Unlike your quads or triceps, your pelvic floor isn’t visible. This makes it easy to forget about or ignore. But it’s a group of muscles just like the other muscles in your body. And it’s just as important to keep these muscles strong so you can enjoy an active, fulfilling life.
Unfortunately, when people have problems with their pelvic floor, they sometimes avoid getting care. They may not even talk about their symptoms. But pelvic floor weakness is common and is nothing to be embarrassed about. Effective exercises and treatments are available. Stronger, healthier pelvic floor muscles can help you have greater confidence while avoiding or reducing pelvic pain.
What exactly is the pelvic floor?
Your pelvic floor includes 3 separate layers of muscles and other tissue in and around your pelvic area. It works like a sling to support internal organs like your bladder and bowel. It tightens to help you “hold it” when you need to. And it relaxes to let you urinate and have bowel movements.
If you have a uterus, your pelvic floor also helps support it. And for people planning to give birth, the pelvic floor relaxes as childbirth approaches. This lets the baby drop into the pelvis during labor.
Why is it important to have a strong pelvic floor?
Your pelvic floor helps you control when you go to the bathroom and when you hold it. If your pelvic floor muscles are weak, you may start to have leaking urine or stool. This can affect a person’s confidence. It can also limit their feelings of freedom and independence. But it’s important to remember that pelvic floor weakness is common. About 1 in 3 women in the U.S. have at least one pelvic floor issue.1
The benefits of a strong pelvic floor aren’t just physical. People who exercise these muscles tend to feel better emotionally too. People in one recent pelvic health program were 11% less likely to have moderate to severe depression compared to a control group.2 They also had 53% less pelvic pain after 12 weeks in the program.
The key is to recognize the symptoms of pelvic floor problems. Then you can take steps to strengthen your pelvic floor and improve your overall well-being.
What are the symptoms of a weak pelvic floor?
The signs of a weak pelvic floor vary from person to person. But in general, these common symptoms to watch for:
- Leaking urine
- Leaking stool
- Having to go to the bathroom often
- Difficulty having bowel movements
- Pain while urinating
- Long-term pelvic pain
- Pelvic organ prolapse — when walls of the vagina weaken, letting nearby body parts, like the bladder, push into it
If you have any of these symptoms, consider doing pelvic floor exercises at home. Need more guidance? Pelvic floor therapy with a physical therapist may be a good option.
How to exercise your pelvic floor muscles
It’s not hard to find your pelvic floor muscles. They’re the same ones you use to stop urinating or passing gas. You can do pelvic floor exercises, known as Kegel exercises, when you’re sitting or standing. To do one, just tighten your pelvic floor muscles like you would to hold your urine or gas. Keep the muscles tightened for several seconds, then slowly release them. Try not to use your abdominal muscles or hold your breath. (This makes pelvic floor strengthening less effective.) Repeat this exercise 10 to 15 times at least 3 times a day.
It may be hard to remember to do your Kegels. As a reminder, choose an activity you do a few times a day as a trigger to help you remember. It could be when you’re brushing your teeth. Or when you hear an ad on TV, the radio, or your phone.
How do you tell if you need pelvic floor therapy?
If your symptoms don’t improve or it’s hard for you to do Kegels on your own, talk to your doctor. They can help you decide if pelvic floor physical therapy is right for you. With therapy, you work with a physical therapist to create a personalized plan to strengthen your pelvic floor muscles. They’ll make sure you’re doing Kegels correctly. They’ll also teach you other exercises and offer extra treatments if needed.
Physical therapy sessions can include a variety of stretches and breathing exercises, and manual therapy. Your physical therapist may use electrical stimulation to reduce pelvic pain. They might also use biofeedback therapy to assess your pelvic floor muscles and track your progress.
Your program of physical therapy will depend on your specific symptoms and needs. You’ll still do pelvic floor exercises at home. But you’ll also have the guidance and support of a trained physical therapist throughout your treatment.
Pelvic floor exercises and childbirth
A strong pelvic floor can also make childbirth easier, contributing to a healthy pregnancy. If you plan to give birth, you can do Kegels while you’re pregnant. They make you more aware of which muscles you’ll need to relax during labor. They also help with bladder control during and after pregnancy. By helping keep your pelvic floor muscles strong, Kegels can also help you heal faster after giving birth.
When people give birth, the pelvic floor muscles need to relax. To help that happen, you can try emptying your bladder frequently during labor. You can also focus on relaxing those muscles. Try repeating phrases like “let the baby move down” or “let my muscles sag.” You can also focus on fully relaxing when doing your Kegel exercises. Fully tighten to strengthen, then fully loosen to relax.
What to do about pelvic pain during labor
As the body prepares for birth, it’s natural for the pelvic floor to relax. This helps the baby move down into the pelvis and through the birth canal. The process may be uncomfortable. If you go into labor and have pelvic pain, you can try:
- Applying a heating pad to your back
- Using pillows to help you rest on your side or in a semireclined position
- Doing yoga exercises or using an exercise ball to reduce tension
- Using a maternity girdle or pelvic support device
Your clinician will let you know if it’s safe to take over-the-counter pain medications like acetaminophen (for example, Tylenol).3
Taking care of the pelvic floor after birth
It’s a good idea to keep doing Kegels even after giving birth. These pelvic floor exercises can help the body get back to normal. They maintain good circulation and encourage healing. They also help with things like bladder control, even when you’re not pregnant. If you have issues that don’t go away, ask your doctor if pelvic floor therapy might help.
For more information
Don’t know if you’re having symptoms of a weak pelvic floor? Not sure what kind of treatment you need? Talk to your doctor. For tips on staying healthy, visit our healthy living resource center.