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Author: Brittany Winfrey

What is the pelvic floor?

If you’re a mom, chances are you’re afraid to jump on a trampoline. You might also have a tendency to cross your legs to sneeze and avoid high impact activities like the plague.  Most women understand having a baby changes things down there. We can empathize with each other. Pushing out a baby puts a lot of stress on pelvic muscles and, since many other moms also experience leaking, then it must be normal, right?

Not quite. Even though leaking is common, that doesn’t mean it’s “normal”.

Our bodies have an amazing system built to withstand different traumas (such as that of childbirth!). The problem is, certain muscles become damaged during traumatic events and need to be retrained to function normally again. With childbirth, the muscles that take the biggest hit are in what is called “the pelvic floor”.  This term is a shorthand for the muscles, ligaments, nerves, and tissue that create a natural hammock slung across the pelvis.

What is the function of the pelvic floor?

Most of us know we have pelvic floor muscles and many women are told doing kegels is the key to strengthen them. But there is a bit more to it than that.

The pelvic floor is a group of muscles that sit inside of the pelvis. Like any muscle in our body, we need our pelvic floor to perform many day-to-day activities. The job duties of these muscles include more than just preventing incontinence. Here is a list of the pelvic floor functions:

1. The pelvic floor muscles constrict the urethra, vagina and anal canal. 

In other words, when your pelvic floor muscles are working optimally, you pee when you wanna pee, so there are no surprises.

2. The pelvic floor muscles provide support for all the internal organs. 

The pelvic floor muscles keep our organs where they should be. When the pelvic floor isn’t working optimally, the organs may shift, causing prolapse.

3. The pelvic floor muscles are stabilizers.

Many people have heard of the importance of a strong core in injury prevention, but what most don’t know is the pelvic floor is part of the core. Our pelvic floor works alongside other core stabilizers to produce smooth and efficient movement.

4. The pelvic floor muscles respond to breathing and changes in intra-abdominal pressure.

When you have the unexpected urge to sneeze, your pelvic floor muscles will contract to prevent leaking. When your pelvic floor is weak, it doesn’t efficiently contract during high pressure activities which causes pressure to be unevenly distributed, often resulting in leakage.

5. The pelvic floor muscles can be affected by emotion.

When we are stressed, our shoulders tend to tense up and our pelvic floor can go through experience this as well, sometimes leading to pain and discomfort.

Our pelvic floor has many different functions. Using a canister as an analogy helps us visualize how the pelvic floor works with our other core muscles: the top of the canister is the diaphragm, the back of the canister is our spinal muscles, the front and sides are our abdominal muscles, and the bottom is our pelvic floor.

While it can be hard to feel a pelvic floor contraction, it helps to realize the action of the pelvic floor is similar to the actions of any other muscle. Our biceps are constantly being used throughout the day but it’s typically so minor we don’t realize it.  We never go a day without both relaxing and contracting our biceps. How much you activate the bicep is dependent on the activity. The amount of muscle fibers you use to pick up a pen is going to be different than to pick up a toddler. This concept is similar to the pelvic floor. While we need it to be able to contract while performing daily activities, the intensity of that contraction should vary depending on your activity.  

How to strengthen your pelvic floor

Most of us have heard we need to be doing kegels to strengthen our pelvic floor muscles. While kegels are a great start, many don’t perform them effectively. 

The key to kegels is to integrate the pelvic floor contraction with our deeper abdominal muscles and our breath. This exercise is often called the “connection breath”.

How to perform the connection breath: 

Lie on your back with a pillow under your head and one under your knees.  Breathe in through your nose gently, and feel the rise of your belly. Now, exhale gently through your nose. Imagine the up and down motion of the diaphragm and the effects on the organs. Do this a few times. Now, bring your awareness to your pelvic floor muscles.  As you breathe out, see if you can engage them by squeezing them gently. This would be the same as stopping the flow of urine when going to the bathroom (do NOT do that as an exercise). The key is to not only contract when you exhale, but also relax when you inhale. As this gets easier to do, practice in a variety of positions such as seated, standing, or while lifting weights.

The connection breath is a great exercise that brings awareness to how the pelvic floor functions. But if you have any pelvic floor dysfunction symptoms (such as leaking, pelvic pain, pain with sex…), it’s also a good idea to receive guidance from a pelvic health physical therapist. This is a physical therapist that is trained in treating symptoms associated with the muscles of the pelvic floor. They can identify the body’s current capabilities, teach strategies that promote full-body functioning, emphasize healing of the pelvic floor, and implement exercise that takes into consideration each woman’s stage of healing. The goal of any pelvic health physical therapist is to give you the tools to strengthen and recover effectively so that you can return to the activities you love in your daily life and fitness. 

Often times as moms, we tend to put ourselves on the bottom of the list, taking care of everyone else’s needs before our own. prioritizing your own health is just as important as taking care of those dependent upon you. Taking the time to heal and strengthen the pelvic floor is one of the ways to practice self-care that will  benefit you for years to come.