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strengthen your pelvic floor
Image courtesy of Nike
Fitness giants Nike recently reached out to me for an article entitled "How To Strengthen Your Pelvic Floor, According to a Physiotherapist", and of course I was glad to offer my insights. It's great to see such a highly visible company in the fitness market taking interest in the topic of pelvic floor health. While at first blush taking care of the pelvic floor may not seem as "sexy" a topic as sculptured calves or bulging biceps, at Femina PT we of course understand the pivotal role that pelvic floor health plays in sexual function (of course!), proper posture, freedom from back and hip pain, avoiding embarrassing bouts of incontinence, and so on. That said, here are some snippets from the article, interspersed with my onw commentary. A link to full article at Nike's site is included below.

Heather Jeffcoat, DPT

Strengthen Your Pelvic Floor to Improve Your Core

What if you can't "Just Do It?"

Nike's longstanding slogan presupposes that your pelvic floor is in full health - but what if it isn't? Pelvic floor issues can have a profound effect on your ability to enjoy sports and other activities, and even if you are able to participate, recovery times may increase and other issues such as incontinence may come into play if things are quite right "down there".

In this article we take a quick look at how to best strengthen your pelvic floor with the aim of improving not only athletic performance but overall wellbeing.

Located at the base of the pelvis, the pelvic floor is made up of a web of muscles and fascia that spans back to front and side to side, said Heather Jeffcoat, a doctor of physiotherapy who specialises in sexual dysfunction, pain and incontinence. "These muscles work together to support the pelvic organs, provide control for your sphincters to prevent leakage, help you maintain an upright posture, aid in sexual function and more", she said.

What Does the Pelvic Floor Do, Exactly?

As I mentioned in the interview, there are 14 muscles that make up the pelvic-floor hammock. These muscles' primary function is to support the pelvic organs (including the uterus, bladder, and rectum). In addition to keeping your reproductive and excretory organs in place, the pelvic floor also aids in keeping you upright, supports childbirth, and supports blood supply and lymphatic supply throughout the body.

The Common Causes and Signs of Pelvic-Floor Dysfunction

According to the article, research shows that 24 percent of women and 16 percent of men have pelvic-floor dysfunction. Unfortunately, for a range of reasons ranging from childbirth and menopause to constipation and chronic stress, many people have pelvic-floor muscles that don't operate optimally.

Hypertonic pelvic floor

Some people have pelvic-floor muscles that can contract properly, but cannot relax fully. These people cannot produce optimal muscle force to contract, usually as a result of chronic stress or frequently holding in pee. Often diagnosed as an overactive or hypertonic pelvic floor, this can lead to leakage, constipation and chronic pelvic or abdominal pain, hip pain and buttock pain.

Hypotonic pelvic floor

Other people have muscles that are consistently in a relaxed position because their pelvic-floor muscle fibre cannot contract. This is known as a hypotonic pelvic floor and causes symptoms similar to that of over-contracted muscles, such as leakage and pelvic pressure, as well as reduced vaginal sensation, and unexplained bladder, abdominal and pelvic pain.

How To Diagnose and Treat Pelvic-Floor Dysfunction

The treatment protocol is different for different pelvic-floor conditions as outlined above. If the muscles are found to be too relaxed, then doing strengthening exercises would be a part of the care plan. Meanwhile, if the muscles are found to be non-relaxing, then doing stretching exercises would be a better start to the treatment plan.

We have a lot more information here regarding various pelvic floor diagnoses we treat.

Pelvic-Floor Exercises for Pelvic-Floor Health

The article then goes into some exercises that can help strengthen your pelvic floor, including:

1. Kegels

Kegels can help with symptoms related to a hypotonic pelvic floor as described above, but they aren't for everyone because they can worsen symptoms in people who have shortened or contracted (hypertonic) pelvic floor muscles. Doing kegels when you have an overly contracted pelvic floor would be like trying to flex your calf when you already have a cramp.

2. Side-lying Clams

Kegels may be part of a proper treatment plan for individuals with pelvic-floor weakness, but they are not a full treatment plan. They also need to be accompanied by hip- and core-strengthening moves like side-lying clams.

3. Happy Baby Stretch

This popular yoga stretch is known for its ability to open the hips—and it does this effectively. It also stretches the muscles in the pelvic floor, which can be beneficial for individuals experiencing internal tightness.

Click here for the full lowdown on the above exercises strengthen your pelvic floor in the full article at Nike's website, and click here if you're ready to take the plunge with one of our trained physical therapists.

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What Our Patients Have to Say

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Testimonial by J.B.

My husband and I were having problems with painful intercourse. My therapist recommended that I go and get a pelvic floor evaluation from a physical therapist. Having never been treated by a physical therapist, I wondered how this really was going to help me. My husband who is a physician was very supportive and agreed that a PT evaluation would be a great idea. So i made the appointment and was blown away by what I learned. I had no idea that pelvic floor muscles could get tight and have trigger points just like any other muscle in the body. I'm a massage therapist and very familiar with tight muscles, and this new thought really amazed me. Heather's program to help relax and strengthen these muscles made such a difference. I can say that I am 100% pain free during intercourse now. Yippee! Going to the PT appointments and doing the at-home exercises was definitely a discipline, but it's 100% worth it! The rewards are amazing.

-- J.B.

Testimonial by T.H.

I started seeing Heather in October 2014. For more than two years, I had been suffering from painful urinary tract infection type symptoms after my bartholins gland surgery which included constant burning and urinary frequency sensation that led to more and more painful intercourse. I had made multiple visits to internist, obgyn and urologist's offices, went through a range of treatment with UTI and bladder frequency medication that included antibiotics, vesicare, estrogen cream, but nothing worked.

Read more: Testimonial by T.H.

Testimonial by Mary L.

I started seeing Heather to treat my Interstitial Cystitis in November 2016. At this time, I was extremely miserable, in constant pain, and felt as though no one was listening or understood what was going on with my body. I have just finished my last appointment and I can honestly say that my life has completely changed for the better because of Heather and her team of PTs! I live almost completely pain free, and when I do have flare ups, I am able to treat them at home on my own. I am so grateful that this office was recommended to me a honestly cannot recommend them enough!

Read more: Testimonial by Mary L.

Testimonial by M.M.

A personal journey and testimonial from one of my patients:

My husband and I were married for 5 years before we were able to have intercourse due to my vaginismus. There was nothing traumatic in my past but for some reason, even though I wanted sex, I mentally avoided "that area" of my body and didn't even admit to myself that there was a problem for a long time, even though I was never able to put tampons in. Once I finally opened my eyes up to the fact that I had a problem, I had a surgery that was supposed to fix the issue.

Read more: Testimonial by M.M.

Testimonial by R.S.

I wanted to thank you so much for helping me get through something I thought I may never be able to. We have achieved pain-free intercourse and this has really solidified our marriage. We are so grateful to you for all the work you do! Thank you!!

-- R.S.

Testimonial by A.W., age 32

I wanted to let you know that my pelvic floor held strong and gave me no trouble whatsoever in my trail race this morning (12 miles)! In a way, I felt like I ran better than ever because my core feels so rock solid from all the exercises you have me doing. That was especially valuable on the technical downhill - I just flew down the trail because I had confidence in my balance and form. Thank you for helping me get back to doing what I love.

-- A.W., age 32
(completed Post-partum Renewal Program using the InTone biofeedback/stim unit)

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