I know that we have at least another month until it's Back To School time! But since we're gearing up for that season... it's POP QUIZ time. (Yes, I hear the collective groan.)
Test your knowledge of pelvic health by answering these 10 true or false questions. If you score 70% or higher, you're really doing well! If not then this is the perfect opportunity to learn some things you really need to know. Ready, set....go. (No cheating now, ya hear?)
It is normal to leak a little after having a baby or as you get older in age. True or False?
A pelvic floor physio is one of only three types of health professionals trained to assess the internal state of the pelvis. True or False?
How you breathe, sit, stand, walk, and think all have an effect on your pelvic health. True or False?
Every woman should be doing kegels, especially after having a baby. True or False?
To do a proper kegel simply squeeze or clench the muscles that stop the flow of urine. True or False?
A pelvic organ prolapse (downward descent of a pelvic organ - namely the uterus, rectum, or bladder - towards the vaginal opening) is reversible. True or False?
The average healthy adult should be able to last 3 to 3 1/2 hours between urinating. True or False?
Your core is made up your abs, back and sides. They should be toned and strong. True or False?
Regular pain and discomfort during pregnancy is pretty normal and will get better after baby is born. True or False?
When giving birth, lying down on your back with legs up is better than delivering upside down. True or False?
Bonus Question 11:
Men don't have pelvic floor problems. True or False?
Ready for the answers? Click the read more button below.
It is normal to leak a little after having a baby or as you get older in age. FALSE
Unfortunately this is one of the biggest myths out there. Ladies, let's not confuse "common" with "normal". Just becasue 25% of the population will die from cancer doesn't mean cancer is normal and should be just accepted as part of ageing.
It's the same for your pelvic health. Leaking a little urine (or stool) is a signal that something is not functioning optimally in your body. That something is the continence system and it is impacted by many many factors. If left untreated it will progressively worsen - and though it will not kill you like cancer can, it will significantly impact your quality of life and probably your wallet too.
Take away point: Yes it is common (1 in 3) for women to leak, but it is absolutely not normal or ideal. It is possible to get help and learn a few basic principles that can save you embarrassment and allow you to do the activities you want to do. The earlier you seek care, the better the outcome.
A pelvic floor physio is one of only three types of regulated health professionals trained to assess the internal state of the pelvis. TRUE
Obviously physicians (family docs and specialists) are trained to assess the pelvic area both vaginally and rectally using manual palpation or using various types of instruments. Midwives also have training in internal assessment. As far as I know, that's about it other than physios.
Physiotherapists are also able to acquire internal assessment skills by taking post-graduate courses. Our focus is on function, not just structure or pathology. We focus a lot on the pelvic floor muscles. But we also consider all the factors that may be contributing to pelvic floor dysfunction - such as the position of the muscles, the tissue tone, texture and quality, we assess pain, movement, pelvic organ position, digestion, your toileting, daily habits, diet, posture, pelvic muscle strength, holding patterns, fears, past trauma, sexual functioning, and much more. If we are only looking at one part or one mechanism, then we really do ourselves a disservice because the body is a dynamic interplay of many systems functioning all together.
How you breathe, sit, stand, walk, and think all have an effect on your pelvic health. TRUE
The answer to question 2 probably gave this one away. Yes, daily habits and movements and even thoughts can impact the pelvic area. Did you ever had a friend in middle school who was uber tall? Perhaps you noticed that she was always slouching and curving forward while she sat in her desk or walked in the hallway. Maybe she was self conscious of her height and tried to blend in. Maybe she was embarrassed that she was taller than all the boys and was told no boy would ever go for chick taller than him. Days, weeks and years of constant slouching will affect the spine, digestive system, the neuromuscular system, the ability to breathe properly, ALL of which have a massive impact on the pelvic floor. It could impact her childbirth and healing post partum. It could make for painful sex. It could contribute to a pelvic organ prolapse. Wondering how your past negative experiences can affect your pelvic health? Check out this blog.
Every woman should be doing kegels, especially after having a baby. FALSE
Kegels have been touted as the magic bullet. They have their place for sure. But they are not the be all and end all that society has made them out to be. First of all there is a good number of women who SHOULD ABSOLUTELY NOT be doing kegels. They have conditions where they need to learn to relax and lengthen muscles or to let go of tension or tone in the muscles. Secondly, 50% of women do kegels incorrectly and thus conclude that they don't work. There's no point doing something wrong becasue it will train an incorrect pattern. I can rant for longer about the infamous kegel, but you can check out this post if you want more.
To do a proper kegel simply squeeze or clench the muscles that stop the flow of urine. FALSE
I'm not a fan of the word squeeze or clench. It leads to women squeezing the heck out of everything remotely connected to their lady bits. It's not the best strategy to find the right muscles. I much more prefer the words "engage" or "activate" or "turn on" or "connect to" the pelvic floor muscles. The sensation is much more subtle and often, when it comes to tuning in to one's body, less is more.
Also, a kegel (aka a pelvic floor muscle contraction) really must have a lift element to it. Think of a hot air balloon gently lifting off the ground and floating into the air. Or think about an elevator slowly rising from ground level up. The lift is what generates better support for the pelvic contents and helps to counteract downward pressure that may be generated from above.
