Your pelvic floor is more important than you might think (that is, if you ever bother to think about it at all). If you care about your home, then consider this: when you’re doing up your house, the fancy curtains might be what people notice, but if you don’t spend good money on your foundations, then your house is going to fall down. Your not-much-noticed pelvic floor is equally fundamental. Ignore your pelvic floor at your peril.
Baz Moffat is a women’s health and fitness coach, specialising in the areas of pelvic floor, core, nutrition and wellness. You’d be hard pushed to find someone more passionate about pelvic floors. There are often jokes about post-pregnancy pad requirements – think those leaky moments trampolining with your toddler or running for the bus – but Baz explains to Storytellhers why this subject is no laughing matter.
Being a pelvic floor expert is an unusual job, but I really feel it’s why I’ve been put on this earth. Originally, I’d dreamt of being an international athlete, but at 22 I got a proper job in corporate management training. I took up rowing to be social, was good at it, got on the GB rowing team when I was 26, and…became an international athlete. I stopped just before the Beijing Olympics.
I had two children within 16 months of each other, and the first birth was very traumatic. I had an athlete’s linear male mentality towards the birth – I dug deeper, pushed harder and didn’t tap into the power of being a woman. I was used to having a body that did anything - a body I could push to achieve more – but I found my pelvic floor affected by the birth. As a focused, ambitious woman, I didn’t know how to excel at being a mother. I was petrified about the second birth, but I met a midwife and doula who made me see it as an intuitive process. Birth is not an emergency, it’s what we are made to do. The second birth was a powerful and pain-free experience.
The fitness industry is designed by men and doesn’t take into account that a woman’s pelvic floor is the first part of her core. Fitness on the gym floor is often what elite athletes themselves are doing - high-performance sport, strength and conditioning. The pelvic floor has to lift as you move. If you hold your breath when you’re lifting weights, for example, there’s a chance you could develop stress incontinence or prolapse because you’re bearing down on your pelvic floor. Most fitness trainers don’t consider this. It’s a system that doesn’t acknowledge that "women are not small men" (to quote Dr Stacey Simms)
Part of the female population will have no symptoms of a weak pelvic floor, but we’re living for longer and we have to train it to last. Some women have problems, and fitness training can make it worse. So, they either wear a pad and ignore these symptoms, or they stop exercising. The biggest killer of women over 50 is a cardiac disease and the rates of osteoporosis are significant post-menopause. If you’re not exercising, then you’re at greater risk in both these areas.
The messaging around the pelvic floor after birth is: “Here’s a leaflet” and “It’s not that difficult to do it in front of the TV.” But it’s best to have a skilled practitioner to assess and help put a plan in place. It’s important whether you have a C-section or vaginal delivery, or whether you’ve got a weak pelvic floor or a tight pelvic floor (that you need to learn how to relax). You won’t know until you’ve been assessed. It’s hard to connect with that part of the body – it requires concentration and it has to be personalised. The messaging around the pelvic floor is generalised/standardised advice (like 5 fruit and veg a day), but this is not right. Everyone has different bodies, and therefore different pelvic floors – some which will need strengthening, others stretching, and others need to be coordinated back in with the rest of your body.
A little leaking – on a trampoline, after two sneezes, or running after a while - has been normalised by women, and some medical professionals too. Commercial advertising, social media influencers and successful women have laughed about leaking and said they’ve got “Tena pads on tap”. They should stop hiding behind the joke and get assessed by a women’s health physiotherapist (either private or NHS) and then learn how to do proper exercises.
Shame, grief, trauma or abuse mean that often the pelvic floor is not discussed, and a lot of women can’t feel it. Some people are disgusted by it and won’t go near it, and until we get through those layers, we can’t integrate that part of the body into what we do daily. I’m the rehab phase of pelvic floor training after you’ve been assessed - I work with you on a program to make sure it’s integrated with the body. It should be working with you all the time, rather than you having to do exercises. Women describe to me what they’re feeling, I can tell from watching if you’re doing it wrong.
You can’t replace your pelvic floor and it’s responsible for your continence. The two times when your pelvic floor is impacted the most are at childbirth and menopause. As you age and hit menopause you have far less oestrogen - the hormone responsible for muscle tone and muscle strength among other things - so it’s a lot harder post menopause to get your pelvic floor back on track. I promise that everyone I see will be on the right path and be confident after 6 weeks. Once you are symptom-free, the training needed is just once a day for less than 5 minutes. The most important thing to know is that it’s not just a mum thing. If you have a baby you almost have “permission” to have issues, but it’s often necessary for athletes or people who’ve suffered sexual trauma or accidents. Women need to know that we are all equal, and there is always hope.
Baz Moffat offers the Holistic Core Restore® Every Woman course in London for 6-8 women for £180.
1:1 sessions with Baz for 6 weeks are £490.