Running with poor pelvic floor- what is your solution

[Runlikeareindeer]

So my pelvic floor isn't great after two vaginal deliveries, one that was forceps. I do my exercises (prob too late)

I'm running again and it is often difficult to control. I've tried tena lady (well the Aldi version) but sometimes that becomes sodden and then I have a great lump in my pants.

Is there anything I can do?

Sufnlower, that's great.

TVT is good surgery, and I'm glad it's worked well for you. But, yep, it's a got a long recovery, and, of course, you still need to #doyerblardyexercises every day.

Milly - comedy's only talking. Talking's pretty much my only skill.

Plus, there's a microphone. People listen if you have a microphone, no one ever listens to a word I say normally...

Thank you will make a real effort to do them everyday I think I was hoping it would fix itself. I'm not on twitter, can't figure out how that thing works!

gussie I do the elevator lifts too. I try and go to twenty floors then when I can't do anymore floors I go back down the floors as far as possible so I am not just letting the muscle go, but am holding it and controlling it on the way down too.

Day - doesn't matter what you use to remember, just find something. Set an alarm, put it in your diary, make an association with brushing your teeth or doing the dishes - anything to get it into being a habit. I hesitate to suggest doing them every time you log onto mumsnet for fear of worn-out-fanjo-syndrome

Milly - TWENTY FLOORS?

Show off.

Gussie - thank you. I needed a boost to really focus on my pathetic PF again. You are totally right; it's a feminist issue. For anyone who's interested, I wrote a TMI column for the Vagenda blog a while ago about incontinence vagendamag.blogspot.co.uk/2013/04/tmi-incontinence.html

It's still a problem for me. My youngest is 15 months now, I've stopped bfing (my physio said sometimes hormone levels could make it worse), but I haven't lost the weight I need to. Finding exercise that isn't embarrassing is difficult. I HATE the pads and the worry. I'm trying so hard not to let it stop me doing stuff, but sometimes it gets to me.

Yep twenty.....I squeeze and tighten very slowly and try to squeeze tighter and tighter up the elevator up 20 times and then hold for ten.... then try to go down as slowly as going up.

Can I ask a question?

Most of the time I'm fine- can run and jump with a full bladder, do my exercises etc. bu every now and then (often when my bladder is quite empty) I'll just randomly leak! There doesn't seem to be any reason and if I go to the toilet, there's not to wee... Any ideas what this might be or what I can do?

Also, I've noticed lately that no matter how much I try to empty my bladder on the toilet, when I stand up and walk (I notice when I'm wearing nightdress) that I dribble a little. I would see dr, but it seems like nothing to ak about, so I thought I could ask here first...

Thank you

The dribbling is because the urethral canal has been stretched out and bent, so some wee collects and when you stand up the wee then drips down because of gravity.
Do your exercises to strengthen the PF around it.

Thanks Gussie, I've started already would be great if I could stop this happening if not I dread to think how bad it could get, so do i just do each exercise once 3 times a day? So the hold for 10 just once, the 10 flicks then the lift thing once? Im struggling with the lift thing I can do 3 levels up but can't control it down hopefully this will get easier

Same as pp I get the leak when standing up after using the loo too, its horrible

When I first had my slight prolapse I did them at least every hour and it toned up really quickly. But as gussie is a physio and more knowledgable on the subject than me, maybe her three times a day is best .

I need to re-read this thread properly esp. about exercises as after 2 vaginal deliveries I really struggle when running (use pads), and am currently in a dilemma as I would love to do a triathlon but can't see how I could make it work with pads / changes etc :(
I had physio after both, did exercises, saw improvement day-to-day but not when running.
I also use the moon-cup for pressure, but it's not enough.

Glass - excellent article.

You are right, it's an outrage. It fascinates me, leaking is a real taboo in a society which scoffs in the face of taboo.

I did a stand up set about pissing myself, but, I dropped it as it didn't really work. It was too awkward, not for me, but the audience did. They laughed, but, it totally killed the atmosphere!

I agree with your PT, sometimes there's a problem until after your hormones settle. And weight (yeah, yeah, yeah, blah, blah, blah, you've heard all that before).

Also, though, catheters can, occasionally cause a problem. Usually resolves with time - but, I assume they've checked there's no tissue damage or nerve irritation.

And, incontinence does get to you - an estimated third of people who leak are also clinically depressed. Having less bladder control than your toddler doesn't make you feel very good about yourself...

Go back and get another assessment?

Milly

stealth boast noted

Autumn, coffee's right, that sounds like urinary retention.