Lastly, a correct kegel involves the breath. Don't hold it. This is super important. More on how to do that properly in another post.
A pelvic organ prolapse (downward descent of a pelvic organ - namely the uterus, rectum, or bladder - towards the vaginal opening) is reversible. FALSE
So it depends on who you talk to actually. There are a few schools of thought out there. A gynaecologist may suggest that a hysterectomy or some type of suspension surgery will "reverse" a prolapse. Some physios may teach certain techniques to help lift a droopy organ higher up into the pelvic cavity. Others will suggest that after childbirth and breastfeeding is over, then things will get better. There are elements of truth to all of these. Generally speaking though, a pelvic organ prolapse, once you have it, is something that has to be managed for life. Surgery doesn't always have long lasting effects and of course comes with its own set of side effects and risks. 50% of women over the age of 50 have a prolapse of some degree - and "while it is not life threatening, it is life altering". Fact: mild to moderate prolapses can do very well with pelvic health physio. Again getting started on learning how to care for that prolapse earlier rather than later can make a HUGE difference. Read more about prolapses here.
The average healthy adult should be able to last 3 to 3 1/2 hours between urinating. TRUE
If you're running to the bathroom frequently, planning out your day based on bathroom availability, feeling like you never are quite empty, and when you go you have to GO NOW - then you show the classic symptoms of "overactive bladder" or urinary urgency which may develop into urge incontinence. You, not your bladder should be running your life. Your bladder has the capacity but for various brain/body reasons it is not meeting that capacity.
Your core is made up your abs, back and sides. They should be toned and strong. FALSE
Are you surprised by this answer? A toned and strong body is not wrong. It's actually really important. But all too often we focus on the outward appearances. It is possible to look strong on the outside, but be very weak on the inside. A good training program will focus first on developing inner strength and control by working the INNER core. (Those are muscles that you can't see but that work pretty much all the time to provide control and stability in advance of our every movement.) From a physio perspective, the inner core is made up of four key muscles: the diaphragm, the pelvic floor, the transversus abdominis, and the multifidus. They all work together like gears in a machine. If one of the gears stops spinning, then the whole machine is no longer working. This is why sometimes problems like persistent back pain is actually a pelvic floor issue. We must train the system, not just one part of it.
Once the inner core is working well, then it is time to strengthen the outer layers and focus on integrating the inner core to work with larger muscles and more complex movements.
Ongoing pain and discomfort during pregnancy is pretty normal and will get better after baby is born. FALSE
I get it that you're growing a baby and that can be a bit uncomfortable as your body adjusts and tries to find its new self (which is a constant moving target during pregnancy!) However persistent pain is not good. It is a sign. Are you starting to get the idea that pain is sign? Certain types of pain, as much as it sucks, can actually be a gift. It tells you that something is amiss in your system and prompts you to find the reason! Our bodies are constantly trying to get into a state of balance and equilibrium. We often sabotage that attempt in different ways.
Pain during pregnancy (joint pain, muscle pain, ligament pain, pelvic pain, internal pain) is not ideal . It is often the result of, believe it or not, poor alignment. How you stack up against gravity will load joints and tissues in certain ways - either optimally or willput more stress on joints. Chances are you sat, stood and walked like that before getting pregnant, but now that you're pregnant there is more weight, greater load, changes in centre of gravity, and the body has less ability to adapt and cover up dysfunction as easily.
The point is that there is A LOT that can be done to address those aches and pains during pregnancy that you thought were just par for the course. It all starts with A = Alignment. Check out this program if you're intrigued.
When giving birth, lying down on your back with legs up is better than delivering upside down. TRUE
Ok, so I'm being a bit cheeky here. Yes, it is definitely better to birth on your back than upside down.
However, pretty much every other possible birthing position is better than being on your back for so. many. reasons. Check out this article for just a few of the reasons. I will also add that birthing in gravity assisted, anatomically efficient ways can really help to protect your pelvic floor!
Men don't have pelvic floor problems. FALSE
Men have a pelvic floor so it stands that they can have problems too. Sadly, there is even more silence around male pelvic dysfunction than there is for women. Thankfully, there's pelvic health physio for men too. Check out this article by a well know PT in the States, Julie Weibe, on pelvic floor dysfunction in men.
So, that brings us to the end of the quiz. How did you do??? I hope you had a bit of fun testing yourself. But even more than that, I hope you learned that some of the commonly health beliefs about the pelvic floor are actually myths. Only by becoming more aware of the facts and sorting truth from fiction can we begin to improve the health for women, men and children in our communities. If you have any concerns about YOUR pelvic health or perinatal health, feel free to make an appointment with one of our physios. We would love to help you.
The Mama's Physio
We are a team of experienced physiotherapists with a passion for women's health and well being. We focus on pelvic health in the context of the whole body. We care for pregnant and post-partum mamas and women at all life stages from teens to the young at heart. We are mothers ourselves and we are women. We love what we do and we are here to serve you.