Spotlight On Pelvic Floor Health

Claire Mockridge holding a pelvis

I spent some time chatting with the wonderful Claire Mockridge all about pelvic floor health recently and her take on how to prevent issues and eliminate issues once they are already there.

Read on to find out more…

How did you get into working with women’s pelvic floor issues?

I've been a Personal Trainer and fitness/Pilates instructor to pregnant and postnatal women in Nottingham for 12+ years, and it was a natural progression for me to really specialise in pelvic floor health to help those clients with problems during pregnancy and post-birth.

My approach to preparing a pregnant person's body for labour, and/or rehabilitating their pelvic floor muscles after birth is very different to most professionals however, and it may surprise you that I haven't prescribed a Kegel for 4+ years, yet my clients get consistent results at improving the function of their pelvic floor.

I assess the body as a whole unit from head to toe using a biomechanics approach. This technique enables me to pinpoint what it is that's above or below the pelvis that's potentially loading the pelvic floor inappropriately, and/or affecting the function of the pelvic floor itself.

Clients often experience a decrease in back, pelvic, knee and foot pain as a result of applying my techniques, because everything above and below the pelvis begins to right itself from the head all the way down to the foot, proving that everything is connected.

side view of the pelvis

What lifestyle choices cause issues with the pelvic floor?

Excessive sitting and the sedentary lifestyles that we lead nowadays means that we're sitting more and moving less. I might also add that we're sitting badly and not moving particularly optimally when we do too, which is also a huge contributing factor to pelvic floor dysfunction.

We're put on the Earth to roam, walk several miles each day, carry loads in our arms, and hunt and gather just like our ancestors, but since the introduction of agriculture and living in a world of convenience nowadays, we do very few of these things on a day-to-day basis.

The pelvic floor needs to experience different loads. Walking, lifting, carrying and moving in an upright position gives the pelvic floor a workout. Sitting for prolonged periods of time with the tailbone tucked under provides limited load for the pelvic floor, and it can attribute to a passive shortening and tightening of the pelvic floor muscles.

Contrary to belief, you do NOT want a tight pelvic floor - you want these muscles to be at their desired length, so that when you laugh/cough/jump/run or do any other movement that applies load to the pelvic floor, these muscles are able to withstand that pressure and close and lift and do their job properly and not leak urine/faeces, or force that pressure downwards excessively.

Footwear choices also have an impact on pelvic floor health too, and I'm a big advocate for transitioning clients out of traditional footwear and into barefoot shoes which enables the foot to articulate and move through a more improved gait cycle.

Traditional shoes have a raise underneath the heel, limited room for the toes to wiggle/move, and oftentimes a rigid/inflexible sole. It's impossible to stand and walk in correct alignment in a heeled shoe, which in turn affects the pelvic floor's ability to function correctly too.

What symptoms or issues might arise if your pelvic floor isn’t functioning as it should?

Common symptoms when the pelvic floor is functioning at its best are:

1) stress incontinence (where you laugh, cough or sneeze and a bit of wee or poo leaks out),

this is an images of the muscles of the pelvic floor

2) urge incontinence (the sudden urgent need to go to the toilet where if you don't get to a bathroom soon, you're at risk of having an accident), and

3) pelvic organ prolapse (of the bladder, rectum or uterus, where an internal organ has descended down further than it should be, causing an obstruction at the exit, the inability to hold a tampon in, or a heavy dragging feeling as the day progresses).

What do you feel is lacking in pelvic floor health/support during pregnancy and the post-partum period within our medical system? How would you like to see that change?

A lot of postnatal women suffer with pelvic floor problems post-birth, and through no fault of their own, they're not getting heard, taken seriously and/or getting a proper assessment or diagnosis due to embarrassment, or a general acceptance that leaking after having a baby is "normal".

Mothers in my area book in for an 8-week "mother and baby check" with their GP, and unfortunately this is an appointment that's more focussed on baby's health rather than mums'.

If mum broaches the pelvic floor weakness topic, the standard response: "Do your pelvic floor exercises" or "Let's wait until you're 6 months" is often banded about, and the thing we need to realise here is that traditional pelvic floor exercises don't work for every woman or every pelvic floor disorder.

Post-birth, symptoms should not be brushed off as "part of having had a baby", but with the rise of adverts on television normalising "whoops moments", it's somewhat of an uphill battle I'm up against here.

Wearing incontinence pads is only masking the issue and it's not getting to the root cause of the problem. Adult nappy sales are on the rise, and my wish would be for the medical system to receive double the funding in Women's Health Physiotherapy Departments so these very capable, yet currently very time-restricted pelvic floor experts are then able to provide a more rounded service to their patients.

This would then provide women with a more individualised assessment/exercise program which includes information on lifestyle factors that affect pelvic floor function, and education about incorporating natural movement into their day too.

What things can women be doing to ensure they are looking after their pelvic floor health during pregnancy and after the birth?

Learning how to stand better is a really good starting point: feet hip distance, outside edge of the feet straight and bodyweight in the heels.

A lot of clients I see in my clinic aren't aware of how making 2 or 3 very simple adjustments to their posture can affect the load that's applied to their pelvic floor muscles.

Sitting less is also beneficial, and note that when you do have to sit, then "Sit better" is my motto. Most women sit with their back against the back rest of a chair, and their tailbone tucked under. Sitting with the pelvis positioned on the edge of the chair and hip bones and pubic bone lined up vertically at the front of the pelvis provides a more optimum length to the pelvic floor.

Other areas to focus on would be improving foot mobility, hamstring length, and just the general "If in doubt, poke your bum out" rule when lifting objects off the floor/stacking the dishwasher, to lengthen the pelvic floor, get the backside switching on, and say good bye to lower back pain.

seated posture.jpg

Is it only women during their child bearing years who need to be thinking about the state of their pelvic floor or should we all be taking steps to care for it regardless of whether or not we have had or want to have children?

Pelvic floor dysfunction is an issue that doesn't just affect pre/postnatal women, no.

I've seen women as young as 16 with leakage problems due to competitive sports; men with pudendal nerve entrapment; and women who've never had children with prolapse, so although a high percentage of women who've had babies have pelvic floor problems, there's a greater incidence of pelvic floor disorder going on here than we think.

And, if you're still reading and thinking this won't affect you, here's a stat that concerns the next generation/your children that may prick your ears up a bit: it's been predicted that in America, by 2050, 80% of women over the age of 18, will have a pelvic floor disorder. You read that correctly: in 30 years' time, 80% of women will have urine or poo leaking regularly, or have a pelvic organ falling out of themselves.

So, let me conclude by saying that if you learn to stand, sit and move better, your children will adopt your more aligned movement habits.

Special thanks to Claire for taking the time to answer these questions and providing the use of her images as well!

Claire offers a wide array of classes as well as one to one sessions (which i can personally highly recommend!), so if you’d like to know more why not pop across to her website or go find her on Facebook.

Sarah Marsden