You may sometimes think of women who have given birth as the only ones who need help to control their pelvic floor muscles. Yet both men and women may deal with pelvic floor issues.
“Pelvic floor dysfunctions are more common than you would think, affecting all genders and ages, with long-term implications if not addressed,” says physical therapist Melissa L. McElroy, a board-certified women’s health clinical specialist for ProRehab Physical Therapy in Louisville, Kentucky. “The more we talk about it, the more we can erase the stigma surrounding it, and the more people can get to feeling better and having a much improved quality of life.”
In this article, we’ll walk through pelvic floor dysfunction and which pelvic floor exercises can help you strengthen this part of your body.
What Is the Pelvic Floor?
Your pelvic floor is a group of muscles across the base of the pelvis. These muscles support your pelvic organs, including the bladder and rectum as well as your reproductive organs.
Your pelvic floor muscles help to support:
— Fecal and urinary control
— Sexual function
— Stabilization of your core, which is the group of muscles that includes your lower back, hips and abs
— Your pelvic organs staying in place
“When the pelvic floor is weak, tight or injured, there can be changes to the ability to participate” in sexual activities, says physical therapist Karen Brandon, a spokesperson for the American Physical Therapy Association and regional clinical practice lead for pelvic rehabilitation at Kaiser Permanente in Fontana, California.
[READ: Top 6 Myths About Pelvic Organ Prolapse]
Why Might Someone Need Help With Their Pelvic Floor?
Reasons for pelvic floor strengthening include:
— Needing help with bladder control
— Problems with bowel issues, such as constipation or fecal incontinence
— Less estrogen in the body for women, leading to pelvic floor problems
— Pelvic organ prolapse, which is when one or more organs from the pelvis drop
— Pregnancy and postpartum support. “Physical therapists can address issues such as pelvic girdle pain, diastasis recti (a separation of the left and right ab muscles during pregnancy) and recovery from caesarean sections or vaginal deliveries,” Brandon says.
— Rehabilitation during certain types of cancers
— Too much sitting and too little physical activity
[READ: Urinary Incontinence: Types and Treatments.]
Signs of Pelvic Floor Dysfunction
Some symptoms of pelvic floor dysfunction are obvious, while others are more subtle. Symptoms of pelvic floor dysfunction and the possible need for pelvic floor exercises include:
— Back or hip pain that doesn’t go away
— Constipation
— Fecal or urinary leakage
— Feeling an urgent need to urinate
— Having to urinate more often than normal (up to seven or eight times a day is normal for most people, according to the Cleveland Clinic)
— Leaking urine when coughing, exercising or laughing
— Numbness or pain with activities like riding a bike or running
— Problems urinating, such as starting or stopping your urine stream
— Sexual function changes, such as pain with an erection or ejaculation or changes to sensation or orgasm intensity
You should see a health care professional if you think you have pelvic floor dysfunction or when you find any of the symptoms above bothersome. You should also seek help if you recently had a baby or had an abdominal or pelvic surgery or injury and continue to have persistent pelvic pain or changes in bowel, bladder or sexual function, Brandon advises.
Although you could start with a primary care doctor, professionals like pelvic health physical therapists specialize in helping patients with pelvic floor issues, says physical therapist Susanna Clark, clinic director and pelvic specialist at Lone Peak Physical Therapy in Helena, Montana. Some states, including Montana, don’t require a referral to see a physical therapist. A gynecologist, obstetrician or urologist also may be able to help you with pelvic floor issues, Clark adds. Occupational therapists are knowledgeable on how to help pelvic floor dysfunction as well.
[READ: How to Prepare for Your First Physical Therapy Session.]
