“I leaked as I ran for the train. I decided this would NEVER happen again.”
After the birth of my second child, I started to leak when I laughed, ran or sneezed. I did my pelvic floor exercises religiously to no avail. I slowly stopped doing the things I loved, telling myself what I’d heard many times before: “I’ve had kids, what did I expect? It’s normal to leak now.”
Then, one day I was out with a friend, travelling to Harrogate to go to the Turkish Baths. We were running late for a train. As we sprinted across the station, I could feel myself starting to leak...?
A few drops turned into a flood down my leg.?
I was mortified.?
Had anybody noticed?
Did I smell??
On the train, I went straight to the toilet and cried. I tried my best to wash my jeans and dry them under the hand dryer, then carry on like nothing had happened. But, at that moment, whilst crying in the train toilet, I decided that this would NEVER happen to me again.
After that day, I immersed myself in research. I read medical papers, built my knowledge and spoke with strength trainers. If the pelvic floor is a muscle, then I figured that, like all other muscles, you should be able to strengthen it!?
I found out about the pivotal role the pelvic floor plays in all our movements. I learned about its connection with the chest, back and hips. And I began to understand why pelvic floor squeezes alone were only half the picture when it came to strengthening the pelvic floor. I rejected traditional pelvic health approaches that hadn’t helped me. Instead, I began to develop a full body approach to strength. It combined weight training, muscle coordination, mobility and breath work. I tried, tested and refined these different approaches, alongside my new understanding of the female body until, eventually, I became leak free. Finally, I understood that to help treat leaks or pain, I had to look at the whole, not just the pelvic floor.
A dream evolved; to open a physiotherapy clinic in Sheffield to help women who are in the same situation I was. I would empower women to move fearlessly again; listen to them, understand them and their journey, and provide nurturing, healing and empowering care. Because no woman should ever have to live with pain or leaks.
Pelvic floor facts
The pelvic floor muscle plays a huge role in how women move. It absorbs shock, keeps us upright and even helps us breathe.
We use it every time we move. Yet many women don’t have the knowledge or support to strengthen their pelvic floor. As a result, they live with symptoms for years, and convince themselves this is normal.
Pelvic floor issues can lead to incontinence, or bladder leaks. There are different types of incontinence in women and understanding this is key when treating it;
Why traditional methods don’t work
I’ve worked as a Physiotherapist in the NHS for many years. Yet, when I had pelvic floor issues after having children, I struggled to get the right support for my issues. I leaked a little when I sneezed and had an overwhelming urge to go to the toilet whenever I got into the shower. But, because I wasn’t told about these potential side effects of giving birth, I was surprised when it started happening and had no clue how to stop it.?
Like so many other women who have visited their GP with issues like bladder leaks and pain, I was sent away and told to “do my kegels”...and little else. GPs don’t discuss exactly how to do kegels (another word for pelvic floor squeezes), so I was left guessing if I was doing them correctly.
As a physiotherapist, you go through years of training about every muscle in the human body, where they attach, how they move, how to treat and strengthen them to stop or prevent pain…. But never did I learn about the pelvic floor. It is a muscle after all, so why didn’t we talk about it? Pelvic health physiotherapy - we were told as students and newly qualified physios - is a mystical, specialist area. You’ll need years of experience to work in the area, but you can’t work in the area without experience. Catch 22!
Because of this perception within the physiotherapy of pelvic health, there are very few physiotherapists in the UK who can provide the help and support that half the population needs. Women wait on average 2 months to see a pelvic health physiotherapist. In that time, their pelvic floor symptoms only get worse. This in turn can lead to dramatic effects on their quality of life and mental health. Untreated pelvic floor dysfunction can impact other areas of the body, from unexplained lower back pain, to constipation and even sore, stiff hips.??
When I finally became a women’s health specialist, and gained a greater insight into pelvic health, I was disappointed that pelvic floor muscle exercises (aka kegels) were the only therapy our public health service provided. Yes, kegels are a GREAT starting place, but you wouldn’t strengthen a painful knee by bending it every now and then when sitting. You’d expect a complete therapy programme to get you pain and symptom free. So why do we not do the same with the pelvic floor??
The pelvic floor is such an intrinsic part of our body. Posture, breathing and even bra size can affect its health and function!
An holistic approach to pelvic floor health
We need to combine a number of factors when treating pelvic floor issues.
The first area is posture: Breasts weigh a lot (on average 1.15kg each!). Poorly supported breasts, due to an ill-fitting bra, can lead us to slump and lean forward. This puts a great deal of pressure on the pelvic floor muscle, which can cause the muscle to work harder than it needs to, so it tires quickly. Yet in the UK, 98% of women are wearing the wrong size bra!
Often, women wear a bra that’s too loose for them. This leaves the breasts unsupported, so they move around more than they should. In fact, breasts can bounce up and down by up to 20cm if they’re not adequately supported - that’s about the length of your forearm!?
So, the first step to better pelvic floor health is to measure your bust size and make sure you’re wearing the right sized bra.
Breathing is another factor to consider. Many people breathe through their mouth, often due to stress or congestion. But when you breathe through your mouth, your chest, ribcage and diaphragm do not go through their full range of movement. If the diaphragm can’t move, then neither can the pelvic floor, meaning it can’t contract fully to prevent leaks.?
Try to take deep breaths through your nose instead, allowing your chest to expand and stomach to relax.
Finally, the big one - pelvic floor squeezes aka kegels. Here’s how to do them properly.
How to do kegels (properly)
If you’re not sure how to do pelvic floor exercises, fear not. Pelvic floor exercises are very quick and easy to do! You can do them anywhere – at your desk, on the train, on the sofa and even in bed.
Just follow these 3 simple steps;
On your next in-breath, relax the squeeze completely and take a couple of seconds to rest. When you feel fully relaxed, repeat the sequence
Once you’ve got the hang of how to squeeze, challenge yourself with quick 1-2 second squeezes, longer squeezes (holding for a few seconds) and squeezing when you cough/sneeze/stand up/bend over.?
As with any muscle, rest is very important after you exercise to help your muscles recover. So make sure you fully relax your pelvic floor muscles between each squeeze. This will allow them to work through their full range of movement.?
NICE guidelines recommend doing sets of 10 short squeezes and 10 longer holds (ie: squeezing for up to 10 seconds), 3 times a day. However, something is always better than nothing!
If you are struggling to feel your pelvic floor relax between squeezes, there are some great yoga poses for resting your pelvic floor muscles. Child’s pose is a good example; lower yourself down onto your knees and reach forward until your top half is as close to the floor as you can get. Reach your arms forward and breathe deeply.?
This pose is a super stress reliever during the day too! Take a few moments to sit in child’s pose, breathing deeply.
Move fearlessly, feel empowered
Women have a right to enjoy their bodies, free from pain and leaks. And I feel that public? healthcare practices are letting us down.
But I appreciate not everyone has the means to get private Physiotherapy. It can be difficult to get a referral from the GP, and even if you do, you may not receive the support you need.
This is why I want to share insight into how you can take control of your pelvic floor. Wear the right bra, breathe through your nose, be conscious of your posture and do your kegels correctly. After a couple of months, you will see an improvement and over time your symptoms should disappear entirely. If they don’t, then do return to your GP and don’t be afraid to push back if they try to dismiss you. No woman should have to live with pain and leaks.?
You can move fearlessly. You can overcome your symptoms. You can THRIVE.