One of the most commonly overlooked—but incredibly important—areas of the body is the pelvic floor. This group of muscles forms the base of your core, supporting pelvic organs like the bladder, uterus, and rectum. Whether you’re recovering postpartum, managing urinary incontinence, or simply looking to improve core stability, strengthening the pelvic floor is vital to overall health and function.
What Is the Pelvic Floor?
The pelvic floor is a sling of muscles stretching from the pubic bone to the tailbone. Think of it as a supportive hammock that holds up your internal organs, helps control bladder and bowel function, and plays a role in sexual health. It’s deeply integrated with the diaphragm, abdominal muscles, and lower back muscles, forming what we often refer to as the “core.”
When these muscles are functioning well, they contract and relax in coordination with movement and pressure changes in the abdomen. But like any other muscle group, they can become weak, tight, or uncoordinated—leading to a range of issues.
Why Pelvic Floor Health Matters
Dysfunction in the pelvic floor can manifest in several ways:
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Urinary or fecal incontinence
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Pelvic organ prolapse
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Low back or pelvic pain
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Pain during intercourse
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Postpartum recovery challenges
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Decreased core strength and balance
The good news? With targeted therapy and the right exercises, most of these issues are treatable.
Signs Your Pelvic Floor May Need Attention
If you’re experiencing any of the following, it’s worth consulting a pelvic floor physical therapist:
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Leaking urine when coughing, sneezing, or running
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Difficulty starting or stopping urine stream
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A feeling of heaviness or bulging in the pelvic area
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Frequent constipation or straining
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Pain in the pelvic region or lower back
How to Strengthen the Pelvic Floor
1. Start With Awareness
Before jumping into exercises, we first need to identify and feel the pelvic floor. One way to do this is to imagine stopping the flow of urine midstream (note: do not practice this on the toilet, just imagine it). You should feel a lifting and tightening sensation. Another thing to think about is pulling a tampon into your body using your muscles.
2. The Basic Kegel
Once you have awareness, you can begin basic contractions:
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Inhale, and then as you exhale gently contract the pelvic floor muscles and hold for 3–5 seconds.
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Fully relax for the same amount of time.
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Repeat 10 times, 2–3 times per day.
Important: Don’t hold your breath or contract your abs, glutes, or inner thighs. The contraction should be isolated to the pelvic floor. If you cannot isolate your pelvic floor from your glutes, try a butterfly position.
3. Progress to Functional Training
Strengthening the pelvic floor isn’t just about isolated exercises. We want the muscles to activate reflexively during everyday activities like lifting, walking, or coughing. This is where functional training comes in:
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Practice engaging your pelvic floor during movements like squats, bridges, or core exercises.
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Try coordinating your breath: exhale as you contract your pelvic floor during exertion.
4. Don’t Overdo It
More isn’t always better. Just like any muscle group, the pelvic floor can become tense and overworked. Some individuals actually suffer from a hypertonic (too tight) pelvic floor, which may require downtraining rather than strengthening. This is where a thorough evaluation by a pelvic health physical therapist is key.
5. Whole-Body Integration
The pelvic floor doesn’t work in isolation. Core stability, hip strength, posture, and breathing all play a role. Incorporating diaphragmatic breathing, gentle yoga, and mobility work can enhance pelvic floor function and support a healthy, responsive core.
When to Seek Help
If you’re unsure whether you’re performing exercises correctly, or if you’re not seeing improvement after a few weeks, it’s time to see a pelvic floor physical therapist. We can perform a full assessment, guide you through a personalized program, and help address any underlying dysfunction.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected].
