pelvic floor



After the birth of my two children and my return to Australia from PNG I was determined to learn more about Women’s health and how to examine, educate and re-train women in safe pelvic floor exercises.
I started my post- grad pelvic floor training in the mid eighties. Working in private practice in Sydney I was able to work with an experienced physiotherapist who had a special interest in pelvic floor problems and re-training.
There was only one recognised Continence and Pelvic Floor Physiotherapist teaching weekend assessment and internal examination of the female pelvis in those days…. Pauline Chiarelli ; Associate Professor and Program Convener for the Discipline of Physiotherapy at Newcastle University (Australia). Dr Chiarelli has an enormous depth of experience as a Women’s health physiotherapist and was Australia’s first Physiotherapist Continence Adviser. Dr Chiarelli developed the Continence & Women’s health post- graduate programmes for physiotherapists. I have been fortunate to be able to grow my ‘hands on ‘ clinical experience along side my post grad education. The speciality of ‘Continence & Women’s Health Physiotherapy’ has come a long way and we now have a post graduate pathway for Physios who want to further their Women’s health training at recognised universities in each state.

So here is some video on the functional  anatomy

Michelle Kenway  shows where and how to activate your pelvic floor muscles in her series of pelvic floor videos
These techniques can assist women find their pelvic floor muscles:
– When emptying the bladder try to stop or slow the stream. Do this only to help identify the pelvic floor and not as a regular exercise.  Do not perform this technique if you suffer from  bladder emptying problems.
– Imagine you are trying to avoid passing wind in doing so attempt to lift and squeeze the muscles in and around the anus. Your buttocks should stay relaxed and your breathing should remain regular.
– Imagine you are trying to hold a tampon in place- drawing it up and in.
– Use a mirror to view the entrance to your vagina. Try to lift and squeeze in and around the entrance of your vagina. You should see a squeeze and inwards lift of the  vaginal entrance.

These Pelvic Floor Muscles (PFM)  are a complex mesh of muscles, fascia and ligaments suspended like a trampoline inside all around the pelvic bowl. Let’s leave the anatomy there for now. You should now have some idea of how to feel and contract your pelvic floor muscles. The side lying position is a good position to do this as Michelle demonstrates. Some of you may also find this better feeling from behind. First the perineum and then the vagina. As soon as  you are able,  do your pelvic floor exercises in sitting. This is more functional and you will be able to do more during your day.

Perfect Posture = good pelvic floor muscle activation. – see ‘posture’

The pelvic floor muscles can develop any of the problems listed below and sometimes a combination of problems may develop.

    • stress urinary incontinence – SUI
    • urgency UI
    • frequency
    • mixed urinary incontinence  overactive bladder – OAB
    • pelvic organ prolapse – POP
    • pelvic pain / painful sex
    • hypertonic pelvic floor muscles (tight pelvic floor muscles))
    • faecal incontinence

You can find more information on all of these problems in the drop down menu
Pelvic pain / painful sex  This a complex and large topic. Pain can be constant and debilitating or intermittent and only aggravated by ‘triggers’
There are many causes of pelvic pain and the first and foremost thing is to see your local doctor who will be able to examine you and decide what if any further investigations need to be done.
See this website for more general sexual health  information.
See ‘pelvic pain’ in the drop down menu.

… two great pictures to help you visualise your insides !

 Superficial PFMCorton 2005  Deep PFM

 Posted by at 5:04 am