Pelvic floor dysfunction refers to a wide range of issues that occur when the muscles of the pelvic floor are weak, tight, or there is an impairment of the nerves of the pelvic floor. Some common symptoms of pelvic floor dysfunction include urinary incontinence, fecal incontinence, pelvic organ prolapse, and pain in the pelvic region. There are many potential causes of pelvic floor dysfunction, such as pregnancy, childbirth, menopause, aging, strenuous physical activity, obesity, chronic coughing, and even genetics.
While there are many treatment options available, including physical therapy, medication, pessaries, and surgery, it is also important to be aware of what activities or behaviors to avoid if you have pelvic floor dysfunction. Certain actions can exacerbate symptoms or prevent the pelvic floor muscles from healing and gaining strength. Being mindful of these triggers is an important part of managing this condition.
Avoid Straining The Pelvic Floor
One of the most important things to avoid with pelvic floor dysfunction is putting extra strain on the pelvic floor. The pelvic floor muscles support the pelvic organs, including the bladder, uterus, and rectum. When these muscles are weak, overly tense, or damaged, placing extra downward pressure on the pelvic floor can cause issues like incontinence, prolapse, or pain.
Some examples of actions that may put a strain on the pelvic floor include:
– Lifting heavy objects, especially incorrectly by rounding the back
– High impact exercises like jumping, running, burpees, or plyometrics
– Straining while using the bathroom, either while urinating or during a bowel movement
– Chronic coughing or repeated vomiting
– Carrying extra weight, especially in the abdominal region
Trying to avoid these triggers can give the pelvic floor a break from excessive pressure. Modifying strenuous activities, treating coughs or illness promptly, maintaining a healthy weight, and using proper form during lifts or exercise can reduce undue strain. Also be sure to avoid holding urine for long periods or rushing bathroom visits.
Improve Bowel and Bladder Habits
Bowel and bladder habits can also contribute to pelvic floor issues in some cases. Constipation, diarrhea, or urine retention problems add additional pressure on the pelvic floor. Making some adjustments to diet, hydration, and bathroom habits may help reduce straining or urgency.
Tips to improve bowel and bladder habits include:
– Stay hydrated to avoid constipation or concentrated urine
– Eat a high fiber diet with plenty of fruits and vegetables
– Limit caffeine and artificial sweeteners, which can irritate the bladder
– Don’t delay bathroom visits when feeling the urge to go
– Take time to empty the bowel and bladder fully when using the restroom
– Treat any persistent gastrointestinal issues, like irritable bowel syndrome
– Consider probiotic supplements to support healthy GI function
Establishing a consistent bathroom routine can also help retrain the bowels and bladder to operate on a predictable schedule without excessive urgency or delay. Get on a potty schedule and allow enough time so you don’t have to rush or strain.
Modify Exercise Routines
Exercise is important for overall health, including helping strengthen a weak pelvic floor. However, certain types of high impact, intense exercise can actually worsen pelvic floor issues if you already have existing dysfunction.
When modifying exercise routines, avoid activities like:
– High intensity interval training (HIIT)
– Plyometrics like jumping lunges or box jumps
– Running, jogging, or jumping rope
– Advanced or hot yoga poses
– Strength training like heavy squats, deadlifts, or overhead shoulder presses
Instead, focus on low-impact exercises that don’t create a lot of downward pressure on the pelvic floor. Some examples include:
– Walking, swimming, or cycling
– Light yoga, Pilates, or gentle stretching
– Bodyweight exercises like push-ups, planks, and lunges
– Light resistance training with lower weights
Also be mindful of form during all exercise. Proper breathing techniques and engaging the core can take some pressure off the pelvic region. Consider working with a pelvic health physical therapist or trainer to develop a safe exercise program. Always listen to your body and avoid activities that cause discomfort, urgency, or leaking.
Manage Chronic Coughing
Chronic coughing, whether due to illness, smoking, seasonal allergies, or other conditions, can worsen pelvic floor dysfunction. The increase in abdominal pressure from coughing can weaken pelvic floor muscles over time. Some ways to help manage chronic coughing include:
– Treating underlying conditions causing cough with medication or lifestyle changes
– Avoiding triggers like smoke, allergens, or air pollution
– Using cough drops, throat sprays, or antihistamines to control coughing fits
– Staying well hydrated to keep mucus thin
– Using coughing etiquette like coughing into the crook of your elbow
– Practicing diaphragmatic breathing exercises to keep airways open
It may not be possible to entirely prevent coughing, but minimizing episodes where possible can help reduce excessive straining. If coughing remains frequent, speak to your doctor about medication options to control symptoms. Avoiding suppressing coughs is also important, so underlying causes still get properly diagnosed and managed.
Improve Posture and Body Mechanics
Poor posture and body mechanics during daily activities can also worsen pelvic floor dysfunction. Slouching, hunching over, or improper bending and lifting can indirectly increase downward pressure on the pelvic floor. Improve posture and body mechanics by:
– Maintaining neutral spine during sitting, standing, and exercising
– Avoiding prolonged sitting or standing periods
– Using lumbar support during sitting
– Keeping shoulders back while sitting at a desk or looking at a phone
– Maintaining engaged core during bending, lifting, carrying
– Keeping feet shoulder-width apart and knees soft during activity
– Holding items close to the body when lifting
– Getting up to walk periodically throughout the day
It can also help to be mindful of posture after giving birth while the pelvic floor is recovering. Gradually return to upright activities like sitting, standing, and walking while engaging the core. Avoid prolonged upright activities or vigorous exercise in the early postpartum period.
