Your pelvic floor is a group of muscles and ligaments that support everything in your pelvic region: your bladder, bowel, and, if you have one, uterus. It's a name we throw around quite a bit, sometimes without actually knowing what it really is. It's important to have a strong pelvic floor, and there are pelvic floor exercises that can help, but how do you know if you need to do them? How do you know if your pelvic floor is weak, and what does that mean, anyway? These questions might seem basic, but they're also confusing. It's worth investigating what your pelvic floor really is and what you should do, now or in the future, to ensure that it's healthy.
What Does Your Pelvic Floor Do?
The muscles and ligaments that make up your pelvic floor form a "hammock-like sling of support" underneath your pelvis, said Christine King, DPT, PRPC, physical therapist lead for Hoag's Pelvic Health Program in Newport Beach, CA. It's located at the base of the pelvis and under your bladder, uterus, and rectum, said pelvic floor physical therapist Heather Jeffcoat, DPT, forming the structure that goes around your urethra, vagina, and anus. The pelvic floor serves several important functions:
- It controls the sphincters of your bowel and bladder, helping to prevent incontinence (leakage of urine or feces).
- It's involved in sexual function and the intensity of orgasms.
- It supports your uterus, bowel, and bladder.
- It helps to support your spine and is actually considered one of your deep core muscles.
Common Pelvic Floor Problems
Pelvic floor muscle problems can contribute to painful, hard-to-talk-about medical issues, Dr. King told POPSUGAR. Urinary and fecal incontinence is perhaps the most well-known, caused by a weakening or extreme tightening of the pelvic floor muscles and thus a lack of control over the sphincters that control your bowels and bladder. Overall, pelvic floor issues can contribute to:
- Pelvic pain
- Pain during sex
- Going to the bathroom too frequently or not frequently enough
It's also worth noting that people without vaginas have pelvic floors as well, though they seem to be most discussed in regard to childbirth. That's because vaginal delivery has the potential to damage your pelvic floor, explained ob-gyn Geoff Cly, MD. The muscles around the vagina "may not be able to contract as well or be as strong and supportive after pregnancy, and that is what leads to pelvic prolapse and urine leakage," he explained.
How to Keep Your Pelvic Floor Healthy
Maintaining the health and function of your pelvic floor muscles isn't just a matter of doing endless Kegel exercises, Dr. King said. These will strengthen your pelvic floor muscles if they're weak, but that may not actually be an issue. Your pelvic floor muscles can also be too tight, she explained, which is a separate problem with different solutions. "If your muscles are excessively tight and hold trigger points, strengthening them can do more harm than good," she said, compressing the surrounding nerves and potentially leading to pain and incontinence.
"Instead of blindly strengthening your pelvic floor muscles, it is wise to consult your doctor if you have significant and painful pelvic floor problems," Dr. King told POPSUGAR. You can also see a pelvic floor physical therapist.
Kegel exercises may be useful if you recently gave birth, Dr. Cly said, as they can help to strengthen the weakened muscles. Here's more on how to do Kegels correctly (hint: it's not just about squeezing). However, you should still talk to a doctor or pelvic floor physical therapist before you get started. Many women do Kegel exercises incorrectly when given only verbal instructions, Dr. Jeffcoat said, and these exercises are often overprescribed when it comes to pelvic floor issues. Rather than being weak, "many times the pelvic floor muscles are actually overactive, and require manual therapy before a pelvic floor strengthening program is initiated," she explained.
According to urogynecologist John Joyce, MD, some exercises that can maintain the health of your pelvic floor include clamshells, hip abduction exercises like the side-lying leg lift, and transverse abdominal marches (like the glute bridge march, but with your butt on the floor). If you experience any symptoms of pelvic floor issues, though, it's best to consult a doctor or physical therapist before starting these exercises.
Bottom line: if you have or start developing pelvic floor issues, they can be painful, tricky to fix on your own, and embarrassing to talk about. They're also common, Dr. King told POPSUGAR, but that's no reason you should have to endure them. "Just because pelvic pain is difficult to talk about, it doesn't mean you have to live life suffering from it," she said.
If you feel pain or notice any of these pelvic floor problems, see your ob-gyn or a urogynecologist, who specialises in pelvic floor issues.