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Pelvic Floor 101

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Let's start with an analogy.

You have a purse. A beautiful, gorgeous purse that you've had for years; a one-of-a-kind treasure that you know you want to keep forever.

There's just one problem: Every time you put something in the purse, it falls right through the gigantic hole in the bottom.

You've tried fixing the purse. You put tape on the handles. You had it professionally cleaned. You even sewed a cute little patch to the outside pocket.

But everything STILL keeps falling out.

WHAT THE HELL. YOU FIXED IT.

But not really, right? I mean, obviously. This is a silly example. OF COURSE getting your purse cleaned isn't going to fix the hole in the bottom.

The foundation is damaged and that needs to be addressed before you do anything else.

Many kinds of exercise, particularly high-impact activities like running, jumping, and burpees, or exercises like planks and crunches that create a lot of intra-abdominal pressure, can cause all kinds of problems if your pelvic floor is out of whack (clinical term). Even day-to-day activities like lifting your kid in and out of her car seat can be problematic.

But what exactly IS the pelvic floor?

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Your pelvic floor is a group of muscles that sit within your pelvis. There are five really important jobs the pelvic floor does:

  1. Sphincteric: The muscles of the pelvic floor relax and lengthen, which allows us to pee and poop, and also contract to stop us from leaking.
  2. Support: The pelvic floor helps to hold up our pelvic organs (bladder, uterus, rectum) and keep them there despite gravity and increases in intra-abdominal pressure. 
  3. Stability: Your pelvic floor helps your abs, hip, and back muscles to control movement of your hips and pelvis.
  4. Sexual: For men, the pelvic floor muscles help them to achieve and sustain an erection. For women, the pelvic floor can cause pain during intercourse if it is too tight, and we also need a sufficient amount of pelvic floor strength to orgasm.
  5. Sump-pump: The pelvic floor acts as a blood/lymph pump for the pelvis, just like your calf muscles help to pump blood and lymphatic fluid back up towards your heart.

Think of your pelvic floor as a little mini trampoline: it can (and should!) move up and down. If you're doing something extremely high-impact like running, a fully-functioning pelvic floor should actually bounce.

Both men and women have pelvic floors, and both men and women can experience problems with their pelvic floors.

How do you know if you're having pelvic floor issues?

Here are some signs, via Pelvic Floor First:

  • accidentally leaking urine when you exercise, laugh, cough or sneeze
  • needing to get to the toilet in a hurry or not making it there in time
  • constantly needing to go to the  toilet
  • finding it difficult to empty your bladder or bowel
  • accidentally losing control of your bladder or bowel
  • accidentally passing wind
  • a prolapse
    • in women, this may be felt as a bulge in the vagina or a feeling of heaviness, discomfort, pulling, dragging or dropping
    • in men, this may be felt as a bulge in the rectum or a feeling of needing to use their bowels but not actually needing to go
    • pain in your pelvic area
    • painful sex

Ladies, please re-read that first bullet point. Leaking urine is extremely common but it is NOT normal. I always thought it was an unfortunate-yet-unavoidable side effect of having a baby. It's not!

If you're experiencing any of the symptoms on this list, please make an appointment to see a pelvic health physical therapist (you may or may not need a referral from your doctor, depending on the practice). These physical therapists have received a ton of specialized training and will give specific-to-you advice and homework to help resolve these issues. Many doctors will just tell you to do kegels. This is a good start but it's NOT ENOUGH. Please go see a PT.

Your pelvic floor will thank you.