Pelvic Floor Muscle Health and Rehabilitation

Pelvic floor muscles are a group of skeletal muscles at the bottom of the male and female pelvis. They are part of the deep core and are responsible for contributing to our core stability, including organ support and managing intra-abdominal pressure. They also have a role in sexual function and health, in addition to maintaining continence of urine, feces and gas.

Considering these important roles, it serves us to maintain a healthy pelvic floor by adopting some good habits. A coordinated pelvic floor knows how to turn on and off. It should contract to hold urine, feces or gas, and it should relax to let these things out at a time of our choosing. Some healthy habits include:

1. Void on a schedule. It is important to void (urinate) every 3 to 4 hours during waking hours. This does not include bowel movements, an urge to have a bowel movement should not be ignored. Voiding on a schedule can help prevent frequency and urgency that is not caused by an infection. A common example of this is the person who goes to the bathroom “just in case” to later find they are having an urge to urinate every hour.
   
2. Improve coordination with daily movements. It is beneficial to call upon our pelvic floor any time we get out of a chair, sneeze, cough, or blow our nose. Since the pelvic floor is a postural and deep core muscle, it should turn on before the cough/sneeze etc. 
3. Exercise specific to the pelvic floor. A healthy pelvic floor can be exercised by doing 60-100 pelvic floor contractions per day. A weak pelvic floor may benefit from as little as 24 contractions per day.
4. Don’t hold your breath. Consistent downward intra-abdominal pressure is stressful for the pelvic floor muscles. Some examples are holding your breath to lift a box or do weight lifting at the gym, or straining to have a bowel movement. One way to relax your pelvic floor and avoid straining, is to sit in a “knees above hips” position.
5. Stretch. A variety of common hip stretches for the inner thighs, glutes and hip flexors help reduce pelvic floor tightness. Yoga can also help the pelvic floor muscles relax.

It is not uncommon that someone has one or many pelvic floor symptoms they have written off as “normal” for their current stage of life. If your pelvic floor is limiting your usual activities - talk to your care provider, as a pelvic floor physical therapist may be able to help.

Audra Eisz is a physical therapist with Barton Rehabilitation. To schedule a consultation for pelvic floor rehabilitation, call 530.543.5720, or to learn more about pelvic floor rehabilitation, visit BartonHealth.org/Rehab.