Pelvic floor issues

Most of us take bladder and bowel control for granted – until something goes wrong. The unintended leakage of urine or faeces, significant enough to make it difficult to maintain good hygiene and carry on with our ordinary social and work lives, affects a large number of older adults and it often goes untreated due to the embarrassment issue and a lack of understanding of the fact that it may well be treatable.

So… what’s the cause of this embarrassing issue?

For women, it’s often a direct result of childbirth and worsened by ageing but other factors such as obesity and a sedentary lifestyle enhance the severity of the problem.

For men, it’s often a side effect of treatment for prostate problems or post surgery, but obesity and a sedentary lifestyle are increasingly prevailing causes as well.

Another cause for both men and women is chronic constipation necessitating forced evacuation of the bowel or chronic coughing putting pressure on the pelvic floor diaphragm.

Depending on the cause of the problem and the severity of any damage already sustained, the treatment might be a simple matter of learning some specific pelvic floor exercises and doing them regularly, together with making some appropriate behavioural and lifestyle changes.

Although it is hidden from view, your pelvic floor diaphragm can be consciously controlled and therefore trained, much like your arm, leg or abdominal muscles. Strengthening your pelvic floor muscles will help you to actively support your bladder and bowel thus improving control. Like all muscles in your body, your pelvic floor muscles will become stronger with a regular, progressive exercise program. This is important for both men and women.

A physiotherapist will be able to assess your pelvic floor and develop an individualised pelvic floor muscle-training program for you. Before starting this program though, it is important that you can identify your pelvic floor muscles correctly and this is what your physiotherapist will be able to help you with initially.

Like all exercises, pelvic floor muscle exercises are most effective when individually tailored and monitored and then performed frequently throughout the day until they become a habit. The good news is that once your strength has been built up, you will not need to do them as often, however, the bad news is that it is something that you will have to continue with for the rest of your life if you want to ensure good muscle tone in this region.

For more information about how to start on a regime of pelvic floor exercises check out the Actively Ageing Handbook and Workbook.

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