Pelvic Floor Exercise: The Key to Foundational Strength

We have all heard of Kegel exercises, right? Practitioners, friends, and family members often advise us to do them after pregnancy. Don't get me wrong, Kegels have their time and place! However, perhaps you have also heard of Pelvic Floor Muscle Training? If not, and you're looking to stop embarrassing leaks when you cough, laugh, sneeze, or work out, then read on to learn more about PFMT and how it differs from Kegels.

Why Kegels may not always be Enough

When we are told to do Kegels, we're often told to engage our pelvic floor muscles. However, many women—and they're in good company—don't really know what they should be feeling when they do. Most of the time, we're just trying to stop the flow of urine.

Kegels are strongly focused on the contraction of the pelvic floor muscles. Depending on who taught you to do Kegels, you may just perform the pelvic floor contraction while trying to stop the flow of urine and just using the front of the pelvic floor muscles. This type of superficial Kegel, unfortunately, won’t address most issues that we are trying to remedy by performing the Kegel. We could even possibly be making the situation worse by contracting the muscles at a time when we want them to be relaxed. .

When taught properly there are several steps to performing Kegels and as you work through the progressions (think the “elevator” Kegel exercise) you will begin to broaden your awareness of the muscles you are using (deeper layers of muscles and back of the pelvic floor included!)

As you broaden this awareness and get better at doing these, then we can begin to use more of the many connections from the pelvic floor muscles. Creating a solid foundation to build strength throughout the body.

What is Pelvic Floor Muscle Training?

Pelvic Floor Muscle Training (PFMT) is a form of exercise that specifically targets the muscles of the pelvic floor, including the deepest layers and all of the many other connections coming from these muscles. Think of this type of exercise as taking Kegels to the next level.

These exercises may be used to treat pelvic floor dysfunction, some levels of prolapse, diastasis recti and are even step one when building up core strength in the postpartum.

How do you know if PFMT is something that you should try? Well, in my honest opinion, everyone should be aware of the movement of their pelvic floor muscles, and PFMT is the best way to gain that awareness. Our pelvic floor muscles take on so much of our daily stress, and even more when we are not breathing properly or standing in good posture - whether you are male or female, given birth or never been pregnant, we all have stress! However, if any of the following apply to you…

• If you are experiencing bladder or fecal incontinence when you are lifting objects, laughing, coughing or sneezing.

• If you are noticing a feeling of pressure anywhere in your pelvic floor.

• If you are experiencing pain with intercourse or urination.

• If you are seeing a “doming” or “tenting” through your abdominal muscles on exertion.

• If you get the feeling that your “organs are falling out” or that your “core muscles are mush” in the postpartum.

  …then Pelvic Floor Muscle Training is for you!

Working with a pelvic floor physical therapist is a great first step to addressing and treating pelvic floor dysfunction, or any other feeling from above. However, if you do not have access to this type of physical therapy, finding a personal trainer that is specially trained to work with the postpartum body can be super useful!

But The muscles are just weak, right?

Often we think that if we have pelvic floor issues that it must mean the muscles are weak. However, the muscles of the pelvic floor can be weak, overly tight, or imbalanced (tight on one side of the pelvic floor and weak on the other side) during pregnancy and in the postpartum.

Consider if you have a super tight muscle anywhere on your body, say your bicep, if it is stuck in a tight position can you get it to tighten and work from that spot? Now imagine that the muscles of your pelvic floor are potentially overly tight. Then you have to go to the bathroom but are not near a toilet, so you try to squeeze your pelvic floor muscles to stop yourself from having an accident, but the muscles are already at their tightest! They can’t give you anymore help so there is nothing additional to stop the flow in that moment. The muscles may be weak, yes, but know that an overly tight muscle or muscles that are imbalanced can have the same symptoms as weak muscles!

The beauty of PFMT training? It is beneficial whether you have imbalanced, overly tight pelvic floor muscles, or if they really are weak!

We begin with relaxing the pelvic floor muscles. Either type of muscle will benefit from relaxing. Then we work to integrate strengthening the pelvic floor muscles and all of the other 40+ muscles that attach to the pelvic floor. We build balance and strength into the foundation from the pelvic floor out.

Pelvic floor muscle training is a safe and effective way to improve pelvic floor dysfunction, reduce incontinence, help to heal a diastasis recti and improve sexual sensation. There is hope if you experience any of these conditions. Know that you are not alone in the postpartum, there are tools to use that can help you to build strength and confidence in your body again.

A great resource that I often recommend is the Pelvic Guru website. They have an international directory to find practitioners near you. You can also check out Concierge Physical Therapy - the Pelvic Floor Physical Therapist will come to you so you don’t even have to worry about getting childcare! Or, if insurance won’t allow for Pelvic Floor PT (hopefully this will be more accepted in the near future!) there are a ton of amazing resources online including the 8-week exercise program “Getting to the Core of Postpartum Fitness” that helps to show you how to integrate the core and pelvic floor into your exercises to build that strong foundation!

Whatever you do, I hope that you don’t just give up and believe that you have to live with pain, discomfort or embarrassing accidents for the rest of your life. There is help out there, you can feel strong, empowered and in control of your body again!