Everyday things that put your pelvic floor at risk

In physio we talk a lot about modifiable and non-modifiable risk factors. In pelvic health terms, the non-modifiable factors or things that you cannot change include: 

  • Gender - Females tend to be more at risk than Males
  • Genetics - There does seem to be a genetic disposition for conditions such as prolapse (thought to be due to composition of connective tissue within the body)
  • Age - unfortunately the risk increases as we get older, particularly after menopause and our estrogen levels decrease


However, the good news is that there are a lot of things that you can change! Starting right now.

This is how I used to sit, especially as a student!
  • Improve your alignment while sitting and standing 
  • Decrease total sitting time during the day
  • Switch out your positive-heeled shoes for flats/barefoot/negative heeled shoes 
  • Avoid any breath holding when lifting or doing any heavy work
  • Decrease and manage straining on the toilet / constipation
  • Ensure good bladder habits. Holding on for too long or going too frequently can affect the bladder's ability to function appropriately. Ideal timing is emptying every 2-4 hours, obviously dependant on fluid intake (see here for more Bladder Info)
  • Increase the amount of natural movement throughout the day
  • Too intense physical activity including high impact running or jumping, sit-ups and crunches can cause damage to the pelvic floor and core especially if you do not have good strength and control beforehand

This is how I sit now (Thanks Diana for modelling!)

Our bodies adapt to positions we are in and the things we do the most, whether it is sitting the majority of the day, wearing positive heeled shoes or straining on the toilet. Exercising intensely for 1 hour of the day, 3-4 times per week does nothing to offset the 8-10 hours of sitting that a lot of us do every day and can in fact do more harm than good. The more that we sit during the day and have poor alignment, the more the muscles of the pelvic floor and 'core' physically switch off, instead we 'hang' off our passive structures (bones and ligaments), limiting the ability of the muscles  to respond appropriately when we need them (think of a sudden sneeze, sprint or change in running direction resulting in urine leaking or prolapse). Similarly with positive-heeled shoes, even a slight angle can change the body's entire alignment and puts the pelvic floor muscles at a great disadvantage. 

Increased intra-abdominal pressure, for example with straining on the toilet and holding your breath subjects the structures within the abdomen and pelvis to inappropriate loads that can result in over-stretching of the ligaments holding up the pelvic organs (as well as disc herniations and abdominal hernias). Since ligaments are passive (non-contractile/non-elastic) structures, once stretched they are not able to return their previous length (see Pelvic Organ Prolapse). 

*Note* While pregnancy and delivery can often exacerbate pelvic health issues, not having babies does not make you risk free. I believe the best step is to optimise your alignment, core and pelvic floor muscle function before and during pregnancy for the best post-natal outcomes. See here for more Pregnancy related posts. 

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