What is a Pelvic Floor?
Your pelvic floor is something you might not even be aware that you have….until something goes wrong! The pelvic floor is the term used for the three muscle layers at make up the base of your hips.
The view you see in the diagram (“Pelvic floor – female – from top down”) is from the inside of the body looking downward through the bones that connect to the base of your spine. Those bones form what is often called the pelvic bowl. This is where a baby sits in the final months of pregnancy.
The pelvic floor supports your internal organs: your bladder, uterus or prostate, anus, urethra, etc. This same set of muscles is important for sexual function. The pelvic floor also supports the sacroiliac joint, lower back, tailbone, and hip joints.
Pelvic Floor Dysfunction
As you might have experienced, these tissues are extremely busy during pregnancy and childbirth and there is a likelihood of damage and dysfunction after the birth of a baby. Just a few of the more common symptoms of pelvic floor dysfunction can include:
- Pain during sex or other sexual dysfunction
- Prolapse of organs: uterus, bladder, rectum
This can feel like something from the inside is falling down or out. Sometimes people just feel a sense of downward pressure
- Urinary or fecal incontinence
- Pain or discomfort in the vulva
- Lower back pain
- Hip pain
Pregnancy and childbirth aren’t the only causes of pelvic floor dysfunction. Other causes can include infections, poor posture, lower back issues like an extreme forward tilt or problems in the sacroiliac joint, trauma, and some surgeries.
What About Kegels?
In summary: no. Many women develop urinary incontinence after pregnancy and leak when coughing, laughing, or sneezing. The current common wisdom from most medical professionals is “do Kegels.” There are a couple of problems with this advice:
You weren’t taught to do them correctly if at all
Most women are told to find the pelvic floor muscles (which are often called the Kegel muscles) by stopping the flow of urine when they go to the bathroom. Lovely. But those aren’t your pelvic floor muscles and that’s not going to strengthen the whole range of muscles that need help.
Doing too many
Most websites say you do 3 sets of kegels with 10 repetitions and you do them 3 times per day while lying down on the floor. Those same sites will then encourage you to do them everywhere you go during the course of your day. Most women will inadvertently do hundreds of them per day every day, standing in line at the grocery checkout, while sitting in the bathroom, while sitting in their chairs at work, etc. If you’ve ever done weight lifting at the gym you know that you do your sets and reps 2-3 times, then you stop and take a rest day the following day. If you did squats as often as you are encouraged to do kegels, your legs would wear out and you wouldn’t be able to walk 40 feet because your legs would be noodles!
The same thing happens with those urine stopping muscles! They get tired after that many kegels, they can’t hold the urine in, and you are left to wonder why you leak when you sneeze since you’ve been doing all those kegels.
Not everyone needs Kegels!
There are two basic conditions in regards to musculature: too tight (hypertonic) and too loose (hypotonic). Regardless of the condition, there are far better ways to treat your pelvic floor than Kegels.
Many women are hypertonic, meaning their pelvic floors are chronically tight. There are many causes for this such as surgical scarring, infection, sexual assault, PTSD, and chronic stress. Women with pelvic floor hypertonicity definitely don’t need to make those muscles tighter. Hypertonicity can cause urinary symptoms like urinary frequency and/or urgency, painful urination, incomplete bladder emptying, even urinary hesitancy or intermittent stopping and starting of urinary flow. Women with hypertonic pelvic floors may also have difficulty with bowel movements. Pain symptoms might include lower back pain, pelvic or hip pain, pain in the genital area or rectum, and/or pain during or after sex or orgasm.
When the pelvic floor is too loose the musculature of the floor is no longer supporting the bladder, rectum, or uterus well. These organs shift away from their previous positions which can cause various problems urinating and problems with bowel movements. Many women will feel as if something is pressing down or falling out. When it gets severe there is organ prolapse and things are indeed falling down.
In short, the exercises you do are different depending on the condition of your pelvic floor and Kegels are proving more and more to be an ineffective solution.
So what do I need to do?
Step 1: You need to be evaluated to determine the condition of your pelvic floor and the appropriate course of treatment. I have extensive training in therapeutic movement and specific extended training in pelvic floor work. I can help you with this and with a wellness plan that will alleviate pain and discomfort. Book your private appointment and get real help now!
Step 2: Check out DeLora’s Rebuild After Birth page for more information on her programs for pelvic floor and diastasis recti recovery.