Understanding Pelvic Floor Health

By Genevieve Richter, PT, DPT – Physical Therapist and co-owner of Method Physical Therapy

Most people have probably heard of the pelvic floor, but few understand what it is and why it’s important. As a physical therapist and pelvic health practitioner, I work to help people understand how a healthy pelvic floor can maintain, and even improve, their quality of life as they age.

What is the pelvic floor?  

The pelvic floor is a bowl-like structure of muscles near the base of the spine. Both men and women have one. It holds up all of our pelvic organs (bladder, bowels, prostate, and uterus) and it plays a key role in:

  • Bowel and bladder function
  • Intercourse
  • Delivering babies
  • Respiration (breathing)

As we age, the strength or integrity of the musculature of our pelvic floor changes. Without proactive management, this can lead to dysfunction, which can drastically decrease quality of life.

In women, this can take the form of urinary incontinence, urgency or frequency, pelvic organ prolapse, constipation, or pain with intercourse. Men might develop urinary incontinence, urgency or frequency of urination, and erectile dysfunction.

Stress incontinence 

Stress urinary incontinence is the sudden loss of urine due to increased intra-abdominal pressure, such as a sneeze, a laugh, a jump, or a cough. This places pressure on the bladder, and if the pelvic floor musculature is too weak to counter it, incontinence can be the result.

If appropriate, people can strengthen their pelvic floor musculature by performing a contraction. Imagine you are sitting on a marble, and then try to lift that marble upwards. Hold this contraction for five seconds, and repeat up to 10 times a day. This action should strengthen your muscles enough to start helping with stress incontinence.

Bladder urgency and frequency

Urgency is the sudden strong urge to urinate that is difficult to overcome. We’ve all experienced this on occasion, but when it occurs frequently it can lead to incidences of incontinence and have serious negative effects on one’s life. People begin to plan places they can go based upon how close they will be to a restroom. Fortunately, improving your pelvic health will take care of this problem.

First, control your exposure to substances that will irritate your bladder. Limiting your intake of acidic, caffeinated, carbonated, or alcoholic beverages reduces inflammation within the bladder. These substances cause the bladder to over-contract, sending the body a signal to use the restroom more than normal. Reducing the intake of bladder irritants will allow bladder inflammation to decrease and sets the stage for the benefits of improved pelvic health.

Relaxing the pelvic floor to create more space around the bladder can also be beneficial.  You can do this by breathing deeply into your lower abdomen. Expand your lower abdomen and feel the space between your sit bones expand with each breath. Bringing more oxygen and nutrients down to your pelvic floor will lead to better pelvic health.

Bottom line

Ultimately, all of the pelvic health issues brought on by normal aging are preventable and treatable. Some people feel embarrassed about these problems but should not. Physical therapists specializing in pelvic health can assess the strength of your pelvic floor and lead you through various exercises that improve strength and function.

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