Habits Take the Hard Work Out of Pelvic Floor Healthcare

Let's be honest. Pelvic floor healthcare can be confusing and intimidating. Just trying to understand all the options and how they might apply to you is enough to make your head spin.

When we talk about Pelvic Floor Healthcare, we're talking about everything from simple self care practises all the way up to surgical options (you can read more here).

There’s the seemingly conflicting advice - drink less water/ drink more water, do your kegels/too much kegels, etc., etc.

Then there’s the demoralising terminology - dysfunction, disorder, or the potentially devastating: routine.

There’s the trial and error nature of recovery - pelvic floor issues can cross a number of specialisms and you can feel like you’re being passed around and not making any progress when you’re looking for solutions.

And of course, there's the fact that change takes time. It's easy to lose heart and just give up trying.

All of this can make it really, really hard to follow the advice you’ve being given consistently. 

If you’ve seen a medical professional about pelvic floor issues, chances are you have been recommended pelvic floor exercises to do. The most common kind are kegel exercises - squeezes of the pelvic floor muscles that can be long and slow or quick and short - usually a mixture of both is prescribed. 

For many people, doing kegel exercises regularly is really hard to achieve. 

There are lots of reasons why this might be. Many people don’t necessarily feel any improvement of their symptoms in the first few weeks. Kegel exercises really start to pay off after a month or two but keeping up motivation when you’re not seeing results is hard. 

Many people doubt they are doing kegel exercises correctly and that can make the whole thing feel pretty pointless.

Many people resist kegel exercises as it can be difficult to connect to your pelvic floor - especially if there has been an injury or some trauma. 

There are lots of other strategies that help improve pelvic floor health outcomes, like meditation and massage, but they can be difficult to sustain too. 

One thing that can really help is to reframe pelvic floor healthcare in terms of small habits. 

Small efforts, applied consistently, add up to big impact on long term health outcomes.

As James Clear, a world leader in the field of habits, puts it:

“The effects of small habits compound over time. For example, if you can get just 1% better each day, you’ll end up with results that are nearly 37 times better after 1 year.” James Clear, Atomic Habits

Habits focus on process, not outcome. We complete our small habitual action, not because of an immediate payoff but because we know it compounds positively over time. 

A habit is like a shortcut for the brain - we take a new action which requires focused conscious thinking to achieve and we repeat it until the brain can move this activity into the unconscious part of our brain.

For example, we often forget if we locked the door or not. It’s such an ingrained habit, if someone asks if we did it, we often have to think hard to remember it.

In fact, we already have lots of healthcare habits in place which involve a small effort now for a big health payoff in the future. The best example of this is brushing our teeth - a small time investment twice daily which prevents major cavities and gum disease down the line. Another example is wiping our bums or washing our hands after we use the toilet. We are so used to doing these actions, we hardly think about them at all.

If we can break down the elements of pelvic floor healthcare that work for us into small, manageable habits then we can build systems that will enable us to do these small actions routinely. The positive effects of these will compound over time leading to better health outcomes over our lifetime. 

If we are adding a new behaviour to our routine, like pelvic floor exercises, there are lots of strategies for making this a habit. 

The following strategies are adapted from Atomic Habits (James Clear):

1. Reframe how you think about pelvic floor exercises - e.g. ‘time to take care of myself and invest in my future health’ (rather than ‘time for those stupid exercises I’m not even sure are doing much good’). The positive intention will add to your motivation to do the exercises and repeat the behaviour. 
2. Make a plan (time and place) for doing your exercises - this plan will be the cue your brain needs to do the behaviour. E.g. when I lie down in bed, I will do 10 quick squeezes of my pelvic floor. The more specific you are, when, where, how many, what kind, the more likely your success. Write it down, stick it on a post-it where you plan to do it. No excuses.
3. Attach your pelvic floor exercise habit to another feel good habit. Say you have a cup of tea at 3 o clock - take 3 mins prior to do your exercises (just enough time for the kettle to boil) and you’ll enjoy the tea with a side of self satisfaction.
4. Use your tribe for motivation - follow a few pelvic floor health instagram accounts. The content will be a positive reminder that you’re not alone, you can take daily action to improve your health outcomes and provide inspiration to mix up your routine if you’re getting bored. 
5. Don’t let a set back or a skipped session be an excuse to stop your new routine. The point is to keep building up positive experiences. This will make it easier to keep going long term. One skipped session is just that, nothing more. Avoid attaching negative judgement. Tomorrow is another day. 

In Sheela’s Guide - 5 Habits for a Happy Pelvic Floor - we’ve used these strategies to help you identify ways to adopt simple, healthy lifestyle changes that will have a big impact on your pelvic floor health over time. Download your free copy here.

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Lastly, if there is a woman out there you think might need to hear any of this, please share. Talking about these issues is essential if we're going to help women move past them.