Pelvic Floor Health: Why These Muscles Matter

Understanding the Pelvic Floor: Muscles and Their Role

If you are like me, you probably don’t think much about your pelvic floor. However, the muscles in the pelvic floor do very important work to support vital organs, including your urogenital system and your anus. Problems with those organs can greatly disrupt your quality of life, so the strength of your pelvic floor can do a lot to prevent issues with digestion, urination, and sexual function.

Anatomically, there are two main muscles in the pelvic floor, which form the pelvic diaphragm. The larger of the two muscles is the Levator Ani, which is composed of three smaller muscles – the pubococcygeus, the iliococcygeus, and the puborectalis. The other muscle that composes the pelvic diaphragm is the Coccygeus (also called the ischiococcygeus), which is located posterior to the levator ani. Together, the muscles of the pelvic diaphragm support and stabilize the organs in your abdomen and pelvis (intestines, bladder, etc). A healthy pelvic floor, in which those muscles have adequate strength and flexibility, helps maintain a plethora of vital bodily functions.

How a Weak Pelvic Floor Impacts Digestion & Bloating

Constipation & Bowel Issues: The Domino Effect

A healthy pelvic floor, in which the muscles of the pelvic diaphragm are adequately strong and flexible, supports the health and smooth function of the surrounding organs, including the bowels. Excessive tightness in pelvic floor muscles can lead to constipation and abdominal discomfort. Fortunately, exercise training the muscles of the pelvic floor can alleviate these symptoms.

Incontinence & Prolapse: Related Pelvic Floor Problems

Weakness and excessive laxity in the pelvic floor muscles can contribute to urinary incontinence and fecal incontinence. This is particularly common after pregnancy and childbirth, or prostate cancer treatment. Fortunately, pelvic floor strengthening has been shown to reduce both urinary and fecal incontinence. 

Prolapse refers to organs (usually womb, bowel or bladder) of the pelvis shifting out of position to fall out of position and protrude into the vagina. This can be very uncomfortable and is unfortunately common, particularly in the geriatric population and during recovery from pregnancy. Pelvic floor strengthening can reduce the odds of organ prolapse, as well as reduce the separation between abdominal muscles following childbirth.

Sexual Function

Digestion and urination are crucial to good health, but so is sex! A strong, flexible pelvic diaphragm supports the health of your sexual organs, too. Pelvic floor training has been found to improve sexual performance and libido in both older men and women.

Strengthening Your Pelvic Floor: Effective Exercises & Techniques

Kegel Exercises: The Classic Pelvic Floor Workout (and How to Do Them Correctly!)

If you have made it this far, I have probably sold you on the importance of developing a strong pelvic diaphragm. So, how can we build one?

Kegel exercises are the classic method for building the pelvic floor. Here's a good way to get a feel for the muscles you're training with Kegels: the next time you urinate, intentionally stop the flow of urine for a few seconds. You are activating the muscles of the pelvic floor to do this! 

You don’t have to (and shouldn’t) only practice Kegels while urinating. After using the urination experiment to get the sensation of those muscles contracting, you can simply perform the exercise without urinating. For best results, lie on your back with your knees flexed and your feet planted. Draw your pelvic muscles up and in, mimicking the sensation you felt when you stopped your urine flow. Hold the up/in pose for 3 sec, then relax. That is one repetition. Rest a bit before doing another. Shoot for 10 repetitions, twice a day. A convenient way to schedule this is to do your Kegels in the morning when you wake up and at night before going to sleep. As you train, 3-second holds will get easier, so extend the length of contraction to 5, then 8, then 10 seconds as your pelvic floor becomes fitter.

When to Seek Professional Help: Pelvic Floor Physical Therapy

The do-it-yourself Kegels I described above are fine, IF you are healthy and looking to maintain that with a fitter pelvic floor. Pelvic floor strengthening for recovery from existing medical issues such as organ prolapse, urinary incontinence, or sexual dysfunction is best done under medical supervision. There are physical therapists who specialize in pelvic floor strengthening and have access to modalities such as electrical stimulation and biofeedback that can significantly enhance the efficacy of the treatment. 

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