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When I (Scott) was in physio school, I was taught mnemonics to help remember anatomy. ‘S2, S3 and S4 keeps pee and poo off the floor’ helped me to remember what the sacral (S) nerves are responsible for.

A properly functioning pelvic floor, supplied by the sacral nerves, will allow normal sexual function and both urinary and fecal continence. It is also an important component of pelvic stability, which can be a contributing factor in lower back and pelvic girdle pain (LBP and PGP).

You’ve all probably heard of Kegel’s (exercises to strengthen the pelvic floor), but it’s important to know that these exercises are not just for pregnant or postpartum women. Pelvic floor dysfunction is not always caused by weak or under active muscles. An overactive pelvic floor can be a cause of incontinence, LBP or PGP as well, and research has shown that an overactive pelvic floor is more commonly associated with disability than weakness is.

Stress incontinence is leakage of urine caused by coughing, sneezing, or other movements (e.g. jumping) that put pressure on the bladder;

Urge incontinence is the loss of urine after feeling a sudden need to urinate. The most common example of urge incontinence is the sudden need to urinate once returning home. For some people, the time it takes to find your keys, open the door and get to the toilet before it’s too late is a challenge.

Stress incontinence is more likely caused by weak or under active pelvic floor muscles, whereas urge incontinence is more often caused by overactive muscles. Knowing which type of incontinence you suffer from can help guide treatment; however, it is always best to see a healthcare professional for a comprehensive assessment and treatment plan. Strengthening an overactive pelvic floor or performing stretches and relaxation techniques for an under active pelvic floor can actually make symptoms worse.

Some guidance

Building awareness of the pelvic floor is often the first step to improving continence. Contrary to belief, these exercises should not be performed while using the toilet. Once you feel comfortable doing these awareness exercises without holding your breath or straining, you can attempt to hold these contractions for longer periods and perform several repetitions. You can also incorporate these into your daily life by contracting your pelvic floor before every time you cough, sneeze or stand up from a chair (a ‘functional kegel’).

Note: please get in touch with Scott for these exercises and more information in an assessment online.

Continence requires pressure in the urethra to exceed that of the bladder, so you can delay the urge to urinate (and avoid an accident) by contracting the pelvic floor. If you are suffering from an overactive pelvic floor, lengthening the pelvic floor muscles with deep squats, pelvic tilts or specific stretches can assist in relaxing these muscles and delaying the urge.

Incomplete emptying or straining while on the toilet can worsen pelvic floor dysfunction. Leaning forward, sitting with your knees above your hips, and breathing can help with these issues. If needed, you can blow into your fist rather than straining.

What to if you have any of the symptoms listed above?

If you are suffering from incontinence, sexual dysfunction, lower back or pelvic girdle pain, please don’t hesitate to get in touch. Leaving these issues alone could make things worse over time, and this can lead to anxiety, depression and fear of social situations.

We will provide you with an accurate diagnosis, teach you how to become aware of your pelvic floor muscles, and create a treatment plan that is right for you so that you can regain control of your life.

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