Pelvic Floor and More

What is the Pelvic Floor?

The pelvic floor is a 'sling' of muscles, a bit like a small muscle hammock that runs between the pubic bone in the front, and the tailbone at the back. A woman's pelvic floor muscles support her womb (uterus), bladder, and bowel (colon). For men, almost the same thing! Your pelvic floor muscles make up the bottom of your pelvis and support your pelvic organs (see Figure 1). They're the muscles that relax when you're urinating (peeing), passing gas, or having a bowel movement (pooping).

Why does it matter?

The pelvic floor is responsible for supporting the function of urination, bowel movements, sex and pregnancy, and delivery. It also keeps the bladder, intestines and reproductive organs in place. And yes! For men too (except the pregnancy and delivery part :)

Who does it matter for?

Both MEN and WOMEN!!!

Why bother strengthening it? Doesn’t it just come naturally?

Like most muscles, you either use them or lose them (both function and tone). There are several problems associated with a weak pelvic floor.

1. Injury! Injury to any other part of your body really, but if you have a weak pelvic floor, you cannot fully engage your “core” muscles in order to let’s say, run downhill without overstriding or going out of control, run fast on an interval without peeing your pants, and lifting weights above your head without pooping your pants! So “squeeze your pee” as I say to clients as I cue them to “engage their core.”

2. Pelvic Organ Prolapse- The weak muscles let the pelvic organs (bladder, uterus, rectum) drop through the muscle and tissue and press into the vagina. No FUN!

3. Urinary Incontinence- as noted above, both men and women could have issues with this. This includes leaking urine, flood gates open, or anything in between.

4. Prolapse of Uterus- pain during sex, pain walking, bleeding/discharge.

5. Bowel Movement Issues- enough said.

How Can I strengthen it?!

First of all, you need to be mindful of ENGAGING the pelvic floor muscles before you can ever strengthen them. This is true of any muscle you are trying to improve. You actually get 26% better results when you FOCUS on the muscle you are working on, not just going through the motions. So how does one engage? (resource: pelvicfloorfirst.org)

Stopping the Flow: The first step in performing pelvic floor muscle exercises is to identify the correct muscles. There are several ways that may help you to correctly identify the different parts of your pelvic floor muscles. One way is to try to stop or slow the flow of urine midway through emptying the bladder. Stopping the flow of urine repeatedly on the toilet is not an exercise, but a way of identifying your pelvic floor muscles. This should only be done to identify which muscles are needed for bladder control.

If you can, stop the flow of urine over the toilet for a second or two, then relax and finish emptying without straining. This 'stop-test' may help you identify the muscles around the front passage which control the flow of urine. It is not recommended as a regular exercise

Visualization: Another method to identify your pelvic floor muscles is to imagine stopping the flow of urine and holding in flatus (wind) at the same time. This can be done lying down, sitting, or standing with legs about shoulder-width apart.

• Relax the muscles of your thighs, bottom, and abdomen (tummy).

• Squeeze in the muscles around the front passage as if trying to stop the flow of urine.

• Squeeze in the muscles around the vagina and suck upwards inside the pelvic.

• Squeeze in the muscles around the back passage as if trying to stop passing wind.

• The muscles around the front and back passages should squeeze up and inside the pelvis.

• Women who are familiar with using tampons can imagine squeezing in the vagina as if squeezing a tampon up higher in the vagina.

• Identify the muscles that contract when you do all these things together. Then relax and loosen them.

Strengthening Exercises

The exercises most commonly performed for strengthening the pelvic floor are:

• Kegels

• Bridges

• Planks

• Squats

But like I said previously, before you perform an interval, run downhill, lift a weight, focus on those muscles, engaging them, tightening them, squeezing them but also BREATHING while you are doing it too! Some things to watch out for:

1. Holding your breath-you should be able to squeeze and breathe!

2. Your hips shifting forward

3. Your glutes squeezed or “pinched” (this typically causes the hips to shift forward, however, you can still engage your glutes while doing it just don’t “pinch” your booty”)

4. No need to tighten your stomach, however, if you are including your “core” in your exercises, then you should be able to do both!

I like to keep a few unique exercises in mind…

• Fitball Kegels- Mount the ball with knees spread being directly on top with legs lying over the side (like you are going to do an inner thigh squeeze). However, leave some space up top between your vagina and the ball, and in order to do this, you typically need to be on your tippy-toes with your feet back. Now focus on the pelvic floor muscles, not the inner thighs. The inner thighs may engage too but just as long as the pelvic floor muscles are. Hold 5 seconds, release. Repeat 5-15x. 3x a week.

• Add a Ball! - One of the easiest ways to say hello to those muscles is taking a medium-sized aired-up ball (not necessarily a medicine ball with weight but even just a kids toy) and keeping it squeezed between your knees or sometimes your ankles when you perform certain movements. Such as a squat (but again, first thing is to engage the pelvic floor, then the rest of the body), v-sit, bridge, and more!

• Finally, you may want to consider following along with some great yoga/mobility programs on youtube that highlight this muscle.

Bottom line: Your pelvic floor is your POWERHOUSE. Without this muscle being strong and functioning well, it’s really difficult to get other body parts to stay balanced and cooperate.

So what about the other functionality?

Release! Yup, you guessed it, just like any other muscle it gets bound up, stressed, and sometimes overworked. So one does need to take into consideration some mobility work for it too! I tested out the yoga ball theory. You can grab one of these here. And check out my video for it here.