5 Things I wish everyone knew about their pelvic floor…
There is a lot of buzz out there these days about the pelvic floor. It seems every exercise class tells you to work your pelvic floor. Lots of celebrities and influencers have advice and gimmicks to help you “strengthen” your pelvic floor muscles.
I have been a physical therapist for over 30 years and have been a pelvic PT for about 20 of those years. Here are 5 things I wish people knew about the pelvic floor:
Number 1: Everyone has a pelvic floor. Every woman. Every man. Every nonbinary and trans person. There is a misnomer that only women have pelvic floors. Everyone does. The pelvic floor is the group of muscles that help you to be able to control when you want to pee and poop. They contract during orgasm. They contract when you cough and sneeze. They contract as you move. These muscles are the floor of your core.
Number 2: Not everyone should be doing Kegels!!! While it is important to have a strong pelvic floor, not everyone needs to or should be doing Kegels. Some people chronically hold their pelvic floors too tightly. Some people have significant pain or dysfunction. For these people, Kegels can actually worsen their issues. These people need to learn how to relax the pelvic floor, NOT strengthen it. Additionally, there can also be problems with scar tissue preventing the urethra from closing properly. No amount of Kegels will fix that problem, either.
Number 3: Around 70% of people do Kegels wrong. This is what bothers me most about the Kegel craze. People are being told to do Kegels in exercise classes and on TikTok and Instagram. Yes, pelvic floor strength is important. However, all of those Kegels are not going to help if a person is not contracting the correct muscles. I have worked with a lot of patients to try to get them to do a Kegel. With some of them, I have run through every cue I know and still cannot get them to contract that pelvic floor. Some people will contract gluts, some their adductors, some their abs, and others will do all of the above. Unless you know for sure you are truly contracting your pelvic floor, please do not try to add it into your exercise program.
Number 4: You don't need to do a million Kegels. When you cough or sneeze, the pelvic floor contracts to help prevent urine from escaping. The difference between peeing or not peeing when you cough or sneeze is milliseconds. A million Kegels will not change that. You can have really strong muscles, but if they do not contract when you need them to, it will not help. Sometimes it is a matter of getting the brain to remember to fire those muscles. So, try contracting the pelvic floor and then do a fake cough. If you need to cough or sneeze, contract first, then cough. After a while, the brain can relearn to fire those muscles when needed.
Number 5: Pelvic Physical Therapists (PTs) exist. We treat bladder, bowel, and sexual dysfunction. Any pelvic PT can help you to understand your pelvic floor. Whether someone is struggling with pain, incontinence, constipation, prolapse, or pain with sex, they can help. Many unnecessarily suffer in silence. No one should. There is help.
Written by our Pelvic Floor Therapist:
Mary Ellen Kramp, DPT, CLT-LANA
