A weak pelvic floor can impact many aspects of your life, regardless of your gender. It makes sense — as part of your deep core, the pelvic floor has a number of crucial functions. "The pelvic floor is a thin, bowl-shaped group of muscles, supported by connective tissue and supplied with important nerves, that makes up the bottom-most portion of the abdomino-pelvic cavity," explained Sarah Collins, MD, urogynecologist at Northwestern Medicine Central DuPage Hospital in Illinois. "It supports your pelvic organs, including your vagina, uterus, rectum, bladder, and urethra . . . and the function of those structures is affected by your pelvic floor." In short, that means your pelvic floor muscles are extremely hard-working.
Just like any muscle in the body, pelvic floor muscles can be weakened or overacting (also referred to colloquially as being too "tight"). Weak pelvic floor muscles are often spoken about in the context of people who've given birth but, it turns out, the pelvic floor is just as crucial for people who've never been pregnant. Turns out, you can still have a weakened pelvic floor if you've never had a baby. "The pelvic floor is still important to everyone, whether you have children or not," physical therapist Karah Charette, DPT, RYT, told POPSUGAR. "Though pregnancy is a major event to the pelvic floor, people are not immune to pelvic pain, incontinence, and other forms of pelvic dysfunction when they do not have children. Other life events including surgeries, injuries, or major stress can still lead to pelvic floor issues."
According to the experts we spoke to — a combination of urologists, urogynecologist, and physical therapists — these are the most common symptoms of weak pelvic floor muscles:
- Urinary incontinence
- Stress incontinence (loss of urine when coughing, sneezing, or exercising)
- Pelvic pain
- Feelings of incomplete emptying of bladder and/or bowel
- Difficulty with bowel control
- Pelvic organ prolapse (where pelvic organs fall out of our pelvis)
- Pain during sex and/or orgasm
- Painful urination
- Lower back pain or hip pain, with no other cause (Jenna Walton, physical therapist at UCHealth Steadman Hawkins Clinic in Denver, said this is more common in the athletic population)
- Testicular pain
- Inguinal and pelvic pain
Historically, the conversation around pelvic floor muscles has centreed around "tightening", but it's actually possible (and quite common) to overstrengthen your pelvic floor muscles. This is why a personalized treatment plan is crucial if you suspect your pelvic floor is weakened. "It is best to train your pelvic floor to have appropriate strength and coordination. It is just as important to know how to relax your pelvic floor as it is to contract your pelvic floor," said Walton. "When the pelvic floor contracts without appropriate coordination, the muscle can become 'tight' or go into a spasm response. In fact, this can become rather counterproductive because when muscles become overactive, they are unable to contract as well, which can lead to progressive weakening over time."
Helen Bernie, DO, a urologist at Indiana University Health, explained that one of the best ways to strengthen your pelvic floor is to perform daily stretches, not only for the physical benefits, but also to help you consciously connect to your body and be aware of how the muscles feel when they relax and contract. She explained that "stretching helps relax and elongate your muscles and alleviate built up stress and tension". Charette added, "if you are someone who wants to strengthen, Pilates is often a good form of exercise that will cue the pelvic floor. As with everything, it is a good idea to do your research and see if who is teaching you has a background or deeper understanding in this part of the body." She pointed out that if any movement is painful or doesn't feel right, it is important to consult with a medical professional who can help guide you.
Charette also explained that treating a weak pelvic floor isn't as simple as doing hundreds of kegels. "People have come to equate pelvic floor health with kegels," she said. "However, most people perform kegels incorrectly, and even if they are able to perform them, it may not be indicated. A majority of our population is walking around with a tight and tense pelvic floor where kegels may actually cause more harm than good, which can lead to increased pelvic pain, sexual dysfunction, incontinence, or even urinary retention. This is why it is important to be evaluated by a medical professional to understand what your pelvic floor needs are."