According to a study (1) on pelvic floor disorders, one-quarter of adult women suffer from at least one pelvic floor disorder (PFD), and this number is set to rise by 2050. Though PFD is a huge concern for women (and men), there is still a lot of stigma surrounding the topic due to the embarrassment around urine leaks, constipation, painful sex and loosening of the muscle. Moreover, practitioners that dismiss symptoms or are unaware of pelvic floor issues can make matters worse.
The pelvic area is an important aspect of self-care and body-awareness.
What are the functions of the pelvic floor?
The pelvic muscles support the bladder, bowel, and uterus. When they contract, the organs are lifted and the openings to the vagina, anus, and urethra are tightened. When the muscles are relaxed, urine and faeces can be released from the body.
Pelvic floor muscles also play an important role in sexual function. Strengthening these muscles can reduce pelvic pain during sex and increase the ability to achieve pleasurable sensations. During pregnancy, pelvic floor muscles support the baby and assist in the birthing process.
There are four main functions of the pelvic floor area.
- Support: The pelvic floor area supports and holds the bladder, uterus, and intestine in place within the pelvis
- Buffer: The pelvic floor area works to lessen the pressure from the abdomen from coughs, sneezes, and the weight of pregnancy
- Closing: This function works to prevent bladder and anal leakage
- Opening: This function helps to relax bodily openings to help facilitate entrance and exit to the vagina and anus. This affects not only sex but also the digestive system
Where is the pelvic floor located?
The pelvic floor area encompasses your core as they work together to help with the main functions mentioned above.
In front, you have the pubic bone and the abdominal muscles. Behind you have the spinal column. On top is the diaphragm and at the bottom are the pelvic floor muscles. The Pelvic floor muscles are a web of muscles and tissues that circle around the areas that allow matter to pass through the body. When it’s in a relaxed state, it allows urine to pass from the bladder to the urethra, defecation to pass from the rectum to the anus, and eases childbirth as the baby passes from the uterus and out the vagina.
How do pelvic floor problems happen?
Pelvic floor problems can occur when the pelvic floor muscles are stretched, weakened or too tight. Some people have weak pelvic floor muscles from an early age, whilst others notice problems after certain life stages. Nonetheless, there are many factors that cause the pelvic floor muscles to weaken. For example:
- Not keeping it active
- Overworking it
- History of back pain
- Ongoing constipation
- Being overweight or obese
- Heavy lifting (e.g. at work or the gym)
- Chronic cough or sneeze (including those linked to asthma, smoking or hayfever)
- Injury to the pelvic region (e.g. a fall, surgery or pelvic radiotherapy)
- Old age
What are the signs and symptoms of pelvic floor problems?
Common signs that can indicate a pelvic floor problem include (2):
- accidentally leaking urine when you exercise, laugh, cough or sneeze
- needing to get to the toilet in a hurry or not making it there in time
- constantly needing to go to the toilet
- finding it difficult to empty your bladder or bowel
- accidentally losing control of your bladder or bowel
- accidentally passing wind
- finding it difficult to empty your bladder or bowel
- a prolapse – which may be felt as a bulge in the vagina or feeling of heaviness, discomfort, pulling, dragging or dropping in the vagina
- pain in your pelvic area
- painful sex.
The pelvic floor muscles can be consciously controlled and therefore trained, much like your arm, leg or abdominal (tummy) muscles. Strengthening your pelvic floor muscles will help you to actively support your bladder and bowel. Like other muscles in your body, your pelvic floor muscles will become stronger with a regular exercise program, which is important for both men and women.
How do you locate the pelvic floor?
You can perform a few exercises to help you locate each section of your pelvic floor.
The best way to do this is to find a comfortable place where you can be alone and take your time to better understand and feel your body.
Posterior Pelvic Area
Place your hands on the back of your spinal column at your waist. Then slide your hands to your hips, cough and feel how your muscles contract.
Now place one hand on your stomach right below your ribs and the other on your navel. Cough again and feel how the movement changes the contraction of your muscles.
Respiration – Diaphragm
Next, place your hands in what I like to call the singer’s position. This is where you place your hands right under your chest in the centre of your ribs. Breath deeply in and out feeling how the muscles stretch to fill the cavity with air, as you breathe in, the diaphragm expands while when you release the air your diaphragm compresses.
Pelvic Diaphragm/Pelvic Floor Muscles
This will help you better understand the positioning of your pelvic floor in the pelvic area. You want to place one hand on the vulva. The vulva is the area from the anus to the pubis. The pelvic floor muscles extend horizontally from this area. Cough again and feel how the area your fingers are touching swells.
Identifying your pelvic floor
Put your hand back on the vulva. Once there, use the contraction that you use when you want to stop the flow of urine while using the bathroom. (It is very important not to do this while urinating, and always empty your bladder before practising these types of exercises.) Those are the pelvic floor muscles. Note how it contracts and relaxes.
What are exercises that can help strengthen the pelvic floor muscles?
Kegles mainly work your pelvic floor muscles and consist of contracting and relaxing your pelvic floor muscles. You may benefit from Kegels if you experience leakage of urine during sneezing, laughing, jumping, or coughing, or have a strong urge to urinate just before losing a large amount of urine.In order to perform Kegels, identify the right muscles. The easiest way to do this is to stop urination midstream. These are the pelvic floor muscles you will be training.
Contract these muscles and hold for 5 seconds. Release for 5 seconds.
Repeat this 10 times, 3 times a day.
Kegel balls have been used for centuries to strengthen vaginal and pelvic floor muscles. But they do more than get your pelvic floor into shape, they can help enhance sexual pleasure.
The bridge is a great exercise for the glutes. But if done correctly, it also activates the pelvic floor muscles in the process. Even without weight, the pause and pulse of this move will have you feeling it.
Lie on the floor. Your spine should be against the ground, with knees bent at a 90-degree angle, feet flat, and arms straight at your sides with palms facing down.
Inhale and push through your heels, raising your hips off the ground by squeezing your glutes, hamstrings, and pelvic floor. Your body, resting on your upper back and shoulders, should form a straight line down from the knees.
Pause 1-2 seconds at the top and return to the starting position.
Complete 10-15 reps and 2-3 sets, resting 30 to 60 seconds between sets.
Bridge with squeeze
Lie on your back, arms by your sides, knees bent. Place a small exercise ball or rolled-up towel between your knees. Squeeze the ball and your glutes as you lift your hips up to the ceiling into a
bridge position. Hold for six seconds, then slowly lower. Repeat 10 times.
You can also do this with one leg. Once you’re in a bridge position, extend one leg so it’s parallel to the floor and hold for three to six seconds.
You can find more exercises in a number of different app:
The pelvic floor is a muscle like any other in your body and with age, it will naturally lose its elasticity and strength. It’s therefore important it is well taken care of.
(1) Wu JM, Vaughan CP, Goode PS, et al. Prevalence and Trends of Symptomatic Pelvic Floor Disorders in U.S. Women. Obstetrics and gynecology. 2014