Women - don't ignore your pelvic floor

TAKING good care of those floors, ladies? Don't worry, you haven't just stumbled across an article from five decades ago - we're talking pelvic floors, and looking after them is almost certainly something you'll want to do.

Pelvic floor exercise isn't really given the air time it deserves. Maybe you first read about it in magazines as a teenager, in the context of enhanced sexual pleasure, though often we don't really become familiar with the concept until everyone starts having babies. But even then, are you really sure what it means? Have you totally got to grips with doing it right?

What exactly is the pelvic floor?

"The pelvic floor is a layer of muscles that extends from your tailbone to your pubic bone [back to front]. This layer forms a sling that's responsible for supporting your pelvic organs [bladder, bowel and uterus], maintaining continence, and has a role in sexual pleasure," explains Holly McKenzie, a women's health physiotherapist at London's BOOST Physio (www.boostphysio.com).

Yes, it's in a region that adjoins your core muscles, but a strong core doesn't automatically equate to a strong pelvic floor. "There are numerous muscles that make up the core, the deeper stability muscles [transverse abdominis, multifidus and the pelvic floor muscles] and the larger global muscles [obliques, rectus abdominis and gluteus maximus],' says McKenzie. "Often when people work on their core, they focus too much on their abdominal muscles. This imbalance can strain the pelvic floor and increase their chance of developing dysfunction."

Is pelvic floor exercise really important?

"It's very important," states McKenzie. "Up to a third of women will experience a problem with their pelvic floor at some point in their lifetime."

The most common problems, she says, are urinary incontinence - which can range from mild (leaking a little when you laugh or run, for instance) to severe - and pelvic organ collapse.

"The pelvic floor also has a role in sexual pleasure, stability of the pelvis and lower back, maintaining bowel continence, and assists in labour by helping the baby's head turn," McKenzie adds.

While the effects of pregnancy and childbirth are most commonly associated with pelvic floor dysfunction, it's something that can affect anybody - chronic constipation, high-impact exercise, heavy lifting, being overweight, chronic cough and menopause can all also be associated, while injuries and chronic health conditions affecting this region may also play a part.

"Regular pelvic floor exercises are essential for all women in the prevention and treatment of pelvic floor dysfunction," McKenzie stresses.

Taboo topic?

"Like lots of women, I never really thought much about the pelvic floor until I had a baby," says Tania Boler, women's health expert and co-founder of Chiaro, a company specialising in women's wearable tech. "My husband's French and I discovered it's normal for French women to attend pelvic floor exercise classes after birth. I was shocked to learn nothing like this existed in other countries, and that one in three women will feel the effects of a weak pelvic floor." She notes that many women with back problems "realise they actually need to work on their pelvic floor muscles as they all work in tandem".

"The problem is," adds Boler, "most women don't think about it until they are pregnant and beginning to feel some of the health problems, such as bladder weakness or prolapse."

Encouraging greater discussion around women's health is a topic Boler's passionate about. "We go through very specific life stages, such as period, menopause and, for many, pregnancy and childbirth. However, these are shrouded in mystery and taboo. As a result, women's health has been neglected, so women lack basic information and tools to make their lives easier."

So what should we be doing?

Hugh Hanley, national personal training manager at Virgin Active (virginactive.co.uk) advises that pregnant women do pelvic floor exercises (often known as 'kegels') daily. However it's a good idea for all women to get in the habit, as a preventative measure and for overall benefits to health, self-confidence and posture.

Unsure how to do them?

"Gradually tighten the muscles you use if you want to stop the flow of urine when going to the toilet," explains Hanley. "Try to do it without holding your breath, squeezing your buttocks together. Hold the squeeze for several seconds and then relax slowly.

"Now pull the muscles up tight and fast. Then relax. Then tighten them quickly again. Use clenching and opening your fist as a visual tool to help you imagine the movement."

There are also products that can help, such as Chiaro's Elvie (£149; elvie.com), a kegel exercise tracker in the form of a medical-grade silicon pod that connects via Bluetooth to an app, guiding women through the exercises and enabling them to monitor biofeedback.

If you're concerned about performing any exercises, McKenzie notes that you can always ask a physio or specialist for advice. And don't worry if you think you've left it too late, and have already started experiencing signs of a weak pelvic floor - it's never too late to start. Exercises can make a big difference, even for women already blighted by stress incontinence, etc. Speak to your GP as a first port of call; there's help out there.