It can feel very challenging to start a pelvic floor training programme, so here are a few tips to help you get started.

First of all, think about your positioning. You can exercise your pelvic floor in any position, but when starting out, it's worth lying on your back with your knees bent or lying on your side. This position will reduce the effects of gravity and will help you to feel more movement within the muscles. As you feel more connected and confident, you can move to sitting and then standing. When progressing to the other positions, you can slightly offload the pelvic floor by leaning forward. So in sitting, lean forward, rest your elbows on your thighs and try to keep your back straight. Have a go at squeezing and releasing and see if it feels good. Then in standing, lean forward onto a worktop / table / wall and see how your pelvic floor movement feels. As soon as you feel confident in the more upright positions, you can progress to adding in your exercises to daily...

Many clients take a long time to reach the point of booking a physiotherapy assessment of their pelvic health problem. We often see ladies who arrive looking very sheepish, reporting that they have done some pelvic floor exercises but life is so busy it's gotten in the way and they've simply forgotten. We're not here to give you a telling off, rather we want to find out how best you can fit in an effective programme of pelvic floor muscle training.

As with any training programme for the muscles of our body, progress will only happen when place increasing demand on the muscles. Whether you have had your problem for weeks, months, years or even decades, it's highly likely that you can make a positive change just from implementing a regular training programme.

During a physiotherapy assessment or wellbeing screening, your physiotherapist will assess your pelvic floor muscle function. This is usually completed with an internal vaginal examination. The examination seeks to find out the...

You may have seen MAPLe advertised on this website as an option for your pelvic floor muscle training. MAPLe is a new device from the Netherlands and is unique in the way it works for pelvic floor muscle training.

The MAPLe treatments are completed in clinic with your physiotherapist and are ideally booked at weekly or fortnightly intervals. The device is set up and handled by your physiotherapist and you are provided with your own probe which can be inserted vaginally or rectally (depending on your symptoms and treatment needs).

The finger-sized probe contains 24 gold electrodes that can do 2 things. Firstly, each electrode can measure the electrical activity in your pelvic floor muscles. Secondly, each electrode can provide electrical stimulation to the pelvic floor muscles. Due to the small size and number of electrodes, it is possible to assess and treat individual muscles within the pelvic floor. For example, if you have delivered a baby vaginally with an episiotomy (cut)...

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10 Weeks since re-opening, Re-Joining the recovery road and pelvic floor hypertonicity and anxiety

There are many devices available that claim to help you train your pelvic floor muscles, but what are they and what do they do?

1. Electrical Stimulator Machines
The best way I can describe these devices are that they artificially exercise your pelvic floor. They are in the same league as those machines you strap to your stomach to get a six-pack.

They work by providing electrical impulses to the pelvic floor muscles via a vaginal or anal probe. The selected settings of the device will target certain actions of the muscle. For example, one setting will work on activation and sensation, another on endurance and increasing hold time and another on speed of contraction.

Electrical impulses can also be used to relax and de-sensitise tight pelvic floor muscles, like a TENS machine for your back. The machines are all able to provide the same treatments and can be a great way to boost your pelvic floor training.

Many of the devices will have pre-set options that you can select easily. There...

Step 1: Technique

It's important to ensure that before you embark on a pelvic floor training programme, you are able to contract and relax the pelvic floor muscles correctly.

Weakness, trauma, disconnection, pain and a lack of pelvic floor awareness can lead to poor technique. 

A poor technique could involve the use of accessory or cheating muscles like the buttocks, abdominals or inner thighs. Or it could include gripping and overactivity of the pelvic floor that causes minimal range of movement and limited release.

It's essential to get the right technique first, and this might mean that you need to work on preparation for a programme more than the programme itself. It's a bit like decorating, the end result will be so much better if you prep the surfaces first. But the preparation phase can feel boring and frustrating! Remember, it will be worth it in the end.

Step 2: Achieving a Habit

The most common cause for failure with pelvic floor muscle training is a lack of...

The pelvic floor muscles are like a hammock sitting at the base of the pelvis. They span the whole of the pelvic outlet, from pubic bone to tail bone and seat bone to seat bone. They also merge with connective tissue known as fascia to provide a dynamic support for your pelvic organs. They're like a cushioned sofa for your bladder, womb and bowel!

So why do I need to train my pelvic floor?

Pelvic floor muscle training is an effective treatment for urinary incontinence. In a review of 31 trials, looking at the effects of pelvic floor muscle training on incontinence in 1,817 women, women experiencing stress urinary incontinence were 8x more likely to report a cure and women with other types of urinary incontinence were 5x more likely to report a cure, if they had undergone a programme of physiotherapist guided pelvic floor muscle training.

You can take a closer look at this information here: https://www.csp.org.uk/frontline/article/pelvic-floor-muscle-training

Let's take a...

The bowels are part of your digestive system and help you to process your food, helping you to absorb nutrients and water. When working well, you should empty them from 3x per day to 3x per week. Anything outside of these ranges could signal problems such as constipation, urgency, food intolerances, prolapse or irritable bowel syndromes.

Problems relating to your bowels can be embarrassing, making you feel nervous when leaving the house. Some of my clients have struggled with their jobs due to bowel issues. It's definitely a problem that needs effective treatment. But the average time taken to seek help is up in the decades, often due to difficulties knowing where to go, who to speak to and embarrassment of talking about the bowels with a stranger.

So, first of all, let's look at bowel problems and put a name to them. This will help you to articulate your problems when seeking help:

1. Constipation
A slow moving bowel often leads to frustration and sometimes pain and bleeding...

What is Stress Urinary Incontinence

Any form of incontinence is the involuntary leakage of urine or stool. It is often unexpected and can be embarrassing. 

Stress urinary incontinence is the leakage of urine at points of physical stress. Anything that causes a squeeze on the bladder can cause the escape of urine. The types of stress can include coughing, sneezing, vomiting, jumping, bending, lifting or even lying on your front!

Although controlling the episodes of stress is a useful treatment, it's not always possible. For example, we can't always control our responses to pollen levels during hay fever season. We can take anti-histamines if able and keep away from the outdoors where possible. 

But, a sneeze can often take us by surprise. And we can avoid running after a toddler who is nearing the road. And should we really have to rule out going running as part of our exercise routine?

As a physio, my answer is a big no!

Movement, activity and exercise are all important...

As it's World Continence Awareness Week, I thought I'd post an email out each day to help you understand more about continence...

We're kicking off with a common condition known as Overactive Bladder. This is a problem where the bladder becomes irritated and struggles to expand and hold larger volumes of urine. A small, stiff and irritated bladder will lead to:

> Increased frequency
> Multiple night time wees
> Sudden and strong urges to urinate
> Multiple small volume wees
> Difficulty making it to the loo in time
> Restricting fluid intake, especially when going out
> Regular 'just in case' wees, to avoid leakage
> Wearing a continence pad for confidence

All of these gradual changes to your day to day life can soon take over and limit you socially, in terms of exercise and in terms of self-confidence.

Specialist physiotherapy is a great way to kickstart your recovery and bladder rehabilitation. Here are a few tips to get you going:
 

Try to drink about 2L of...