Table of Contents
About the author 1
Acknowledgements 3
Foreword 5
Introduction 7
Chapter 1 Your Pelvic Floor - A Bit of Anatomy 15
The Pelvis 15
The pelvic floor 16
The Core Four 17
The diaphragm 18
The transversus abdominis 19
The multifidus 20
Whole-body Movement and the Pelvic Floor 20
Chapter 2 The Symptoms of Pelvic Floor Dysfunction 23
Incontinence 23
Stress Urinary Incontinence 25
What is "Intra-Abdominal Pressure"? 26
Overactive Bladder 29
Urge Incontinence 29
Mixed Incontinence 31
Faecal Urgency and Incontinence 32
Vaginal Wind 33
Pelvic Organ Prolapse (POP) 33
Can prolapse be prevented? 35
Pelvic Girdle Pain (PGP) 36
Vulval/Vaginal Pain 37
What Causes PGP and Can it Be Treated? 38
Lower Back Pain 41
Chapter 3 What Causes Pelvic Floor Dysfunction? 43
The Influence of Posture 44
An Overactive Pelvic Floor 45
Protective Postures 46
Footwear 46
Ageing 47
Doing Pelvic Floor Exercise (such as Kegels) Incorrectly 48
How Do I Learn How to "Do My Pelvic Floors" Correctly? 48
Using Pelvic Tech 49
Hormones 49
Menstruation 50
Days 1-7 Menstruation 51
Days 8-14 Follicular Phase 51
Days 15-20 Ovulation 52
Days 20-28 Luteal Phase 52
Endometriosis 52
Menopause 56
Hysterectomy 58
Family History 61
Connective Tissue Disorders 61
Obesity and a Sedentary Lifestyle 61
High-Impact Exercise 62
Running 63
Heavy Lifting 63
Stress 64
Toilet Habits 66
Chapter 4 Pregnancy, Birth and Pelvic Floor Recovery 69
Pelvic Floor Exercises in Pregnancy 71
Hormones in Pregnancy 72
Human Chorionic Gonadotropin (HCG) 72
Progesterone 73
Oestrogen 74
Relaxin 74
Breathing 75
Alignment 75
The Abdomen 76
Diastasis Rectus Abdominis 77
The Impact of Birth on the Body 80
How Pushing Affects the Pelvic Floor 81
Episiotomy Surgery and the Pelvic Floor 81
Birthing Positions 82
Abdominal Birth (Caesarean Section) 83
Abdominal and Scar Massage 84
Pelvic Floor Massage Post-Birth 85
The Mother's Rebirth 85
Postnatal Depression and Pelvic Floor Dysfunction 86
Postpartum Recovery 88
The First 40 Days 88
Retraining Your Core 89
Returning to Running 90
Chapter 5 The Non-Physical Effects of Pelvic Floor Dysfunction 93
The Affect on Mental Health 93
Reduce or Avoid Exercise 94
Relationships and Intimacy 96
Let's Talk About Sex, Baby! 97
Painful Sex 98
Chapter 6 Solutions for Managing Pelvic Floor Dysfunction 101
Pelvic Floor Physiotherapy 101
Pelvic Floor Muscle Training 103
Pelvic Floor Exercises (Kegels) 104
Popular Cues for Finding Your Pelvic Floor 105
What Happens When You Breathe In? 106
What Happens When You Breathe Out? 106
How Often Should I Be Doing My Pelvic Floor Exercises? 107
Remembering to "Do Your Pelvic Floors" 108
Building Pelvic Floor Work into Functional Movement 108
Pelvic Floor Hypertonicity 109
Kegel Weights 110
Pessaries 111
Fitness and Lifestyle 112
Hypopressives 117
Surgery 121
Clothing 125
Chapter 7 Movement and Exercise 127
Learn Your ABCs 128
Retrain Before You Train 129
Pelvic Floor Retraining Exercises 129
Down-Training Exercises 129
Beginner Up Training 133
Intermediate Up Training 136
Advanced Up Training 138
Chapter 8 Frequently Asked Questions And Final Tips 141
Frequently Asked Questions 141
Do I Need to Do Pelvic Floor Exercises Every Day? 141
Should I Add Pelvic Floor Awareness to My Cardio Too? 141
Is it Too Late For Me? 142
How Long Will it Take For Me to See Results? 142
Can I Do Crunches? 142
Final Thoughts and Tips 143
Do the Maths 143
Book in to See A Pelvic Floor Physiotherapist 144
Walk Every Day 144
Build Your Pelvic Health Team 144
Appendix 1 Movement Methods To Train The Pelvic Floor - Pfilates and Hypropressives 147
Pillates 147
Hypopressives 149
Appendix 2 The Core Collaborators 151
The Psoas 151
The Piriformis 152
The Quadratus Lumborum 152
The Glutes 152
The Adductors 153
The Obturator Internus 153
Appendix 3 Pessaries 155
Tips From The Global Pelvic Health Village - What Pelvic Experts Say 157
Resources And Useful Organizations 169
Pelvic Floor Exercises and Equipment 169
Pregnancy, Birth and Motherhood 169
Menopause 171
Sex 171
Incontinence and Bowel Issues 171
Useful Websites 172
Books 173
Endnotes 175
Index 183
