We don’t talk enough about our pelvic floor. Here’s why we should be.
Your pelvic floor is trending. “My pelvic what?,” you might be asking yourself. Or at least that’s what most of my close friends said when I inquired about how friendly they were with their deepest set of muscles. Had they ever peed their pants a little during spin class? Well, yes, one new mom sheepishly responded. But it was all just part of life post-childbirth…wasn’t it?
Last month in Toronto, a group of writers and editors were invited to a vaginal painting party where we were encouraged to illustrate our beloved private parts. Standing in front of our easels with glasses of wine in hand, it was like a page right out of The Red Tent, but instead of sharing menstruation tips in cover of darkness, we felt poised for the self-care revolution.
The event was put on by Elvie, the maker of a Gwyneth Paltrow-approved pelvic trainer promising Kegel exercise precision. Kegels, you might remember, are those barely there movements touted for their ability to tighten you up down there (the exercises are so slight that Samantha Jones once completed a set during brunch on Sex and the City). But Kegels aren’t just a punch line. As it turns out, they are key to the next frontier of women’s health: strengthening the pelvic floor.
The pelvic floor is a diamond-shaped group of muscles that supports our internal organs, bladder, uterus and vagina. Over time, those muscles weaken and loosen, resulting in a wide array of issues such as incontinence (urine leaks), lower back pain, and discomfort during sex. Incontinence affects approximately 10% of the Canadian population, with the statistics rising to 70% in women who have recently given birth.
Nikki Bergen is a Toronto-based Pilates instructor who began specializing in core and pelvic floor workouts after an increasing number of post-natal clients complained about incontinence during their fitness routines. “I would have 35-year-olds telling me that they’d pee their pants in class and that is not okay,” she says. “I think women are just resigned to this being part of having children, but it’s not.”
In fact, one in 10 women experience incontinence after childbirth, while pelvic floor issues will affect one in three women. Bergen suggests that part of the problem is a result of heightened pressure on women to reclaim their post-baby bodies at a rapid pace. “This has been happening for a very long time, but when my mom had me, was she feeling the same pressure to get her body back right away? Today, we’ll do whatever it takes at the expense of our pelvic health,” Bergen says. “There’s an epidemic of women with pelvic floor dysfunction and a lot of times it exists before pregnancy, so they’re going into [childbirth] with existing issues.”
While post-natal conditions are extremely common, they’re not the only reason for seeking treatment. “It is a myth that only those that conceive and birth a child are susceptible to developing a pelvic floor disorder,” says Angelique Montano-Bresolin, clinic director at Toronto’s Proactive Pelvic Health Centre.
In fact, there are many younger adolescents and children that can struggle with pelvic pain or leakage issues,” Montano-Bresolin says. One in four women middle-aged or older and 15 percent of all men aged 60 and over suffer from incontinence. Athletes too, especially those engaging in high-intensity activities like CrossFit, weight training, and running, which can put pressure on the muscles, and lead to bladder leakage, prolapse, and pelvic pain.
So why does this feel like news? Montano-Bresolin says that pelvic health hasn’t raised red enough red flags because it’s never, well, killed anyone. And pelvic treatments are not yet covered by OHIP, which is a far cry from France, where “perineal re-education” is prescribed to all new mothers, to help strengthen their pelvic floor.
What the French already seem to have a handle on is that prevention is key. “I think that all women should see a pelvic floor physiotherapist, just like all women are recommended to have an annual physical or mammogram,” says Montano-Bresolin. A physiotherapist can assess tone, strength and function, before guiding you through a rehabilitation program. “We commonly use a variety of manual therapy techniques, exercises, bladder and bowel retraining, biofeedback [read: sensors] and other modalities to improve overall pelvic floor function,” she says.
Personal trainers and specialized fitness groups can also help focus your efforts and ensure that you are doing the exercises correctly. “So many women are doing the complete opposite of a Kegel; they’re doing something called a Valsalva, where they’re bearing down to have a bowel movement,” says Bergen. Devices like the Elvie make for a slick at-home transition. The gadget, which is smaller than an iPhone 6 and looks like little pet mouse, comes with a companion app that offers up biofeedback in a gamified way: the ball goes up if you’re doing your Kegel correctly, and down as you release.“[Women] often come with this perspective of needing to ‘blast the baby fat,’ but actually, they need to lay on the floor and breathe and learn how to connect to their deep core,” Bergen explains.
“Women can also continue to be stronger advocates for themselves and their health. The best thing a woman can do is tell a friend, colleague, sister, mother, or her doctor about the importance of pelvic health care,” says Montano-Bresolin. “We need to educate each other about things like: it is actually not normal to leak (whether or not you have had a baby) or have pain during intercourse. There is still some stigma associated with speaking up about these concerns, but the tides are changing.”
While I’m a long way from having a child, I’ll admit my vaginal muscles remained quite clenched through my writing of this piece. And as a result, the idea of trialing my own Elvie trainer went from a distant “might” to an bedtime “must.” Every few nights, I insert Elvie and lift on command, catching the proverbial Pokémon with my lower abdominal walls.