A survey (1) by the Chartered Society of Physiotherapy (CSP) reveals over 70 per cent of people in Scotland do not know where their pelvic floor muscles are, with more than half (61.4 per cent) incorrectly thinking they are in the lower stomach or abdomen.
The survey also reveals that in Scotland:
· over 45 per cent of people never exercise these vital muscles
· 6.6 per cent of people incorrectly think their pelvic floor muscles are in their buttocks, feet, chest or ears
· over 37 per cent of people incorrectly think that if you do not exercise your pelvic floor muscles you might develop a problem with walking, breathing or your back, or that you might put on weight or go blind
Pelvic floor muscles, which span the area between the legs, support the bladder, uterus and bowel, are vital in preventing bladder and bowel incontinence. They also play a part in sexual function and satisfaction, including enabling men to achieve and maintain an erection, and are important during pregnancy and childbirth. Whatever your age or gender, everyone needs strong pelvic floor muscles.
Sammy Margo, chartered physiotherapist and CSP spokesperson, says:
‘The survey clearly shows men and women are complacent when it comes to their pelvic floor muscles, despite the fact they are fundamental for optimal bladder, bowel and sexual function.
‘A strong pelvic floor can help prevent incontinence and boost your sex life but you can’t achieve this if you don’t know where your pelvic floor muscles are and have never exercised them. Weakening of these muscles can profoundly affect quality of life in that your sexual performance may deteriorate and you could become incontinent.
‘Men with weak pelvic floor muscles could be risking relationship difficulties caused by erectile dysfunction. Exercising the muscles correctly and frequently has been proven to have benefits comparable to drugs like Viagra.’
Almost half of all women have urinary leakage at one time or another and having fit pelvic floor muscles also plays a part in enabling women to enjoy sex and to reach orgasm.
Erectile dysfunction is a problem for at least one in every ten men in the UK (3). Research has shown that 40 per cent of men who experienced erectile dysfunction were cured after 3-6 months of pelvic floor exercises. (3)
Pelvic floor health is also particularly important for men recovering from surgery for a prostate problem, such as an enlarged prostate (benign prostatic hyperplasia - BPH) or for prostate cancer. This surgery can often lead to incontinence or erectile dysfunction. About half of all men will have BPH by the age of 60 and prostate cancer is now the most common cancer diagnosed in men in the UK (3).
Survey respondents reported that if they were having problems achieving orgasm, only 19.1 per cent of them would exercise their pelvic floor muscles in the first instance, despite the fact this can be an easy way to remedy the problem without the use of medication.
The CSP is offering a free fact-sheet Personal Training for Your Pelvic Floor Muscles (visit www.csp.org.uk/pelvicfloor) with straightforward advice to help men and women of all ages to get pelvic floor fit. The tips are designed to help people easily incorporate simple pelvic floor exercises as part of their every day routines.
Case study one:
Leslie, aged 53, who runs his own flooring business in Angus, Scotland, experienced incontinence following a prostatectomy. He says:
‘After I was diagnosed with prostate cancer I was offered a prostatectomy which involved removing all of the prostate gland. Following the procedure, I was cleared of cancer but I developed stress incontinence and was referred to physiotherapy. Being incontinent was not good for my state of mind and I was not in a nice place mentally as I felt it was the worst thing that could happen to a man. Simple things such as coughing, sneezing, physical activity, standing up or sitting down resulted in urinary leakage. I couldn't continue with certain aspects of my work because of its manual and physical nature. I felt I was being consumed by incontinence as I was affected every time I moved. Undergoing physiotherapy was an incredible healing and learning process. With the help of my brilliant and supportive physiotherapist, I learnt to use my pelvic floor muscles to improve bladder control and with very simple advice and contraction-based exercises I was able to regain my confidence and lead an active life again within six months of starting treatment.’
Case study two:
Dianne, aged 47, a chartered physiotherapist from Bradford, West Yorkshire, suffered from stress incontinence after the birth of her first child. She says:
‘I used to be a fitness instructor and led a very active life. Nineteen years ago I had my first baby. I had a very difficult delivery and as a result developed stress incontinence, which meant for me the physical activity I loved caused urinary leakage. I was referred to a gynaecologist who said I had a prolapsed bladder which needed repair. In those days this also involved a hysterectomy. I wanted to have more children in the future so turned down surgery. At that point I was referred to a physiotherapist. I was prescribed pelvic floor exercises and given electrical muscle stimulation. In a short while, I think it was about three months, I was able to regain bladder control and resume high impact physical activity. I also subsequently had two future pregnancies and births without any return of my leakage. I still live with a prolapsed bladder but I am hardly aware of it and have avoided surgical intervention. I put this down to increasing the strength of my pelvic floor. Using my pelvic floor muscles is an automatic process now. I engage them every time I cough, sneeze, jump, shout and exercise. It is crucially important that we have strong pelvic floor muscles. It is a potential weak point in our anatomy as the pelvis has a big hole at the bottom of it. It is easy to keep the muscles strong to ward off future problems. I was so impressed by my treatment and physiotherapist that it inspired me to change careers and work in women's health physiotherapy.’
Case study three:
Amanda, aged 50, from Norwich, East of England, suffered from stress incontinence after the birth of her second child. She says:
‘I developed stress incontinence 21 years ago after giving birth naturally to a 10lb baby. Before my bladder problems, I was enthusiastic about keeping fit and was a keen horse rider but staying physically active was hampered by urinary leakage. I became very unhappy that I was unable to continue horse riding. I explored the possibility of surgical intervention but was discouraged by my GP who said it would be a major operation to go through and that I should simply put up with it. Up until five years ago I was still experiencing problems with my bladder but after visiting a female GP last summer she advised me to undergo a tension-free vaginal tape procedure which I did and I was also referred to physiotherapy. My physiotherapist gave me electrical muscle stimulation at hospital as well as a unit to carry out this treatment myself at home together with pelvic floor exercises. Muscle stimulation is excellent at building up pelvic floor strength especially if your muscles are severely weakened and cannot be built up with exercise alone. The physiotherapy has been fantastic and I am able to pursue my love of horse riding again. I urge all women to think about pelvic floor training before it is too late - even before thinking about pregnancy and especially if there's a chance you might have a big baby!’
For further information on pelvic floor health or to speak with a case study, please call the CSP press office on 020 7306 1111 or on 07786 332197.
Notes to editors
1. The CSP’s pelvic floor survey was carried out by Opinion Matters/Tickbox.net. The survey involved 2124 UK adults aged 16+
2. The Chartered Society of Physiotherapy is the professional, educational and trade union body for the UK’s 48,000 physiotherapists, physiotherapy students and assistants.
3. Statistics references:
Erectile dysfunction: http://www.bbc.co.uk/health/conditions/impotence1.shtml; Mens Health Forum (http://www.malehealth.co.uk) and Dorey et al, 2004
Incontinence: Dorey et al, 2004
4. The CSP guide, ‘Personal training for your pelvic floor muscles’ is available at www.csp.org.uk/pelvicfloor
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