Sure you might have heard about glute bridges and Kegel exercises, but strengthening your pelvic floor is more than just that. Whether you’re a new mom or not, having a strong pelvic floor can help with both bladder and sexual health issues. Here’s what every woman needs to know about her pelvic floor.
What Is the Pelvic Floor?
The pelvic floor is made up of muscles on the inside of your pelvis that form a basket holding the bladder, urethra, small intestine, rectum, cervix, vagina and uterus in place. It also keeps the pelvis stable. According to Abby Bales, DPT, a physical therapist in New York City, you’ll know your pelvic floor is healthy if you don’t have urinary or fecal leakage, especially when you’re jumping, running or sneezing. Sex also shouldn’t be painful, and you shouldn’t experience hip, groin or pelvic pain.
Pelvic Floor Disorders 101
Almost one in three U.S. women suffer from a pelvic floor disorder (when the pelvic floor muscles are weak or injured). Because pregnancy and birth put pressure on your pelvic, that rate that jumps among women who’ve just had a baby. “At postpartum, up to 65 percent of women have incontinence, but that’s only those who are reporting their symptoms to their doctors,” says Bales. “It’s probably closer to 75 percent, because most gynecologists aren’t screening for it,” she notes.
Common pelvic floor disorders include:
- Bladder control problems: Also known as incontinence, the leaking of urine and the strong, sudden urge to pee happens when the bladder drops because the pelvic floor can’t support it.
- Bowel control problems: Leaking of stool from the rectum happens when the rectum is out of place or the anal sphincter, which closes off the anus, is damaged.
- Pelvic floor prolapse: When the pelvic floor muscles and fascia can no longer support the uterus, bladder and bowel, these organs can drop downwards into the vagina or anus. Symptoms include a feeling of puffiness, heaviness or achiness in the vagina or anus. You could also feel like something is dropping through the vagina or anus. “Pelvic organ prolapse can happen to anyone regardless of whether they’ve had kids, although it’s associated with post-childbirth in women,” says Bales.
Can You Over-Exercise Your Pelvic Floor?
Although pregnancy and birth are the most common causes for a pelvic floor disorder, issues can occur even if you’ve never had a child. Being overweight, having chronic constipation or having a chronic cough also put pressure on the pelvic floor. As women age, their estrogen production lowers, which makes it harder to maintain muscle everywhere (including down there), says Bales.
Bales also says that certain exercises can increase your risk of pelvic floor issues. Crossfitters and other high-intensity athletes may experience incontinence due to improper form. Women who lift heavy weights may experience leakage because the weights bear down on the vagina or anus. But Bales says you can learn how to coordinate your breath with pulling in your pelvic floor as you lift.
It’s also possible to have an overly tight pelvic floor due to over-exercising it with workouts like Pilates. Symptoms include difficulty urinating, painful intercourse, pain around vaginal area, bladder urgency or frequency and constipation, says Stacey Futterman, M.P.T., a pelvic floor physical therapist in New York City. If you notice any of the above, a specialist can help you diagnose and treat the issue.
Treating Pelvic Floor Disorders
The good news is that you can easily treat pelvic floor issues. “Your pelvic floor is just like any other muscle: You can train it to make sure it’s responding as it should,” Bales says. That’s true even if you have a post-birth tear that your doctor can’t repair surgically. “Techniques can compensate for muscles that are damaged during birth,” she adds.
If your symptoms are moderate and you’re wearing pads, see a professional pelvic floor physical therapist. They can out rule any other issues you may have and can show you how to engage your muscles properly. (Your ob-gyn isn’t trained to treat pelvic floor disorders.) “Sometimes it’s not just your pelvic floor but other muscles, like weak glutes or transverse abs, or tighter mobility in your joints. You might also be too tight, in which case exercises won’t help,” says Futterman.
How to Do Kegel Exercises
You’ve probably heard of Kegel exercises — which engage your pelvic floor to improve your muscle tone and sexual health. You can test the strength of your pelvic floor and know what a Kegel should feel like by trying to stop the flow of urine when you go to bathroom.
Here’s the right way to do a Kegel: As you exhale, draw your vaginal muscles up and together, squeezing and pulling your belly button inward and upward. Visualize closing the vaginal opening, bringing your tailbone toward you pubic bone and stopping gas, suggests Futterman. You should be able to isolate your pelvic floor and feel the contraction. If you can’t, it likely means your muscles are either too tight or too weak, she says.
Exercises to Support Your Pelvic Floor
Keep in mind, Futterman doesn’t recommend relying solely on Kegels as your exercise Rx. It’s a myth that you have to do 100 Kegels a day to keep your pelvic floor healthy, Futterman says. Because the pelvic floor is supported by your glutes, abs, hip flexors and diaphragm, it’s essential to strengthen those surrounding muscles. “A lot of women have weak glute muscles, so activating those muscles and incorporating them into your exercise routine is important,” says Futterman.
Bales recommends adding Kegels to your exercise routine two to three times a week, whether that includes Pilates, barre, weight training or running. Futterman says one high-quality set of 10 pelvic floor exercises per day — such as the Pilates clam and squats — along with good posture and technique is a great base.
Also, think about activating your pelvic floor only 50 percent during exercise to avoid overworking your muscles, Futterman suggests. If you focus on Kegeling for your first few reps, you’ll usually find that your pelvic floor will remain engaged throughout your workout. If you have an injured pelvic floor, Bales recommends doing 60 reps of pelvic floor exercises four to five times a week.
“Mix up your workouts to keep your body in balance. Have fun and be mindful. If something doesn’t feel right, it most likely isn’t,” says Futterman.