How To Strengthen Your Pelvic Floor, According to a Physical Therapist
Health & Wellness
A licensed physical therapist lends insight into how pelvic floor exercises can ease discomfort and improve wellbeing.
Ask someone to share the body parts they want to strengthen, and they’ll rattle off a series of "mirror muscles," such as biceps, traps, pecs, and glutes. But there’s a less visible muscle structure that deserves a place on that list: the pelvic floor.
Located at the base of the pelvis, the pelvic floor is made up of a web of muscles and fascia that spans back to front and side to side, said Heather Jeffcoat, a doctor of physical therapy who specializes in sexual dysfunction, pain and incontinence. “These muscles work together to support pelvic organs, provide control for your sphincters to prevent leakage, help you maintain an upright posture, aid in sexual function and more,” she said.
As is true with the other muscles in your body, the pelvic floor muscles do their job best when they are strong. That’s why we asked Jeffcoat to share the best pelvic floor strengthening moves.
Ahead, for the best pelvic floor strengthening exercises — plus, insights on when pelvic floor exercises could be especially beneficial.
What Does the Pelvic Floor Do, Exactly?
Often described as a supportive hammock, there are a whopping 14 muscles that make up the pelvic floor hammock, including the core muscles. These muscles' primary function is to support pelvic organs (including the bladder, rectum and uterus for those who have them), Jeffcoat said.
In addition to keeping your reproductive and excretory organs in place, the pelvic floor also aids in keeping you upright, supports childbirth for those who get pregnant, and supports blood supply and lymphatic supply throughout the body, she said.
The Common Causes and Signs of Pelvic Floor Dysfunction
In order for your pelvic floor muscles to operate optimally, they need to be able to contract and relax fully, Jeffcoat said. This ability to switch between the two modes is what allows us to control when we eliminate waste, among other functions.
Unfortunately, for a range of reasons ranging from childbirth and menopause to constipation and chronic stress, many people have pelvic floor muscles that don’t operate optimally. For a sense of scale, research shows that 24 percent of women and 16 percent of men have pelvic floor dysfunction.
Some people have pelvic floor muscles that can contract properly, but cannot relax fully. These people cannot produce optimal muscle force to contract, Jeffcoat said, usually as a result of chronic stress or frequently holding pee. Often diagnosed as an overactive or hypertonic pelvic floor, this can lead to leakage, constipation, and chronic pelvic or abdominal pain, hip pain and buttock pain, she said.
Other people have muscles that are consistently in a relaxed position because their pelvic floor muscle fibers cannot contract, Jeffcoat explained. This causes symptoms similar to that of over-contracted muscles such as leakage and pelvic pressure, as well as reduced vaginal sensation, and unexplained bladder, abdominal and pelvic pain, she said.
How To Diagnose and Treat Pelvic Floor Dysfunction
If you’re experiencing symptoms associated with a contracted or weakened pelvic floor, your first move should be to work with your doctor or a pelvic floor physical therapist.
Why? In short, because the treatment protocol is different for different pelvic floor conditions. If the muscles are found to be too relaxed, then doing strengthening exercises would be a part of the care plan, Jeffcoat said. Meanwhile, if the muscles are found to be non-relaxing, then doing stretching exercises would be a better start to the treatment plan, she said.
If you're currently experiencing any pelvic symptoms, remember it’s always best to clear moves with your provider before attempting any of them to ensure they’re right for you.
3 Pelvic Floor Exercises for Pelvic Floor Health
Anyone with a pelvic floor — which is everyone!— can benefit from the pelvic floor care routine, according to Jeffcoat. Read on to learn about three pelvic floor exercises you might consider incorporating into your routine.
1.Kegels
When it comes to pelvic floor exercises, kegels get all the attention. As a refresher: A kegel is an exercise that involves contracting the pelvic floor muscles for a sustained period of time before completely relaxing them.
There is a time and place for this exercise, according to Jeffcoat. For people who need to strengthen and shorten their pelvic floor muscles, kegels can be hugely beneficial.
But kegels aren’t for everyone. Kegels can worsen symptoms in people who have shortened or contracted pelvic floor muscles, she said. Doing kegels when you have an overly contracted pelvic floor would be like trying to flex your calf when you already have a charley horse.
How to do it: Lie on your back, with your knees bent and feet planted on the floor. As you breathe out, lift and squeeze your pelvic floor muscles. A key part of the instructions are to lift, otherwise you’re just contracting. Thinking about inhaling through a straw, but through your genitals, can help.
Hold for two seconds, then release. Repeat for at least 10 repetitions.
2.Side-lying Clams
Kegels may be part of a proper treatment plan for individuals with pelvic floor weakness, but they are not a full treatment plan. They also need to be accompanied by hip and core strengthening moves like side-lying clams, Jeffcoat said.
How to do it: Lie on your side with your hips and knees bent at a 45-degree angle. Keeping your feet together, open your knees apart like you are opening a clamshell while keeping your hips stacked on one another. As you move, try to keep your midline and spine from shifting.
Aim to complete two sets of 10 to15 repetitions. If it feels too easy, you can add a resistance band around your mid thighs to increase the burn.
3.Happy Baby Stretch
This popular yoga stretch is known for its ability to open the hips — and it does this effectively. But Jeffcoat said that it also stretches the muscles in the pelvic floor, which can be beneficial for individuals experiencing internal tightness.
How to do it: Lie on your back and bend your knees all the way into your chest. Keeping your knees tight to your chest, grab the inside arches of your feet and hold for 30 to 45 seconds. Repeat three times.
Next, experiment with opening your knees and feet to increase the stretch in your groin. As you hold this position, practice slowing down the breath. Repeat for as long as is comfortable.
Words by Gabrielle Kassel