Pelvic Floor Health

Multitudes of women suffer in silence with pelvic floor issues. In fact, according to the National Institutes of Health, one in four women experience issues associated with the pelvic floor. These issues can be exacerbated during or after cancer treatment, due to cancer and cancer surgeries, nerve damage, hormonal shifts and the side effects of other treatments. Age and other health conditions can contribute to pelvic floor problems for both women and men.

Fortunately, there are many resources to support pelvic floor health, including experts in physical therapy and yoga for the pelvic floor. To review some of the resources and issues related to pelvic floor health, we have a Q and A with certified pelvic floor expert Rita Meier, RYT-500.

How did you get involved with pelvic floor health?

In 2003, I took up yoga. That changed everything and I’ve never looked back. All throughout my life, I’ve taught in one capacity or another. So, in my retirement, I decided to become a yoga teacher. I took the 200-hour training at Moksha Yoga in Chicago and completed the 500-hour advanced teacher training at Prairie Yoga in Lisle, Illinois. My interest is Iyengar-style Yoga, with an emphasis on alignment and the use of a lot of props. Over the last years, I’ve developed a specialization in the Pelvic Floor.

I teach workshops in “Women’s Health” and “The Core and the Pelvic Floor” for women of all ages. This has been very popular for the cancer survivor community, as it touches so many women. Women have found this workshop very helpful to overcome incontinence, pelvic pain and a host of other issues related to the pelvis. I’m certified by the Women’s Health Foundation Total Control Program. This organization, based in Chicago, has spearheaded research and programs on pelvic issues with an emphasis on relieving incontinence. I am also certified by Leslie Howard, a San Francisco-based yoga teacher who teaches programs on pelvic health across the country and overseas, and you can find information at Leslie Howard Yoga Pelvic Floor Teacher Training.

What are the most common problems that people experience with the pelvic floor?

• By far, the most common problem is incontinence.
• Many people experience pelvic pain
• Many women suffer from female prolapse, as pelvic organs may lose support and descend into the vagina.

On opposite ends of the spectrum, pelvic floor muscles can be either too tight or too lax. Both issues can cause incontinence, which has myriad symptoms. Some people suffer from overactive bladder, while others experience leaking when sneezing, coughing or running. Incontinence can begin quite innocently, and build slowly over time to significantly affect daily life.

What role does the pelvic floor play in the actions of the core?

Although the core is a common source of discussion and focus for exercise, few realize that the pelvic floor is integral to the core. The pelvic floor is not part of our normal conversation.

This Essential Yoga Therapy video illustrates the role the pelvic floor plays in the core muscles.

What generally causes pelvic floor problems?

Age, pregnancy, childbirth and poor daily habits can contribute to weak pelvic floor muscles. Exercising the core and pelvic floor regularly can effectively improve functionality. A strong core and pelvic floor are important to support internal organs and for proper control of the bladder.

Who should I turn to for professional help?

Talk to your OB/Gyn about your experience. Don’t be shy! Ask your doctor about physical therapy for the pelvic floor. I can’t recommend this too highly! Ask for a physical therapist who specializes in the pelvic floor.

What does pelvic pain indicate?

There are a number of problems that can cause pelvic pain, so it is good to discuss it with your doctor. Many women experience pelvic pain due to a tight pelvic floor. This can be a result of gripping; similar to what others experience in tight shoulders or back. Athletic people often develop pelvic pain from constant work to strengthen their core. Sometimes a traumatic experience, such as abuse, can lead to long term gripping and pain.

My doctor is recommending medication or surgery. Are there alternatives; some simple things a person can do to gain more control?

Yes, in addition to the information that you can get from your doctor and physical therapist, there are lots of good resources on the internet. I recommend some videos at the end of this article. In addition, I recommend yoga or some regular exercise regime.

It is important to learn to incorporate the pelvic floor as part of the core when exerting in any exercise, however. That is, on the exhale, draw your navel toward your spine and squeeze and lift your pelvic floor. Then, when you lift a child or engage in an exercise, your core will be prepared!

Do men have pelvic floor problems as well?

Yes, both men and women may experience incontinence in varying degrees. Both also can suffer from the pain of too constricted a pelvic floor or other pelvic floor issues.

What are key benefits of a supple pelvic floor?

There are lots of reasons to develop and maintain healthy pelvic floor muscles. Some of the key benefits are:

• Better urinary control
• Better balance and posture
• Improved self confidence

Pelvic health is a subject that simply does not get enough attention. There is a certain reticence in our society in this regard. In my workshop, a little humor goes a long way, and soon everyone is relaxing and sharing their own stories. The six-hour workshop is half lecture and half exercises. There is so much that can be done to gain more control!

How can people get in touch with you?

Currently, I teach yoga in the Lisle area. For over two years, I’ve taught cancer survivors on a weekly basis. For more information on these classes and my pelvic floor workshops, you can email me.

Rita Meier’s References and Recommended Resources:

• The book You Go Girl…but only when you want to! by Missy Lavender and Dorothy Smith is excellent.
• The Continence Foundation of Australia has a valuable free publication on Pelvic Floor Fitness.
• National Institutes of Health provide more information in these two articles on Pelvic Floor Disorders and a Q&A with Medical officer and gynecologist Susan Meikle, M.D., M.S.P.H., from NICHD’s Gynecologic Health and Disease Branch.
• “Yoga for the Pelvic Floor, Kegels are Not Enough!” by Rita Meier was published in the November/December 2014 issue of YogaChicago.

YouTube Videos

A wealth of information on the pelvic floor and instructions on exercises are available on YouTube. The Australian Pelvic Floor physiotherapist, Michelle Kenway, has created great videos describing the details of the pelvic floor anatomy and showing how to do a variety of exercises to benefit pelvic floor health. You can subscribe to her channel on YouTube.

See also Michelle’s series called “How to Kegel Exercises for Women”