Pelvic health conditions

21 March 2018

Beth Haxby of Spire Norwich Hospital discusses Pelvic health conditions, and the important role of pelvic floor muscles with Emma Gampell Specialist Physiotherapist.

Pelvic floor dysfunctions are more common than you think, and one of the reasons that you may not know this is – we don’t talk about them! Our pelvic floor muscles silently do their job to assist with bladder, bowel and sexual function. They also have a very significant contribution in keeping our core strong and our backs healthy. However, many of us are unaware that these muscles exist and in turn, do very little to keep them healthy and use them appropriately. So I had a chat with Emma Gampell Specialist Physiotherapist at Spire Norwich Hospital to find out more.

Where are the pelvic floor muscles?

‘The ‘floor’ of the pelvis is made of two layers of muscle (deep and superficial) and other connective tissues. These layers form a bowl shaped hammock from the tail bone at the back to the pubic bone in front (along the line of your knickers between your legs). The pelvic floor muscles wrap around and support the rectum (back passage), the vagina (birth canal) and the urethra (front passage).’

What are the functions of the pelvic floor muscles?

They support the bladder, womb (uterus) and bowel to help prevent prolapse, they also play an important role in bladder and bowel control allowing elimination of urine and faeces from the body controlling stress incontinence and urgency as well as contracting during sexual activity.

What are the most common reasons for pelvic floor muscles weakening?

‘I see a lot of post pregnancy (perhaps from traumatic childbirth) and post menopause (changes in hormone levels) patients, but reasons for weak pelvic floor muscles can vary from straining to empty bowels with chronic constipation, repeated heavy lifting, being overweight, and sexual activity, amongst other reasons.’

What are the benefits of pelvic floor exercises?

‘A daily pelvic floor exercise routine helps to control adverse effects on the pelvic organs and support bladder control. It is important to maintain this muscle strength throughout your life in particular: to prevent prolapse (when the walls of the vagina become lax, the organs that they should be supporting bulge into the vagina (creating the sensation of a lump hanging down), control stress incontinence (a regular leak of urine when coughing, sneezing or exercising), during pregnancy or following childbirth, following pelvic or abdominal surgery and once you have gone through the menopause.’

How do you contract the pelvic floor muscles?

‘Firstly identify the muscles that need to be exercised. These can be described as the muscles which tighten and lift the pelvic floor as when trying to control wind or when preventing the flow of urine (not the stomach or buttock muscles). The pelvic floor muscles respond to exercise in a similar way as the muscles anywhere else in your body. As with any other muscle training you need to build both strength and endurance. It is the effort put in to each contraction, going for the maximum power you can achieve rather than the number of repetitions you do which can build up strength and tone. You don’t need to hold the contraction for more than ten seconds, and the number of repetitions depends on how quickly your muscles start to fatigue.’

If I had concerns about my pelvic floor and had a consultation with you, what happens during that appointment?

‘At your first appointment a detailed medical history will be taken, and we will discuss any relevant information (ie children, lifestyle, exercise regimes etc), followed by a thorough assessment of your condition, which may include an internal examination (this isn’t uncomfortable and performed very quickly). This will enable me to establish your baseline function, from which we can measure your improvement.’

You will receive expert advice and treatment with a personalised programme tailored to your needs and with the patients consent; we can also refer you to a private consultant who can arrange access, when necessary, to our private diagnostic facilities including X-ray, CT and MRI scanning.’

How long is the typical treatment period?

‘The average is three months, with around four to six sessions during this time, treatment time varies depending on each patient’s case though. The exercises will increase in intensity over time, and when I feel the patient is ready I will also teach them how to incorporate the pelvic floor exercises into other exercises, such as Pilates. It takes several months to build up the strength in any muscles, don’t give up. You will have good and bad days along the way but if you persevere you can make a big difference to your lifestyle.’

How to arrange an appointment

Pelvic health conditions can be treated and better managed, and for this reason it is important to talk to your doctor about your symptoms. The Women’s and Men’s Health Centre is open to all, not just those with private medical insurance. For consultation and treatment pricing information please contact the physiotherapy department at Spire Norwich Hospital on 01603 255 587.

For further information regarding Specialist Physiotherapist Emma Gampell, please visit and ‘click’ on their consultant profile.

The content of this page is provided for general information only.  It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.


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