Targeted training can strengthen pelvic floor muscles

Hamburg - Muscle training is in, but hardly anyone talks about the muscles of the pelvic floor even though its the most worked muscle group in the human body for both women and men.

If the pelvic muscle group is strained or damaged there can be serious results. The three layers of muscles on the pelvic floor span between the pubic bone, tail bone and the seat bone and lie over one another in a lattice. They support the organs of the lower torso and stabilize the pelvis and close it off at the bottom.

The muscle group's weaknesses are its openings for the large intestines, the urethra and, in women, the vagina, said Eckhard Petersmann of a German self-help organization for people with incontinence. These openings must open and close at the right moment.

"Muscles, connective tissue, nerves and blood flow are responsible for functionality," said Ursula Peschers, chief physician at the pelvic centre in Munich. If one or more of these elements is disrupted, the pelvic floor's support mechanism is no longer in tact.

Women are far more commonly affected by pelvic floor problems than men. They have more of a weak spot there and pregnancy and birth place extreme strain on the connective tissue, muscles and nerves of the pelvic floor. Other risk factors are excess weight and chronic constipation. These factors damage the connective tissue and the nerves. With age and often depending on hereditary factors - the connective tissue loosens and blood flow is weaker.

Weakness of the pelvic floor or damage to the pelvic floor often is expressed as urinary incontinence. It often begins with the release of a few drops of urine when sneezing, coughing or running. Other signs are the inability to hold back stool.

"Still other patients describe a type of strange physical feeling and the sensation that they lack the ability to hold back urine and bowel movements," said Peschers. Many people affected stay silent about the problem.

"We have many members who don't dare go out for months because they are afraid they might stink or they fear messing in their pants," said Petersmann of the self-help organization. "In the organization they come to understand that they are not alone and they become more confident in themselves."

In addition the group provides comprehensive information and helps people to get medical treatment.

"The pelvic floor is a muscle group like any other and should be viewed and handled as such," said Franziska Liesner, a physiotherapist in Hamburg. As a rule people who suffer the problems discuss them first with their gynaecologists. But general practitioners and specialists in urogynecology, proctology and pelvic floor reconstruction can help.

Liesner said normally physical therapy is the first treatment method.

"The therapy should always consist of two equal components: training of the pelvic floor and the muscles nearby on one side and a behavioural instruction on the other," said Liesner. (dpa)