The Low Down on Down Below

By December 30, 2018 The Body Space

It’s a fact of life that having a baby has a huge impact on a woman’s body and not always a good one. Our boobs get huge and then saggy, we get a mummy belly that never seems to quite go away and our pelvic floor often seems to forget what it’s supposed to do and we can start getting embarrassing leaks. But all is not lost! As a Women’s Health Physio, I see lots of women who struggle with pelvic floor problems and what’s great, is almost always, there are things I can do to dramatically help ease their symptoms or eradicate them all together.

Leaking a bit of wee when you laugh, cough or jump might be common after having a baby but nothing about it’s normal and don’t let anyone tell you otherwise! There’s plenty that can be done to help and that all starts by seeing a Women’s Health Physio. “A whatey what physio?” I hear you say. Well we are a small subsect of physios that specialise in treating the pelvic floor.

So what do you need to know about the pelvic floor and why is it so darn important? Well think of it as a sling of muscle that goes from your tailbone to your pubic bone. It’s role is to literally hold up your abdominal content and help control weeing, pooing and it also goes a long way towards having a cracking orgasm! When you’re busy growing a tiny human, your pelvic floor can hold up to an extra 4-5kg in weight and that’s no small feat. So regardless of how you have your baby, that pelvic floor has had a tough time throughout pregnancy.

When you come to have your baby (vaginally or via C-section) the pelvic floor gets a bit of a hammering. Whether it be from a big old head passing through it (maybe even a set of forceps or a ventouse thrown in for good measure) or poor communication with the brain afterwards because it’s closest ally, the deep tummy muscles just got cut having a C-section, the pelvic floor just isn’t firing on all cylinder afterwards and needs some much deserved TLC!

So what should happen? In an ideal world, every woman in the UK would have a pelvic floor assessment and rehab after having a baby. In reality, almost every woman gets told a bit of pelvic floor weakness is normal after having a baby and it’ll probably get better in time!

Here are the stats (MacArthur et al 2012):

· If you’re incontinent a few months after giving birth, there’s a high chance you still will be 10 years

· 1 in 3 women have a pelvic floor problem

· 45% of all mothers will experience urine incontinence within 7 years of giving birth

Frankly, that sucks and what’s even worse, is it’s so preventable! If 6 weeks after having your baby you’re having a bit of a leak (or before that if you having a full wee), ask your GP for a Women’s Health Physio referral. If you can afford to go privately, then that’s a good option too, if nothing else because our poor NHS physios are hugely stretched and resources are low. Don’t always expect your GP to know much about Women’s Health Physios too – we are a hugely untapped source, mainly due to lack of public and doctor’s awareness.

But aren’t pelvic floor exercises meant to sort all this out? Well yes and no. Many women have what we call an over active pelvic floor. Imagine your calf in cramp – hurts a lot right? Well, same sort of thing can happen with the pelvic floor. It can get tighter and tighter, unable to relax fully. This can cause symptoms such as constipation, back and pelvic pain, pain during sex, tummy ache….to name but a few. If you try do the normal pelvic floor exercise when you’re overactive, all you do is make it worse. Instead you have to teach it relax before you can then start strengthen it! So having your pelvic floor checked first before you start your exercises really is very important.

Pelvic floor problems extend way beyond leaking wee. They can include uncontrollable flatulence, being incontinent of poo, terrible pain in the pelvis or vagina (the list goes on) – all of which can be helped by physio. We can also help with pelvic organ prolapse, with statistics showing pelvic floor physiotherapy exercises are more effective than surgery in most cases of pelvic organ prolapse (when your uterus, bladder or rectum push into the vaginal space).

Our main message, please don’t suffer in silence. With 1:3 women struggling with this stuff, you are in excellent company. There is help out there so please ask your GP to refer you or google your nearest Women’s Health Physio. Spread the world and help us to make the UK a drier place!!

You can find more from our women’s health physio’s on the Total Health Physiotherapy website and Facebook page.


Author Sarah

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