It can either be that your bladder's not emptying fully, you've got a kink, or you're hopping off the pan before you've finished (usually when the kids are knocking lumps out of each other outside the toilet door)

A trick is to pee, count to 10, then try to pee a bit more.

Or, pee, count to 10, lean forwards, then try to pee a bit more.

Certainly, it's worth telling your GP, that's not a weakness thing. It might be from scar tissue, side effect of medication, something's up with your brain co-ordinating with your bladder, or, you're just in a hurry.

Often fixed by re-learning good bladder habits, and there's medication that can help.

Day, Milli's right - the more, the better.

The evidence is 70-80% improvement with x3 a day, but, the more the better. (with the caveat that you can over-do it and if you do you'll get either pain or a tired fanjo. In which case, do less)

Less than x3 day will help, but, less efficiently.

Once you've got good control, x1 day minimum for maintenance.

running - it is a problem.

The impact can simply be too much.

But, the goal of triathalon can be a big draw - so, suggest:

good footwear, avoid pavements, #doyerblardyexercises, pee before training, don't get dehydrated, keep distances low, try a pessary (incostress) and consider having a wee jumper tied round your waist and dousing yourself in water at every feeding station for camouflage.

It's not impossible, but, in the long-term some folk find it's just not worth it.

Have you been checked to see if there's any prolapse? Might be worth it, and then you'll get specific advice.

Gussie.

I'm doingmyblardyexercises three times a day now, usually when sitting as I drive a lot for work. I guess I'll need to transfer doing them into standing at some point will I?

When I do them though, I feel like I can contract much better towards the back and middle, but not so well at the front (where it's really needed) iykwim. What can I do about that?

Delighted to hear it, wish - have a shiney!

Yep, like any exercise programme, it should be progressive - so, lying, sitting, standing, walking, jumping like a loon in a mosh pit.

It's very common to be able to feel it around the bumhole and not around the pee-hole. That's partly because you'll be (and forgive me for presuming) more used to holding in a fart than holding in when you're bursting. However, there WILL be some muscle activity at the front if you actively contract the back - the one that makes all the muscles work is the "lift"one.

Keep going, you'll feel it as you gain strength in your undercarriage.

Marvellous! Thanks for your words of wisdom and encouragement.

Sorry, just adding - you feel it more in the bum because that's where the bigger part of the PF muscle is so it's natural to feel more if there's more of it.
PF is diamond shaped.
Eventually you'll have mastered the moves and can work more on the front bits.
I think!!

Sorry, Gussie, I'll bugger off now...
As you were!

Ohhelp - well, first of all, they should smile, be kind and put you at ease.

We know that most people find it excruciatingly embarrassing to get your kecks off and show your broken bits to some stranger.

So, first of all, you have a chat. You'll be asked questions about your symptoms, history, previous treatment and general health.

You'll be asked quite a lot about what you drink, how much and when. Also, how often you pee, and leak, whether you leak poo and whether there's any pattern or predictability to the accidents.

If you've had children there will be questions about pregnancy, labour and delivery, tearing/episiotomy. If you've had C-sections there will be questions about the catheter and recovery.

Then you'll be asked to undress and lie up on the couch, in the same way as a gyn exam (and, possibly the same too small paper cover if you're NHS. Private will havea bigger bit). Your abdomen will be palpated to see if there's any tenderness or constipation.

Then, if you're happy, the physio will have a look at your bits to check for infection, skin problems, marked prolapse etc.

It would be expected that you'd also have an internal. By palpating inside the vagina we can see if there is any loss of muscle bulk, loss of sensation, prolapse, spasm, pain or muscle damage. Then your power will be assessed by getting you to squeeze - that's graded.

It's not compulsory to have an internal. But, it is the NICE guidelines, as, it's the best way to check the state of the muscle.

And, the thing to remember is that, yours is the latest in a long line of fannies the physio's looked at. No more startling than an elbow or a neck.

Some physios use ultrasound to show you contracting the muscle - so, they scan your tummy (much as during pregnancy) and you'll see the muscles on the screen. It's very visual, you'll do the exercise and see the muscle lift up.

For women who can't intiate a contraction at all there's a number of options - often electrotherapy which can artificially stimulate the muscle until you've gained enough power to do it voluntarily.

So, we'd expect that you would leave the appointment with a diagnosis, a treatment plan, advice about what to avoid, advice about what to do and a review appointment.

You won't be asked to do anything that you simply don't want to - there's always ways of working round comfort zones.

It is the most satisfying type of work - changes lives.

Good point, coffee!

I just like talking about farting...