible that we will get worse instead of better or even get out."

4. "

to start, during or end urination, as well as to defecate. And not adopt a physiological position for it."

CONTRAINDICATED PHYSICAL ACTIVITIES

of ​​the body should be avoided

, since this can worsen the symptoms and increase urinary or fecal incontinence, among other things as I commented before".

What physical activities are we talking about?

Here is a list:

-Jumping and high-impact exercises,

"such as running, jumping rope or doing jumps with open legs."

exercises

, "such as weight lifting, weight squats, or heavy lifting."

exercises

, "such as

(yes, planks are wonderful but you have to review how they are done and they are not the most appropriate exercise when there are pelvic floor problems). In general, any in which the trunk is raised or the legs are placed diagonally, because

and if they are not performed properly and with a competent abdomen they could worsen the symptoms and weakness of the pelvic floor".

-Yoga or Pilates exercises that involve movements that increase abdominal pressure

, "such as the downward facing dog (it depends on how the woman performs it), the V or the hundred Pilates."

Is

, especially after having been a mother or after a certain age?

, but there may be certain factors associated with the exercise of running that can be problematic for the pelvic floor. The pelvic floor is a set of muscles and ligaments that support the pelvic organs. such as the bladder, uterus and rectum

.

If your pelvic floor muscles are weak or damaged, this pressure can cause problems like the ones mentioned above.

For example, if the intra-abdominal pressure increases the pressure in the bladder and this is greater than what the urethra can withstand.

there will be a small or large urine leak on impact."

This specialist points out that "at certain stages of a woman's life, such as after giving birth to a baby or in the menopause, the risk is greater due to hormonal changes that do not usually favor the state of the pelvic floor. Therefore, there would be In these cases, assess their condition before starting to run".

However, he clarifies, "there are

, such as strengthening and toning your pelvic floor muscles with specific exercises and making sure you have good running form."

In addition, "there are different types of pessaries, tampons or vaginal umbrellas that can help

. Their use should be recommended after a pelvic floor assessment by a specialized professional. It is not necessary or recommended in all cases and is always accompanied by exercises or treatment of the pelvic floor".

In short, "running isn't necessarily bad for your pelvic floor, but it's important to take steps to protect, tone, and strengthen it while running" and, in any case, "it's important to consult with a women's health professional before running

" starting any physical activity if you have pelvic floor weakness. Also, it's a good idea to work with a pelvic floor physical therapist to strengthen and rehabilitate this area before beginning any strenuous physical activity."

TIPS FOR MAINTAINING A FIRM PELVIC FLOOR

These are Arantxa Saldise's five tips to prevent, improve and tone the pelvic floor:

1. "

. Stay self-elongated, as if you were growing."

2.

It's about contracting and relaxing your pelvic floor. Of course, it's important to do them correctly and not push your pelvic floor."

2. "Perform a

before the efforts. Before carrying weight or sneezing, for example."

3. "

. Activate and work your abdomen and transverse, either with adequate abdominal exercises that respect your pelvic floor, with hypopressives, with the trunk or 5p method or any exercise to improve the core that does not hurt the pelvic floor."

4. "

. Give mobility to your ribs and release the air when making efforts to protect your pelvic floor."

According to the criteria of The Trust Project

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