Strengthening the Pelvic Floor

As you may know, the muscles of the pelvic floor are very important. They support the bladder, bowel and uterus. They prevent incontinence of the bladder and bowel, and prolapse of the uterus.
Other functions of the pelvic floor include support for the internal organs and control of the sphincters, stability of the trunk during extremity movements and assisting the circulatory system to get lymphatic fluid from the legs back to the heart.
The pelvic floor muscles allow your body to absorb outside pressure from lifting heaving objects (and even coughing!) in a way that protects your spine and organs. The deep pelvic floor muscles consist of the pubococcygeus, iliococcygeus, coccygeus and puborectalis muscles.
The pelvic floor can be weakened by pregnancy, childbirth, prostate cancer treatment, obesity and the straining of chronic constipation. Incorrect heavy lifting, a chronic cough or sneeze, previous injury to the pelvic region and growing older are all causes of weakened pelvic floor muscles.
One of the most common signs of weak pelvic floor muscles is urinary incontinence. This can manifest as stress incontinence (leakage when coughing, sneezing or laughing), urge incontinence (sudden urge to urinate) or both. So how do you work on these important muscles?
To strengthen the pelvic floor muscles, lift (pull upwards) and squeeze the muscles (like stopping your stream of urine) up to 10 times while sitting, standing or lying down. Don’t hold your breath or tighten your stomach, bottom or thigh muscles at the same time. As you get used to doing pelvic floor exercises, you can try holding each squeeze for one or two seconds. These exercises can be done up to three times a day, and you should start to notice a difference at around three to six weeks.
Kegels are a great way to train your pelvic floor muscles by contracting and relaxing your pelvic floor. These can be done using a small soft ball or pillow between the knees while including the lifting and squeezing movements. You can do three sets of 10 repetitions several days a week.
Another great option is a physical therapist who specializes in pelvic floor training. This person may give you one-time information, or they may see you over the course of weeks or months to address your issue. This option is especially good if you are dealing with stress incontinence or urge incontinence. The therapist might have you try certain lifestyle changes (temporarily or permanently) as well as pelvic floor and breathing exercises.
Walking is also good for the pelvic floor, especially if you have been sedentary and inactive.
Pelvic tilts (while standing) and glute bridges (while lying on your back) can help as well. To perform the pelvic tilt, stand with your hands on your hips, and think of the pelvis as the shape of a bucket; “tip” the top of the bucket forward and backward 5-10 times. To perform glute bridges, lie on your back on your bed or floor and lift the buttocks off the ground while keeping the knees bent and feet flat on the floor or bed; hold one or two seconds, then lower and repeat 10-20 times.
If you are more advanced, compound (multi-joint, multi-muscle) heavy weight lifting exercises of the lower body, such as squats, lunges and deadlifts, are hip thrusts that not only improve the strength of the legs and glutes, but the lower back, abdominals and pelvic floor muscles (which must be braced well in order to perform the exercise safely). If unsure, always consult a personal trainer or other fitness professional for guidance and cueing of correct techniques.
If your pelvic floor muscles are too tight, walking, yoga, pilates and targeted stretches can help. Pelvic floor tension myalgia, also known as pelvic floor dysfunction, is chronic pelvic pain caused by the inability to control your pelvic floor muscles. The muscles of the pelvic floor feel tight and constantly contracted, which is uncomfortable and can lead to long-term damage.
The primary treatment is physical therapy to retrain your muscles. Your doctor can recommend a therapist with training in pelvic floor dysfunction. Strategies physical therapists use include biofeedback to teach you how to contract and relax your muscles correctly.
It’s never too late to start exercising these muscles! Pelvic floor issues are not an inevitable part of aging. Maintaining a strong pelvic floor can help prevent issues in the future.

Lori Vance
Body Image Fitness, LLC
503.351.6476

Editor’s note: Wellness Word is an informational column which is not meant to replace a healthcare professional’s diagnosis, treatment or medication.

Strengthening the Pelvic Floor

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