Your pelvic floor supports many of your lower body muscles and organs. and for us ladies, our pelvic floor also controls our bladder.
Here's an instance -- you sneeze and out comes a little tinkle. Or you just can’t quite make it to the bathroom in time. Maybe you’re to the point of having to wear a pantyliner throughout the day for those little “oops” moments. All of this may be due to a weak pelvic floor, and according to UCLA Health, one in three women will experience pelvic floor disorder in their lifetime.
But a weak pelvic floor is totally fixable. That’s why we sat down with Courtney Broderick, DPT and physical therapy director, and Cathriona Fey, pre/post-natal fitness expert at Core Fitness and Physical Therapy in Evergreen Park, IL, just outside of Chicago, to talk about the importance of having a strong pelvic floor and how to strengthen yours.
What is Pelvic Floor?
Your pelvic floor contains the muscles that physically hold up your pelvic organs (bladder, rectum, and uterus). Think of them as a sling or a hammock. These muscles are located in your pelvis between your tailbone and pubic bone, and just like any other muscle, if they are not exercised, they become weak.
Pelvic Floor Dysfunction
Pelvic floor dysfunction is when you have lost control of your pelvic floor muscles. Without that muscle support, you experience a drop in your pelvic organs and less control over their functions. When it comes to pelvic muscles, Courtney tells us, “if you don’t use it, you lose it.”
“And remember, everything will go toward gravity and descend,” she explains.
Pelvic floor dysfunction can lead to serious issues including:
Bladder Issues and Incontinence
Incontinence is when you cannot control your bladder or your bowels. The weakened pelvic muscles make it harder to “hold it” til you get to the bathroom. Symptoms of incontinence include:
- Strong urge to urinate as soon as you feel it coming
- Urinary leakage while walking, standing, leaning, sneezing, etc.
- Inability to hold bowel movements or flatulence
Pelvic Organ Prolapse
Pelvic organ prolapse happens when your muscles can no longer support your pelvic organs, causing them to descend into the vagina. This can cause painful bulging pressure. According to womenshealth.gov, pelvic organ prolapse can include:
- Uterine prolapse – When the uterus bulges in or out of the vagina, also known as a dropped uterus.
- Dropped bladder – Also called cystocele. When the bladder drops against or out of the vagina.
- Rectocele – When the rectum bulges in or out of the vagina.
Pelvic Floor and Pregnancy
Your pelvic floor plays a huge role during pregnancy. Not only is it supporting pelvic organs, but now it has a growing baby to hold as well. It goes through a lot of stress and trauma and becomes weak after giving birth. If not rehabbed properly, this can lead to more issues down the road.
“The pelvic floor gets overlooked because we don’t see it,” Cathriona says. “Oftentimes it takes pregnancy or postpartum for women to even know it’s there.”
And just as important as it is to have a strong pelvic floor during pregnancy, you want to make sure those muscles stay strong after the pregnancy as well.
Courtney says physical therapy should be a part of postpartum recovery. The sooner the better, but even if it’s been several years since you last had a baby, it’s never too late to repair those muscles.
“We see women in their 50s and 60s who say they had babies 30 years ago, but they didn’t strengthen those pelvic muscles, which eventually became weaker,” Courtney says.
Rebuilding Your Pelvic Floor
You don’t need to take drastic measures to fix a weak pelvic floor. All it takes is proper care and exercise.
“Everyone is fixable, everyone can strengthen it,” Courtney says. “Everyone has the ability to have a strong pelvic floor. The education is just not there. This is a thing that everybody should do. It’s never too late.”
“On the physical therapy side, we work more on stretching a tight pelvic floor, whereas Cathriona focuses more on strengthening,” Courtney continues.
To strengthen a pelvic floor, Cathriona says it starts with a strong core and paying attention to other major muscles in your body. Remember, the body works as a whole, and if any one area of the body is weak, you are depending on the rest of your body to compensate and work overtime.
“With age comes muscle wasting in general,” Cathriona says. “As those glutes get weaker, those biceps get weaker, and the pelvic floor is getting weaker. We treat the pelvic floor as sort of a full deep core system.”
“It’s like strengthening a bicep,” she continues. “You don’t just pick up a weight and say you’re going to have this big, strong bicep. Same as someone who says they will just kegal 500 times a day and contract their pelvic floor. It doesn’t happen like that.”