Treatment for Pelvic Floor Dysfunction
In addition to pelvic floor exercises (see below), there are several other treatments that a physical therapist may use to help you with pelvic floor dysfunction:
— Bladder and bowel retraining to help establish a more routine schedule for using the bathroom
— Gradual exposure to activities that were painful, such as bladder, bowel or sexual activity
— Pelvic floor muscle manual therapy to be performed by the pelvic health specialist, a trusted partner or by yourself
— Sexuality counseling if needed
— Surface electromyography or ultrasound-guided biofeedback
— Help with nutrition, which may be done with a registered dietitian well-versed in bladder, bowel or sexual health
Artificial sweeteners, caffeine, processed foods, alcohol and restrictive diets can have a negative impact on pelvic floor health, says Kristin Schellhaas, a physical therapist specializing in pelvic health at ProRehab Physical Therapy in Louisville.
“Moderation and well-rounded food choices are best,” she adds.
Pelvic Floor Exercises
Various types of exercises can help strengthen the pelvic floor. One key step is first identifying where your pelvic floor muscles are and how to isolate them. For both men and women, think of stopping the flow of urine to engage your front pelvic muscles, says physical therapist Susie Gronski, a certified pelvic rehabilitation practitioner in Asheville, North Carolina. To engage the back pelvic muscles, you think of squeezing as if you’re holding back gas.
It’s also helpful to think of inhaling, exhaling and then engaging the pelvic floor as your first step before adding other muscles to help, such as glutes and hip flexors, McElroy says.
Here are some pelvic floor exercises. Keep in mind that it’s best to consult first with a pelvic health specialist to make sure you’re doing the right exercises for your pelvic health issues.
— Kegels
— Fog the mirror
— Clamshells
— Quadruped hover
Kegels
You’ve probably heard of kegels or even performed them, but here’s something you may not know: If you’re doing them wrong, you could be making your pelvic floor dysfunction worse instead of better.
Kegels are done by contracting your pelvic floor muscles in coordination with your breathing.
“To contract, you are breathing out and drawing your pelvic floor up and in,” Clark says. “Think of picking something up with your vulva, and pulling it toward the belly button.”
As you breathe back in, think about breathing into your pelvis and lengthening your pelvic floor muscles, not pushing them.
“Timing and syncing with breathing is key,” Clark explains.
Fog the Mirror
Lie on your back with your knees bent and your feet flat on an exercise mat. Inhale through your nose, and breathe into the belly.
Exhale as if you are fogging a mirror, McElroy describes. Gently contract the pelvic floor muscles, as if you were cutting off the flow of urine. Continue to breathe throughout.
Hold for five seconds, working up to 10 seconds. Repeat up to 30 times. Eventually, you can perform Fog the Mirror while sitting, laying on your side or standing.
Clamshells
Lie on your side with your knees bent and head supported.
Take a deep belly inhale and then exhale. When you exhale, engage your pelvic floor. Lift your upper knee without moving your pelvis or lifting your foot. Hold for five seconds.
Lower your knee. Repeat 20 times.
Quadruped hover
Start on your hands and knees, with your hands directly under your shoulders and your knees directly under your hips.
Keep your back flat as if you are making a box shape with your body.
Curl your toes under. Inhale, exhale and engage the pelvic floor as you raise your knees one inch off the ground, McElroy says. Hold for five seconds. Repeat 10 to 20 times.
What to expect with pelvic floor exercises
Common mistakes to avoid when doing pelvic floor contractions include the following, according to Gronski:
— Holding your breath
— Pushing out your ab muscles
— Pushing or bearing down
— Squeezing your abs, buttocks or thighs
A pelvic health specialist also may recommend certain types of overall strengthening exercises (like squats) and yoga-like stretches to help improve your pelvic floor function. This may include the following, Schellhaas says:
— Butterfly
— Child’s pose
— Pigeon’s pose
— Single knee to chest
— Spinal rotation
It can take eight to 12 weeks to notice a difference in pelvic floor function, Brandon says. Make sure to follow any exercises as recommended within that time period. You’ll know the exercises are helping if you have:
— Better posture
— Better sexual functioning
— Less pain in the pelvic area
— Less constipation or easier bowel movements
More from U.S. News
Best Foods to Eat for Gut Health
Health Questions to Ask Your Doctor
Pelvic Floor Exercises: How to Strengthen Pelvic Floor Muscles originally appeared on usnews.com
