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The pelvic floor and core

The pelvic floor muscles form the base of the group of muscles commonly called the ‘core’.  These muscles work with the deep abdominal (tummy) and back muscles and the diaphragm (breathing muscle) to support the spine and control the pressure inside the abdomen. 

During exercise, the internal pressure in the abdomen changes. For example; when lifting a weight - the internal pressure increases, when the weight is put down – the internal pressure returns to normal

In the ideal situation the regulation of pressure within the abdomen happens automatically. For example, when lifting a weight, the muscles of the ‘core’ work together well- the pelvic floor muscles lift, the abdominal and back muscles draw in to support the spine, and breathing is easy (Diagram 1). In this scenario, the pelvic floor muscles respond appropriately to the increase in abdominal pressure.

If any of the muscles of the ‘core’, including the pelvic floor, are weakened or damaged, this coordinated automatic action may be altered.  In this situation, during exercises that increase the internal abdominal pressure, there is potential to overload the pelvic floor causing depression (Diagram 2). When this happens many times during each exercise session, over time this may place strain down on the pelvic organs and this may result in loss of bladder or bowel control, or pelvic organ prolapse.  If a problem already exists, then pelvic floor symptoms can potentially be worsened.

Correct action and incorrect action
 
 Diagram 1. Correct action             Diagram 2. Incorrect action

 

Pelvic floor muscles need to be flexible to work as part of the ‘core’, which means that they need to be able to relax as well as lift and hold. It is common for people to brace their ‘core’ muscles constantly during exercise in the belief they are supporting the spine, but constant bracing can lead to the muscles becoming excessively tight and stiff. 

Pelvic floor muscle stiffness commonly coexists with muscle weakness and can contribute to problems such as urinary urgency and leakage.  Other problems often associated with the pelvic floor muscles being too tight include pelvic pain, pain with intercourse and difficulty emptying the bladder. 

 

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