TLC for the PFM: How to Locate, Exercise and Care for your Pelvic Floor Muscles

TLC FOR THE PFM: HOW TO LOCATE, EXERCISE AND CARE
FOR YOUR PELVIC FLOOR MUSCLES

As women, we've all heard about the importance of our pelvic floor, but let's have a show of hands: how many of us really keep up with our regular exercises, or even know if we're doing them correctly in the first place?

For women recovering from breast cancer, strengthening the pelvic floor is key to a full body recovery, especially following a mastectomy or reconstruction, as pelvic floor muscles can be significantly impacted by these procedures.

To tackle this complex topic, Cancer Rehabilitation Specialist, Occupational Therapist and founder of the Bounce Back from Breast Cancer program, Kate Perkins, recently hosted an in-depth conversation with Exercise Physiologist, expert in pelvic floor function and founder of Healthy Bumps, Alison Taylor. Here we share the highlights from this wide-ranging, practical and enlightening discussion.

First things first: what is the 'pelvic floor', and where would you find it in the female body?
The pelvic floor sits in the base of your pelvis, and it plays a huge role – helping with the control and stability of your hips, while holding up your organs, including your bowel, bladder and uterus.
 
All this work means that the pelvic floor has a pretty substantial weight sitting on it at all times, and when you've got a baby on board, it needs to hold up that additional load, too.
 
It's also involved in sexual function, and studies have shown a correlation between good pelvic floors and better orgasms – and that the more you orgasm, the stronger your pelvic floor gets.
How many muscles are there in the pelvic floor?
A huge number – it's essentially a web of muscles. A woman has three 'holes', which are your sphincters, that are encased in a ligament sling that attaches to the front.
 
For women who have had a mastectomy there are so many muscles involved and affected, and that includes the abdominal and pelvic muscles. Women who have had reconstructions using a TRAM flap or DIEP flap will find their lower abdominal muscles significantly impacted. Also, any women who have previously undergone childbirth or a hysterectomy will have already had their deeper abdominal muscles affected by these events, making pelvic floor muscle strengthening especially important in these cases.
How do I go about finding my pelvic floor in order to strengthen it?
Many people are most able to get a sense of where everything is when they're sitting down on the floor.
 
Essentially, you've got the bones at the front, and your tailbone, and then you've got those 'sit bones' that dig into the ground.
 
These are the four points where all these muscles intertwine, and they create a 'hammock' at the base of your pelvis. In the middle, you'll find the gap for the three holes.
Is there a 'right' method to find our pelvic floor? Is it the same for everyone?
It's important to note that there's never a blanket approach, and different methods or techniques can work for different women.
 
If you need assistance to locate your pelvic floor, as a first step, our experts highly encourage you to seek out the guidance of a Women's Health Physiotherapist – the 'gurus' of the pelvic floor.
 
Additionally, if you want to make sure you're exercising your pelvic floor correctly, a Women's Health Physio can do an internal assessment to tell you exactly how your pelvic floor is performing – if it's tight, weak on one side, dysfunctional in one area, and able to engage or not.
 
Once you know how to engage your pelvic floor properly, and you have an understanding of any weaknesses, you can start to work on improving them.
What are some common errors when trying to strengthen a person's pelvic floor?
The pelvic floor is a full muscle and it engages, tightens and relaxes, much like a bicep.
 
A lot of people tend to engage their pelvic floor a little bit, but then fail to adequately release it, and if you can't relax your pelvic floor, it can't function properly.
What happens when a woman experiences a prolapse?
A prolapse is when the weakness becomes a little bit overbearing for this 'hammock' of muscles, and either the bowel, the bladder, or the uterus is unable to stay within the sphincter.
 
As a result, the organ comes down or out of the hole slightly.
 
There are a range of levels – it might be resting on the hole and unable to be held up into its original position, or it might actually come down the hole itself. In this case, surgery may be required.
How common is prolapse?
Prolapses are really common – once pregnant women have actually had their baby, they tend to get caught up looking after baby and becoming a 'supermum', and forget to look after themselves.
 
Often, a woman might not even feel it coming, because the muscles often don't give us much warning. This is why it's so important to get ahead of the issue as much as you can.
Now we know why a strong pelvic floor is so important – how can I be sure that I'm strengthening or 'switching it on' properly?
There are a great number of websites, exercises and videos available on the subject, but if you're at all in doubt, our experts recommend searching for a Women's Health Physiotherapist who specialises in pelvic floor rehabilitation as your first port of call.
Get in Touch
Pelvic floor expert Alison Taylor's 'Vagina Rehab' classes will be available to all members of the Bounce Back from Breast Cancer community. Head to bouncebackfrombreastcancer.com to find out how you can become a member.
 
To find out more about moving through breast cancer rehabilitation contact Cancer Rehabilitation & Lymphatic Solutions on 4312 7033 or email [email protected]
 
To learn about a whole range of issues affecting women's health tune into our Talking with the Experts podcast series.