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Handy Hints

Improve your Sitting Posture      

 

Here are a few hints to improve your sitting posture and ease the pain from tight muscles:

  1. If possible lift your seat up so that your hips are slightly higher than your knees. If this is not possible, for example in a car seat, try folding a towel up and placing it in the back half of the seat so that it lifts your bottom higher than your thighs.
  2. Neutral alignment of your spine helps your core muscles to turn on and stabilise your back. To achieve neutral alignment, rock your pelvis forward so that you can feel you are sitting up onto your sitz bones (ischeal tuberosities]. Now relax your bottom. Relax your tummy, and relax your legs, but don’t let yourself rock back off your sitz bones! Finally, gently turn your core muscles on. If you are unsure how to do this, just imagine lifting your pelvic floor, or imagine lifting your head 1mm off your neck. Try to hold this position as you work, and reposition your self into this same position every time you sit down
  3. Stay away from soft couches and low seats as they will make it hard for you to sit well.
    poor_posture    good_posture
    Poor Posture           Good sitting Posture with neutral spine alignment

 

How Good is Your Pelvic Floor?

Written by: Dr Barbara Hungerford

 

We all have a pelvic floor and we all want to be able to control going to the toilet without any mishaps. However, sometimes our pelvic floor muscles don't always work as well as they should, and this can lead to leakage or loss of control.

Recent research has confirmed that gentle contraction of the pelvic floor creates a lift of these muscles under the bladder and our pelvic organs. This lift of the pelvic floor muscles puts tension on the neck of the bladder to stop the flow of urine and maintain continence (Junginger et al, 2008, see Recent Research update).

So why do some people suffer from incontinence or leakage? This is a complex issue that can occur for a number of reasons, and can effect both men and women. Some possibilities are:

-difficulty activating the front part of the pelvic floor after childbirth or in conjunction with organ prolapse

-inhibition of correct pelvic floor lift due to back pain or pelvic injury

-inhibition of correct pelvic floor lift after surgery such as hysterectomy, caesarian section, or prostatectomy

-poor core stability and over active abdominal muscles or poor breathing patterns, that puts pressure on the pelvic floor

Regaining control of your pelvic floor and continence takes some practice, but is certainly possible with correct advice and retraining. Why not try the exercise we describe below? If you would like further advice about exercises for pelvic floor control please contact us for an appointment on 02-97199114.

 


Enhance your Pelvic Floor control

 

  1. Imagine a triangle that has its tip at your pubic bone, and the back part of the triangle links your 2 sitz bones (ischeal tuberosities)                                 
  2. The first step is to relax your bottom and imagine the back part of the triangle staying wide (don't let your bottom squeeze and don't let your sitz bones squeeze tight at all!!)
  3. Now keep the back part of your triangle wide, and imagine gently lifting the tip of the triangle (your pubic bone) up towards  your belly button. Imagine a string connecting your pubic bone to your umbilicus that is gently tightening upwards.
  4. See if you can keep this imaginary string tight and lifted as you breath in and out 3 times. Relax, and then repeat the exercise 10 times.
  5. Practice this exercise every morning, and then at least 3 more times a day. Once you can feel your pelvic floor starting to work, see if you can turn this image on when you first feel the urge to go to the bathroom.

 

 

Recent Research Findings

 

Effect of Abdominal & Pelvic Floor tasks on muscle activity, abdominal pressure and bladder neck

Authors: B Junginger, K Baessler, R Sapsford, P Hodges

International Urogynecology Journal Sept 09

 

Abstract:

Introduction & hypothesis: Although the bladder neck is elevated during a pelvic floor muscle (PFM) contraction, it descends during straining. This study aimed to investigate the relationship between bladder neck displacement, electromyography (EMG) of the pelvic floor and abdominal muscles, and intrabdominal pressure (IAP) during different pelvic floor and abdominal muscle contractions.

Methods: Nine women without PFM dysfunction performed maximal, gentle and moderate PFM contractions, Maximal and gentle transversus abdominis (TrA) contractions, bracing, valsalva, and head lift. Bladder neck position was assessed by perineal ultrasound. PFM and abdominal muscle activities were recorded with a vaginal probe and fine-wire electrodes, respectively. IAP was recorded with a rectal balloon.

Results: Bladder neck elevation only occurred during PFM and TrA contractions. PFM EMG and IAP increased during all tasks from 0.5 (gentle TrA) to 45.7 cmH2O (Maximal valsalva).

Conclusion: Bladder neck elevation was only observed when the activity of PFM EMG was high relative to IAP increase.

 

What does this research mean?

Everything in life is a balance. Our Pelvic floor muscles are meant to activate and create a lift under the bladder in order to close the bladder neck and help us maintain continence. The pelvic floor muscles should turn on with a gentle contraction of the deepest layer of our abdominal muscles, as this also helps us to keep our back and pelvis stable (these muscles are also often desc ribed as our core muscles). If we try too hard and overactivate all of our abdominal muscles, such as when we hold our breath and bear down, this will actually put pressure down onto the pelvic floor and make it hard for this muscle to lift under the bladder. This may increase the likelihood of incontinence.

The authors suggest that gentle contractions of the pelvic floor and transversus abdominis muscles may be best for assisting pelvic control.