Pelvic Floor Weakness – what is it and how can it be treated?

Pelvic floor weakness may be seen as an embarrassing problem for some, but it is certainly not something to shy away from – and it is more common than you think. But what does it actually mean?

The pelvic floor muscles support the bladder, bowel, uterus, vagina and prostate. If they are weakened, you can lose control of the muscles and the internal organs can’t be fully supported.

Symptoms include leaking urine when coughing, sneezing or laughing, painful urination, being unable to control the bowels, pressure or pain in the pelvis area or rectum. Sufferers may also have a prolapse – in women this is a bulge in the vagina or a feeling of heaviness or discomfort. In men it may be felt as a bulge in the rectum or a feeling of needing to empty their bowels without actually needing to go.

So what are the causes? Sometimes, the pelvic floor weakness cannot be explained. However, the most common causes are:

● Pregnancy and childbirth – the muscles have to support the increased weight of the uterus during pregnancy, and childbirth puts massive pressure on the muscles and can lead to over stretching

● Chronic constipation – the straining to pass stools and being unable to relax the muscles during bowel movements can lead to pelvic floor problems

● Surgery – some forms of surgery require cutting the muscles around the pelvic floor, leading to potential damage and weakness

● Obesity – being overweight can lead to increased pressure on the muscles, causing them to weaken over time

● Age – pelvic floor muscles can deteriorate over time due to age, particularly if some of the above factors have come in to play

Now we’ve looked at the common causes pelvic floor weakness, how can it be treated?

The most common treatment is pelvic floor, or kegel exercises, which involves squeezing and relaxing the muscles to strengthen them. You should sit comfortably and squeeze the muscles 10 to 15 times in a row, without holding your breath or tightening the stomach, buttock or thigh muscles. The muscles should be squeezed quickly then released, but when you get used to doing the exercises you can try to hold each squeeze for a few seconds.

Physiotherapists can also help to strengthen and rehabilitate the pelvic floor area by teaching you additional gentle exercises to train the muscles, as well as giving advice about daily activities, fitness and good bladder and bowel habits. They may also use a specialist technique called ‘biofeedback’, during which they use sensors and a computer to show how your muscles are working, allowing the physio and the patient to see how your muscles are being exercised when you contract and release them. The physiotherapist will look at your muscle strength and create a series of exercises specific to you to continue at home – which is vital if you want to see results.

Along side this treatment, your doctor may prescribe you with muscle relaxant medication, which can stop the muscles from over contracting, which can lead to fatigue. Surgery may also be considered if other therapies aren’t working, however this is usually a last resort. What’s important to remember is that, if you are diagnosed with pelvic floor weakness, there are ways to help. Once you have received a diagnosis from a medical professional, they will be able to put a treatment plan together to get you well on the road to recovery.

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