#StrongInside - why pelvic floor strength is vital through pregnancy and beyond

The writer of this article, Saskia, is a Product Manager at Elvie - a company with a mission to improve women’s lives through smarter technology. We asked her to explain why pelvic floor strength is so important, and this is what she had to say:

Your pelvic floor is a powerful set of muscles that play an important role in core stability, bladder control and intimate wellbeing. Pelvic floor problems, including incontinence, are surprisingly common, affecting over 1 in 3 women, and up to 70% of expectant and new mums (1). Yet many people don’t realise there are exercises, often referred to as ‘Kegels’, that you can do to strengthen your pelvic floor and overcome these! Kegel exercises have a role to play throughout all stages of pregnancy and beyond, yet despite their importance, they are often overlooked. Read on to find out more!

Before pregnancy

Your pelvic floor, like any muscle, needs a little love to stay in good condition. Having a strong pelvic floor contributes to your overall core strength, helping you support your body through whatever life throws at you - whether you’re lifting weights in the gym or have a persistent cough. It can be a bit tricky to engage these muscles correctly, since you can’t see them - I always say it’s a bit like trying to wiggle your ears - which is one of the reasons why we designed the Elvie Trainer, which can help you visualise your squeezes using biofeedback! Biofeedback has been shown to be the most reliable way to encourage commitment and improve outcomes from pelvic floor muscle training (2), and is essentially a way for you to see in real-time what your body is up to inside. The app has a gem which moves up and down the screen in response to your squeezes - the harder you squeeze, the higher it goes!

If you are trying to conceive, Kegel exercises can help your body prepare - after all, growing a baby means adding a little more weight for your pelvic floor to support, each day for nine months! Kick-starting your pregnancy with a strong pelvic floor will put you in a better position to handle these changes, and can even reduce the risk of prolapse (3). If you’re like me and struggle to remember what day it is… you can use Elvie Trainer’s inbuilt goals and reminders to keep you on track, and view your progress over time to stay motivated.

In addition, Kegels build muscle strength, increase sensation and boost blood flow to the vagina, which in turn helps you to experience stronger orgasms… making the process of getting pregnant that much more enjoyable ;)

During pregnancy

During pregnancy, your organs shift, and downwards pressure increases as your baby grows. A strong pelvic floor can help support your organs through this increased pressure, and maintain better bladder control despite the changes. However, 1 in 3 women push down when doing kegel exercises (4), which can cause damage in the long term. Unlike any other at-home biofeedback pelvic floor exercise tool, Elvie Trainer’s patented force and motion sensor system can detect if you’re pushing down, and alerts you via the app, allowing you to see whether you’re getting those kegels right (5)!

In addition to the weight of a growing baby, the process of giving birth can put a lot of pressure through your pelvic floor, and cause significant reductions in pelvic floor strength (6). Practicing kegels throughout pregnancy gives your body a chance to prepare for this, strengthening the area in advance. So when you’re practicing your breathing exercises for giving birth, try practicing your kegels too!

After pregnancy

After giving birth, pelvic floor strengthening exercises can help you with postnatal recovery. Many women assume small leaks of urine are to be expected after giving birth, especially when running, laughing or trampolining - it’s easy to think ‘it’s just one of those things’. However, these issues can often be resolved! Building up pelvic floor strength can help improve bladder control in most cases (3), and Elvie Trainer’s programmes are designed to improve both overall strength, and the responsiveness of the fast-twitch muscles required for holding in urine for short bursts of pressure such as sneezing and laughing. While it’s certainly possible to wear pads and incontinence pants, these address the symptoms and not the cause - and here at Elvie, we want to give you your freedom back!

That said, you can do Kegels without a device too - and there’s never a bad time to be practicing them, so long as you have your technique right. So why not give it a try right now?! Check out our handy tips below:

Find the correct muscles

You might find it helpful to identify your pelvic floor muscles by attempting to stop your pee mid-flow. Once you’ve found them, you’ll be able to do the exercises in any position.

Lift and relax

Squeeze and lift your pelvic floor muscles. Hold this contraction for five seconds and then relax for five seconds. Repeat this sequence five times.

Focus

For optimum results, make sure you only contract your pelvic floor muscles. Keep the muscles in your abdomen, thighs and buttocks relaxed. Don’t hold your breath! Exhale while you’re contracting the muscles and inhale while you’re relaxing the muscles.

Consistency

If you’re hoping to treat symptoms of stress urinary incontinence, for example, it’s advised that you repeat your Kegels three times a day. Try to aim for three sets of five repetitions daily, gradually working up to 10 second contractions.

A big thanks to our blog contributor Elvie - a company we're excited to partner with as they have a mission to improve women’s lives through smarter technology.

References

1.  Lawrence, J. M., et al. (2008) Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women. Obstetrics and Gynecology, 111(3), 678-685.

2. Glavind, K. et al. (1996). ‘Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence.’ International Urogynecology Journal, 7(6), 339–343.

3. Dumoulin, C. et al. (2015). ‘2014 consensus statement on improving pelvic floor muscle training adherence: International Continence Society 2011 State-of-the-Science Seminar.’ Neurourology and Urodynamics, 34(7), 600–605.

4. Bø, K. (2004) Pelvic floor muscle training is effective in treatment of female stress urinary incontinence, but how does it work? International Urogynecology Journal and Pelvic floor Dysfunction, 15(2), 76-84.

5. McCarthy, S. (2017) ‘Does Elvie compare with real-time transperineal ultrasound measurement of urethral movement direction?’ Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, 120, 69-70.

6. Hilde G, Stær-Jensen J, Siafarikas F, et al. Impact of childbirth and mode of delivery on vaginal resting pressure and on pelvic floor muscle strength and endurance. Am J Obstet Gynecol 2013;208:50.e1-7.