Women's Health

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Pelvic Floor Weakness:

The pelvic floor forms a muscular sling commencing from the pubic bone and passing between the legs to attack to the sacrum or tailbone. Its role is to support the abdominal organs as well as ensure timely passage of urine and faeces.

The pelvic floor muscles are commonly stretched by the weight of the baby during pregnancy and may be stretched or torn during the baby's birth. Weakness results in the involuntary passage of urine, known as incontinence. There are two types of incontinence. Urge Incontinence is where the patient "can't hold on", and Stress Incontinence where an increase in abdominal pressure such as a cough, sneeze or vigorous athletic activity results in a small amount of urine being passed. Both are, of course, unpleasant but, unfortunately surprisingly common. Weakness can manifest itself during or after pregnancy, or later in life, but can also occur in women who have not had children.

The good news is that, like all other muscles, the pelvic floor can be strengthened. Your physiotherapist will make an initial assessment to determine your level of weakness then train you in a simple exercise programme aimed at progressive strengthening. With diligence good results can be expected.

Pregnancy-Related Low Back Pain:

During pregnancy, the hormone relaxin is released. Its role is to increase the laxity of the ligaments in the pelvic and low back region so that the birth canal can dilate sufficiently to allow the baby's head through at birth. Unfortunately, the combination of this increased ligamentous laxity and the weight of the baby results in a high incidence of low back pain, particularly in later stage pregnancy. Physiotherapy treatment can be very effective in relieving this pain.

Treatment can include:

Gently joint mobilizations to relieve pain
Gentle strengthening exercises
Provision of a stability belt
Advice regarding positions of comfort

Pre- and Post-Natal Exercise:

Pre-natal exercises aim to prepare the abdominal and pelvic floor muscles for pregnancy and birth. Exercises for relief of low back pain are also included.

Post-natal exercises aim to return the abdominal and pelvic floor muscles to a level of adequate strength and endurance. As these muscles are important core stabilizers, prevention of weakness in these areas is essential to maintain a healthy body and prevent complications such as low back pain.