Big news: we all have a pelvic floor. Every single one of us. And having a strong and healthy pelvic floor isn’t just important for people who have been through pregnancy and/or birth. It’s important for everyone.
Yep, that’s right – you need to work on yours too. In case you missed the news, the wider world is beginning to wake up to the importance of pelvic floor exercises, as evidenced by draft guidelines issued in 2021 stating that exercises should be taught in schools. Said guidelines don’t go far enough in my opinion (see above point about EVERYONE needing these exercises – they aren’t gendered), but they are at least a start.
But what about those of us who are no longer in school, and are either unlikely or not going to have a baby (or any more of them!), or those of us who want to prepare in advance? Read on for three things you can do to look after your pelvic floor, and one thing to absolutely avoid…
First Do: Speak up if you’re experiencing symptoms
Women in particular have some serious unlearning to do. One of the greatest lies we’ve been told for generations is that a variety of symptoms are “normal” and “to be expected”. Some of this is rooted in embarrassment and shame, and some of it relates to healthcare and medical research inequality. Ask yourself this: if you are hiding something, is that acceptable? What’s the reason for you hiding said thing? This should be the only clue you need to get help.
Some of the symptoms you should seek help for are: urinary leakage (in any situation); frequently needing to urinate; urinary incontinence; faecal incontinence; anxiety regarding access to toilets; constipation; difficulty passing urine; blood in urine or stool. The first step should be your GP to discuss your symptoms and check for any broader health conditions. Once these have been ruled in or out, you may also be able to find a private practitioner to work on the specifics with you.
Nothing changes if nothing changes. You need to speak up. Embarrassing or challenging as it may be, it’s the only way to make a difference.
Second Do: Listen to your body
“You should’ve gone before we left” and “really, you need to go AGAIN?!” and many other such phrases make us feel even worse about our need to use the toilet. But the fact is that all bodies are different, and nobody knows yours better than you do.
Particularly with the desire to poo, you HAVE to listen to your body, and go when you need to go. One of the greatest facts I’ve ever learned is that our cues to wee and poo are wired differently: ignore the need to urinate and your body will persistently remind you; whereas if you ignore the signal to poo, your body will give up and instead kickstart some wonderful constipation. When you feel the initial need to poo, you have 15 minutes to answer that call – pay attention and start the clock (since paying attention to this fact, I have felt a lot healthier!).
If you need to go – go. It’s as simple as that. Our bodies send us these messages because they require a response, it’s not a negotiation.
Third Do: Learn correct and effective technique
Next revelation of this post: Kegels are crap. You read that right – the world’s most famous lower body exercise is a complete waste of time, it just had a very good agent. The first issue with them is that they don’t engage enough of the pelvic floor (it’s a group of muscles, and some practitioners argue that our pelvic floor includes the majority of our abdominal muscles, but that’s an argument for another day).
When most pelvic health experts say “pelvic floor”, they mean the set of muscles which, together, resemble a hammock, which literally supports your pelvis and many of the organs which sit above it – the pelvic floor therefore goes far beyond urinary continence (or the heteronormative patriarchal definition of pleasurable penetrative sex… oops, that’s another one to argue about another time). Pelvic floor strength also plays into key compound exercises such as squats and deadlifts, primal movements which are critically functional within our day to day lives (now do you see why they’re important to all humans? Whilst we all urinate and defecate, a large number of us also want to pick things up off the floor and clamber in and out of chairs or vehicles).
So: following the classic instruction of “practice by pausing the stream of urine mid-flow” or (for those who have them) “imagine you’re walking into a cold body of water and clench like you do when your balls touch it” (yes, that is genuine guidance provided by a qualified fitness professional – needless to say, that person is not me) is not enough.
The other significant problem with the above practice is that it only teaches you 50% of the movement – it teaches you to engage (some of) the muscle, but it doesn’t teach you to disengage it. Can you imagine if I put you in the plank position and then said goodbye and went off to see my next client? Or handed you dumbbells, asked you to perform a bicep curl, but just to hold the dumbbells at the top for the rest of the day? That’s the equivalent – telling someone to perform half an exercise. When it comes to the pelvic floor, that’s incredibly problematic.
My recommendation (because I have worked with Sarah on my own pelvic floor and this is a genuine good review) is to check out Complete Core Control to learn how to work your muscles correctly (they work with people of all genders).
And What Not To Do: Believe in quick fixes
The straw that broke this camel’s back was an ad which popped up on my Instagram feed. Said advert was for “kegels in a supplement”. Which is an idea I remain as horrified by as when it first happened across my gaze (I reported the ad as being misleading).
The problem with this is very straightforward: as discussed, your pelvic floor is a muscle; pills do not strengthen muscles. Ever. And that’s the claim they’ve made. Muscles get stronger via a process known as progressive overload – it’s the reason your strength programmes have to keep getting more difficult; we build muscle by working what’s already there, which creates microscopic tears in the muscle; when our body recovers, it lays down more cells to increase the size of the muscle.
If you think that same process can be achieved via taking a pill… well, go ahead and try it. But also please don’t. You’re wasting both your time and your money by doing so.
Improving strength requires work and patience. Please do have hope – you absolutely do not have to continue to suffer any symptoms, or wait for them to get even worse. And pelvic floor exercises are particularly accessible, and truly can be done at any time in any location. Help is available, just avoid the con artists!
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