Episode 18: The Importance of Pelvic Floor Health & Training – What You Need to Know with Jude

In this informative and essential episode, we’re joined by Jude, a pelvic floor specialist, to talk all things pelvic floor health and how it ties into exercise and training—for both women and men.

Jude breaks down the basics of how a healthy pelvic floor should function, the difference between underactive and overactive muscles, and why pelvic health matters at every stage of life.

We also dive into the common issues postnatal clients face when returning to exercise, what can happen if these issues are ignored, and the best ways to support your pelvic floor both pre- and postnatally.

This is a must-listen for anyone who wants to train smart, protect their core, and truly understand their body from the inside out.
🧠💪 Empowering, educational, and something we all need to be talking about.

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The content discussed in this video is for general information purposes only. No material  on this channel is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek advice from your physician or other trusted health care provider before undertaking any new health care regimen contained in this video.

 

The Pelvic floor muscle

Anatomy: 2 layers of muscle: 

Deep = Levator Ani. (Pubo-coccygeus, Pubo-Rectalis, Iliococcygeus and Ischiococcygeus)

Role : 

• Support pelvic organs along with connective tissue. (against gravity and our body weight) 
• Collaborate with the diaphragm and abdominal muscles to respond to changes in intrabdominal pressure
• Bladder and bowel control 
• Part of the core muscle group so support and a postural role

Superficial layer: Anal sphincter, Bulbocavernosus,  Ischiocavernosus,  Transvers perineal muscles 

• Back = anal sphincter. 
• Front = sexual response

Healthy muscle= good quality muscle has some tone (but doesn’t need to be tense constantly) needs to have the strength and endurance, flexibility and coordination to enable us to do the things we choose.

Analogy of a trampoline useful.

 When exercising we are relying on the pelvic floor muscle to absorb force (heel strike) and contract to support the internal organs against intra-abdominal pressure and close pelvic openings- urethra, vagina ano-rectum continence and function with other core muscles.

There are times when the PFM needs to be able to relax ie emptying the bladder or bowel and during penetrative sex, intimate examinations.    

 

PFM can be overactive 

• In response to stress/anxiety and pain due to the sympathetic nervous system driving protective behaviour
• Over training
• Over-active bladder
• Hypermobilty  
• They can be both overactive and weak 

 

Risk factors for PFM dysfunction:

• Multiple pregnancies and vaginal births
• Big babies =4kg (consider assoc with high BMI and gestational diabetes)
• Long second stage of labour
• Forceps deliveries
• Obstetric anal sphincter injuries.

Connective tissue considerations with forms of hypermobility ( risk of prolapse)

 

Why do women come to see a Pelvic /Women’s health Physio?

During the pregnancy:

• Pelvic floor muscle function/bladder/bowel issues
• Exercise in pregnancy guidelines 
• Pregnancy related LBP or PGP 
• Discuss physical preparation for birth 

Post natal:

• Healing scar/pain related to the scar- perineal or CS
• PFM rehab – assessment and management – strengthen or relax then function
• RAD -assessment and exercise rehab 
• Breast feeding pain – nipples, blocked milk ducts /mastitis 
• Bowels: haemorrhoids/straining
• Bladder: urgency (oestrogen) stress urinary incontinence ( exertion)
• Poor bladder sensation 
• Prolapse:  looks/feels different – management 
• Pain with return to sex- vaginal and caesarian 
• Return to exercise – in general and preferred exercise/sport.   

How can we support the pelvic floor during the childbearing period?

• Optimise PFM function= fitness
• Protect the connective tissue from unnecessary intra-abdominal pressure if possible- manage constipation, treat cough/ hayfever, work out within the ability of the PFM/abdominal muscles to coordinate and support in the background.
• Get help early on – AN or PN 
• Midwives are in a perfect position to make referrals to physios in the hospitals/birth centres.
• Physios in community – look for those with post grad masters in Women’s and Men’s and Pelvic health 
• PN period – balance activity and rest for first weeks: allow time for healing, hormonal changes to resolve and rehab to improve muscles. Low impact/low intensity for a while.
• Creative with positions used to target specific muscle groups – consider unloading the PF from gravity and body weight.

 

Resources:

Australian Physiotherapy Association, Find a Physio website

Continence Foundation of Australia – lots of resources.

Canadian Guideline for physical activity throughout pregnancy 2019

Australian and New Zealand College of Obstetric and Gynaecologists Guidelines for exercise during pregnancy: https://ranzcog.edu.au/wp-content/uploads/Exercise-During-Pregnancy.pdf