Manage Other Health Conditions
Other health conditions that increase abdominal pressure may require additional management alongside pelvic floor dysfunction. These include:
– Obesity: Take steps to reach a healthy weight through improved diet and exercise. This reduces chronic strain on the pelvic floor.
– Chronic respiratory disease: Properly manage lung conditions with medication and avoid exacerbating coughing.
– Gastroesophageal reflux disease (GERD): Treat reflux with medication and dietary changes to avoid straining or irritation of the pelvic region.
– Neurological conditions: Some neurological diseases increase urgency and frequency. Follow recommended treatment plans.
– Abdominal hernias: Repairing hernias can reduce abdominal pressure on pelvic organs.
– Peripheral nerve disorders: Physical therapy and pain medication can help control pain or spasticity in pelvic nerves.
Treating these conditions can alleviate some of the secondary effects causing increased pressure on the pelvic floor. A multidisciplinary approach works best, involving all the doctors and specialists supporting your care.
Modify Diet to Prevent Constipation
Diet is a key factor governing bowel health and constipation. Since constipation and straining worsen pelvic floor dysfunction, modifying diet to stay regular is important. Tips to prevent constipation through diet include:
– Eating more fiber-rich foods like fruits, vegetables, whole grains
– Drinking plenty of fluids, aim for 8 glasses of water daily
– Limiting foods that may cause constipation, like cheese, eggs, and red meat
– Avoiding overuse of binding foods like bananas or rice
– Spicing up meals with probiotic foods like yogurt, kefir, kimchi
– Incorporating magnesium and fiber supplements if needed
– Introducing more plant-based proteins like beans, lentils, tofu
Creating balanced meals with a focus on fiber, fluids, and nutrients that support healthy digestion and bowel regularity can help reduce straining during bowel movements. Keeping a food diary to identify triggers of constipation may also help customize your diet.
Alternative Therapies to Discuss with Your Provider
Some alternative therapies may help support pelvic health, but should only be used after discussion with your healthcare provider. Options to ask your provider about include:
– Acupuncture – Fine needles are inserted into specific points of the body. May help relieve pelvic pain or tension.
– Pelvic floor physical therapy – Specialized internal and external soft tissue techniques performed by qualified pelvic floor PTs. Can help relax tight muscles and strengthen weak ones.
– Electrical stimulation therapy – Low voltage electric current is applied internally or externally to stimulate and strengthen pelvic floor muscles.
– Biofeedback training – Using visual cues and sensors to retrain proper pelvic floor muscle contraction and relaxation. Helps gain voluntary control.
– Vaginal dilators – Progressive use of tapered dilators to gently relax tightened pelvic floor muscles and tissues. Helps reduce pain with penetration.
– Pessaries – Removable devices inserted into the vagina to support prolapsed organs or incontinence. Provides mechanical support.
– Manual therapy techniques – Gentle internal and external manipulation using hands-on techniques to release tight fascia, muscles, nerves.
Always consult with your OB/GYN or urogynecologist before pursuing alternative pelvic therapies to ensure safety and efficacy. Report any worsening of symptoms or concerns immediately.
Avoid Heavy Lifting or Strenuous Activity
During times when the pelvic floor is weakened or recovering, such as in the postpartum period or after pelvic surgery, it is essential to avoid activities that place excessive downward pressure on the pelvic region. Heavy lifting, strenuous exercise, and high impact activities can worsen prolapse or provoke leakage if the pelvic floor is not yet healed and strengthened.
Follow any guidelines provided by your healthcare provider on activity restrictions after delivery or surgery. In general, avoid:
– Lifting anything over 10-15 pounds
– Vigorous strength training with weights, resistance bands
– High-intensity exercise classes
– Jumping, running, bouncing activities
– Repeated bending, squatting movements
– Lifting children or groceries
– Pushing heavy objects like furniture or strollers
Scale back activity to simple walking, pelvic rest periods, slow postnatal core strengthening exercises, and light household tasks. Listen to your body and stop anything causing discomfort, heaviness, or leaking. Slowly return to normal activity under your doctor’s guidance once healed.
Avoid Smoking and Secondhand Smoke Exposure
Smoking and secondhand smoke exposure negatively impact pelvic health in numerous ways. Smoke triggers chronic coughing, bladder irritation, and exacerbates other lung and digestive diseases. All of these effects can worsen pelvic floor dysfunction.
Quitting smoking and avoiding secondhand smoke is strongly recommended to help manage pelvic floor dysfunction and promote healing after treatment. Smoking cessation resources include:
– Consulting your physician about quit smoking programs, counseling, or medication
– Joining a support group in person or online
– Using nicotine patches, gum, or other cessation aids
– Identifying your triggers and avoiding smoking cues
– Trying stress management techniques if cravings are worse during stress
– Exercising regularly to help withdrawals and cravings
Also ensure your home and work environments are smoke-free zones. Make it a rule to only socialize in smoke-free locations. The harmful impacts of smoking worsen the more years a person smokes. Quitting now improves health and can help resolve many smoking-related effects on the bladder and pelvic floor.
Conclusion
Pelvic floor dysfunction encompasses a range of troublesome and often painful conditions affecting bladder and bowel function. There are numerous triggers and activities that can exacerbate these issues that are within your control to modify. Being mindful of habits, diet, exercise routines, and lifestyle factors that increase downward strain on the pelvic floor is essential. While professional treatment is key for resolving pelvic floor dysfunction, making certain changes to avoid potential triggers can facilitate healing and prevent future worsening of symptoms. Work closely with your healthcare providers to find an appropriate pelvic floor management plan tailored to your needs and symptoms. With time and consistency reducing strain and strengthening the pelvic floor, improvement in many cases is possible.
