Venturing into Pelvic Floor
探索盆底肌
Everything you see in red on this photo are pelvic floor muscles. Pelvic floor muscles are located at the bottom of our pelvis and are essential to everyone - men & women, young & old. They support our bladder, rectum and uterus.
Pelvic floor muscles are often associated with
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Low back pain
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Tail bone pain
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Pelvic girdle pain
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Menstrual pain/ endometriosis
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Leaking urine/ incontinence
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Painful bladder
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Constipation
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Painful sex
Most people thought this must be due to pelvic floor muscle weakness/ laxity and thus working hard on practicing the squeezing/ tightening exercise.
HOWEVER from my experience in the clinic, it is often caused by the increased pelvic floor tension instead (which squeezing exercise might actually make it worse). Yes, you can have leaking urine with overly tight pelvic floor muscles.
照片上红色的部分叫“盆底肌”。盆底肌位于盆骨的底部，对每个人（男女老幼）都至关重要。它支持我们的膀胱，直肠和子宫。
盆底肌功能异常与以下症状有关:
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腰背疼痛
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尾椎骨痛
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盆骨痛
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经痛/ 子宫内膜异位症
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膀胱疼痛
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尿失禁/ 漏尿
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便秘
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性行为疼痛
大家常误以为这一定是盆底肌松弛造成的，并努力地练习收缩运动。
然而在诊所里经检查发现，其实很多时候是因为盆底肌过于紧绷造成的, 收缩运动反而会让问题恶化。是的，以上痛症和尿失禁都很大可能是因为盆底肌过于紧绷造成的。
You might have heard of the Kegel exercise -- an exercise that is important to prepare your pelvic floor for delivery and recovery after birth. A complete and correct Kegel exercise includes the CONTRACTION and the RELAXATION of the pelvic floor muscles.
The most common cue for pelvic floor CONTRACTION is ‘holding your pee halfway through urination’. However, do not make a habit of doing the kegel exercise while emptying your bladder as this might lead to urinary tract infection due to incomplete bladder emptying.
Below are a few other cues that I found useful when working with my clients. Try them out one by one and find out the one that works the best for you.
Avoid
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Tensing up buttocks/ inner thigh muscles
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Breath holding
大家或许对盆底肌肉运动 Pelvic Floor Exercise/Kegel 不陌生，但你做对了吗？
盆底肌肉的收缩，除了普遍讲的像忍尿的感觉，这裡给大家多几个提示，留言分享你们对哪个最有感觉吧~
切记，不要
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收紧屁股/大腿内侧肌肉
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憋气
记得配合呼吸做，收缩时呼气，然后收缩后要完全放松！下一个post会给大家讲解盆底肌的放松，放松这一部分可比收缩还来得重要，但>95%的人都将它忽略了!
Now that you have practiced the contraction part, let's move on to the RELAXATION part of the pelvic floor exercise (which is more important in my opinion however being ignored by >95% of people). Besides being able to correctly contract your pelvic floor muscles, it is crucial to be able to completely 𝗿𝗲𝗹𝗮𝘅 𝗮𝗻𝗱 𝗹𝗲𝘁 𝗴𝗼 of your pelvic floor muscles.
Clinically, I am seeing most clients with pelvic floor dysfunctions ( leaking urine/faeces, prolapse, phantom/ recurrent urinary tract infections/ painful sex) have issues with pelvic floor muscles that are overlytight and have difficulty to relax them instead of having true weakness in the pelvic floor.
These conditions might also be caused by a combination of tension and weakness of the pelvic floor muscles. Like any other muscles in our bodies, it is more effective to relax the muscles first before strengthening them.
Relaxation of the pelvic floor is also essential for urination, defecation and birthing of a baby.
Check out below cues which I found extremely useful to guide my clients to let go the tension in their pelvic floors.
除了收缩，盆底肌肉的放松（配合吸气）也一样重要哦。临床上发现许多与盆底肌有关的问题，如大小便失禁、器官下垂、性行为疼痛、长期反复尿道发炎的现象，都与盆底肌过于紧绷有关。
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很多人无法理解为何大小便失禁是盆底肌紧绷，而非松弛所导致。试想想如果一个肌肉长期处于过度紧綳、过度操劳的状态，当需要额外出力时（打喷嚏、咳嗽）就无法正常地作高强度收缩，而发生尿失禁的情况。
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而生产时，push的过程就是盆地肌肉放松运动x100倍的感觉啦！怀孕的妈妈平时上大号时可以记得这个感觉，只是push比push的强度要高出1000倍~
I hope you have found a fun & effective cue to practice both the pelvic floor contraction and relaxation. Most pelvic floor related dysfunctions are caused by pelvic floor tension or also called hypertonic pelvic floor, overactive pelvic floor, tight pelvic floor. They can be treated by a Women’s Health Physiotherapist who is able to carry out internal assessment and treatment. This is a specially trained skill, not commonly practiced hence these issues are often being ignored.
If you are experiencing one or more of the conditions mentioned in the beginning of the article and you can’t seem to find relief -- you need to get your pelvic floor checked! We provide both in-person and online consultation. Reach out if you think you might benefit from this.
希望大家对盆底肌肉、盆底肌肉运动、以及与盆底肌相关的不适有了初步的认识。大多数盆底肌功能异常或相关的不适，都与盆底肌的过度活跃或紧绷有关。而女性健康物理治疗师能透过与内检类似的方式治疗与放松盆底肌，并还原其应有的状态。这手法是需要专业训练的，因此不是普遍的物理治疗师能够提供的。
如你有任何与盆底肌相关的不适，欢迎向我们查询。这种情况其实很普遍，只是不常被提及和关注而已。我们已帮助了不少的女士（当中有20岁出头的年轻女生、产前产后的妈妈、更年期的女士）。她们在接受治疗后都得到非常大的改善，而她们最常反映的是“一直都不知道原来有的救的”“因该要让更多人知道”...