But just like any other exercise routine, building pelvic floor strength takes time. And you can’t build a muscle without stretching it as well.
Stretching Your Pelvic Floor
Stretching your pelvic floor is just as important as strengthening it. Tightness of the pelvic floor can lead to pain in other parts of the body, like lower back pain and painful intercourse. When getting physical therapy for a tight floor, Courtney says they use instrumentation to help stretch those muscles.
“The more superficial tool to stretch your pelvic floor is a dilater,” Courtney explains. “It just stretches the tissues out to tolerate internal medical exams and intercourse.”
Courtney says there is another muscle deeper in your pelvis – the obturator internus, or hip rotator. If that muscle gets tight, it can cause lower back pain, groin pain, and more.
“We use a therawand for that,” Courtney says. “It just has a little different curve to it to stretch those muscles.”
Outside of physical therapy, doing stretches and yoga poses such as child’s pose, happy baby, and flat frog can also help with pelvic floor tightness. But Courtney says to remember that stretching is a process, and that it takes time to lengthen a muscle.
“It’s good to put yourself into a stretching program,” Courtney says. “It’s hard to strengthen a shortened muscle. This is what Pilates is. You have one movement building strength and one movement building length.”
Cathriona goes back to her example of the bicep muscles.
“So that strong bicep comes from being able to lengthen that muscle, and then curl that weight,” Cathriona says. “When a shortened bicep goes to reach that carseat or bag of groceries, it’s not going to feel good. But a muscle that has been lengthened and strengthened will perform much better. The same thing goes for your pelvic floor.”
Physical Therapy Success Story
Courtney and Cathriona say they worked with a patient in her late 50s who was 22 years postpartum and seeking help for incontinence. Between therapy with Courtney and strengthening with Cathriona, they say this patient was able to avoid surgery to help with her pelvic weakness.
“With surgery, it is only a temporary fix, as opposed to a permanent fix by strengthening the muscles,” Courtney says.
Within seven months, she was experiencing less bladder leakage, was able to stop using pantyliners, and started moving more in general.
“She even started doing yoga classes,” Cathriona says. “It just sparked this new energy in her, and now she comes every Saturday to my interval training class. She’s doing all these movements now, like deadlifts, that she couldn’t do before therapy.”
3 Easy Exercises Build Pelvic Floor Strength at Home
Muscle work and exercise are the best ways to rebuild your pelvic floor. However, keep in mind that this is a marathon, not a sprint. The more you work those muscles, the better your outcome.
Here are three easy-to-do exercises to build your pelvic floor strength at home, no equipment needed.
- While seated or standing, pull your lower pelvic muscles tight and up toward your abdomen, as if you are trying to grip a marble.
- Hold for five seconds, release, and repeat. Aim to do three to four sets of 10 a day. You can also use kegal balls to intensify this workout.
Bridges will help build your core and glutes as well, both of which will help take pressure and extra compensation from your pelvic floor muscles. It also provides stretch of your lower abdomen, which can help with mobility.
- Lie flat on your back on the floor with your knees bent at a 90-degree angle. Keep your soles flat on the floor and arms at your side, palms-down.
- Pushing through your heels, raise your hips off the ground by squeezing your glutes, pelvic floor, and hamstrings.
- Hold for a few seconds, slowly return to the first position, and repeat.
- Stand straight with your feet hip-width apart.
- Squat slowly and with control until your knees are at a 90 degree angle.
- Hold for 10 seconds, slowly return to standing, and relax your pelvic muscles. Repeat for 10 reps.
Bottom Line: It’s Never Too Late
No matter your age or stage you are in life, a weakened pelvic floor can be fixed. If you are having trouble with incontinence or experiencing pelvic and lower back pain, it’s always smart to consult with a strength specialist or physical therapist for treatment.
We also recommend reading Between the Hips: A Practical Guide for Women. It contains a wealth of information about life stages, pregnancy/postpartum and pelvic pain, bladder health, and even healthy orgasms!
Remember, the longer you wait, the worse it can get. Paying simple attention to our bodies and strengthening from within can drastically improve your quality of life, so don’t ignore any symptoms!