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Understanding Pelvic Floor Muscles

Updated: May 13

The pelvic floor muscles consist of layers of muscle and tissue that form a supportive structure resembling a hammock. They stretch from the pubic bone in the front of the pelvis to the tailbone at the back, and from one ischeal tuberosity to the other, effectively forming the base of the group of muscles commonly called the ‘core’. These muscles work with other muscles to support the spine and control the pressure inside the abdomen, playing a crucial role in holding organs in place and controlling the release of urine. Primarily, these muscles support vital organs such as the bladder, uterus, and bowel. Additionally, they facilitate control over functions like urination, defecation, and sexual activity. It's important to coordinate the pelvic floor muscles with the abdominal muscles, ensuring that engaging in exercises doesn't lead to the use of stomach muscles or any movement in the stomach, for optimal pelvic floor function.

Causes of Pelvic Floor Weakness

Various factors can contribute to the weakening of pelvic floor muscles, including weak pelvic floor muscles and a weakened pelvic floor:

  1. Pregnancy and Childbirth: The stress and strain of pregnancy and childbirth can significantly weaken pelvic floor muscles, leading to conditions such as weak pelvic floor muscles.

  2. Hormonal Changes: Hormonal fluctuations throughout a woman’s life, including puberty, pregnancy, and menopause, can affect pelvic floor muscle strength, potentially resulting in a weakened pelvic floor.

  3. Heavy Lifting: Continuous lifting of heavy weights, whether in the context of childcare, weightlifting exercises, or certain occupations, can strain the pelvic floor muscles, contributing to weak pelvic floor muscles.

  4. Overweight: Excess weight can put additional pressure on the pelvic floor, leading to weakening over time and the development of weakened pelvic floor muscles.

  5. Poor Fitness: Lack of overall fitness and muscle tone can contribute to pelvic floor weakness, including conditions of weak pelvic floor muscles.

  6. Chronic Conditions: Conditions such as persistent coughing and constipation can also weaken pelvic floor muscles, further exacerbating the issue of a weakened pelvic floor.

Signs and Symptoms of Pelvic Floor Dysfunction

Recognizing the signs of pelvic floor dysfunction is crucial for seeking appropriate treatment. Common symptoms include:

  • Bladder Incontinence (Urinary Incontinence): Stress incontinence (leakage of urine during activities like coughing, laughing, or jumping), urge incontinence (sudden urge to urinate leading to leakage), urgency (frequent urge to urinate), and mixed incontinence (combination of stress and urge incontinence). Factors such as pregnancy, childbirth, menopause, straining on the toilet, pelvic surgery, heavy lifting, high-impact exercise, age, and weight can all contribute to pelvic floor muscle weakness and result in urinary incontinence.

  • Bowel Incontinence: Loss of control over bowel movements, leading to leakage of stool or gas.

  • Pelvic Pain: Discomfort or pain during daily activities such as walking, sitting, standing, or sexual intercourse.

  • Pelvic Organ Prolapse: Descent of pelvic organs (bladder, uterus, or bowel) into the pelvic cavity, causing discomfort and potentially interfering with normal bodily functions.

Importance of Pelvic Floor Muscle Exercises

Pelvic floor muscle exercises, also known as Kegel exercises, are vital for maintaining pelvic floor health. These exercises involve contracting and relaxing the pelvic floor muscles to improve strength, endurance, and coordination. It's crucial to 'squeeze your pelvic floor' during these exercises, as this action ensures you're using the correct muscles effectively, enhancing the exercises' benefits by sending the right messages to your nervous system and bladder. Regular practice of pelvic floor exercises can:

  • Prevent Incontinence: Strengthening the pelvic floor muscles can reduce the risk of bladder and bowel incontinence.

  • Alleviate Pelvic Pain: Stronger pelvic floor muscles can provide better support and alleviate pelvic pain associated with various activities.

  • Prevent Prolapse: By supporting pelvic organs more effectively, pelvic floor exercises can help prevent or alleviate pelvic organ prolapse.

  • Enhance Sexual Function: Improved pelvic floor muscle strength can enhance sexual sensation and satisfaction.

Pelvic Floor Therapy

Pelvic floor therapy is a specialized form of physical therapy aimed at addressing issues related to the pelvic floor muscles (PFMs). These muscles, often overlooked and underappreciated, play a crucial role in maintaining various bodily functions, including bladder and bowel control, support of pelvic organs, and sexual sensation. Understanding the importance of pelvic floor therapy and its benefits can help individuals, particularly women, lead healthier and more comfortable lives. Maintaining pelvic floor muscle tone through targeted therapy and exercises is essential, especially during pregnancy and after childbirth, to ensure long-term pelvic health and function.

Pelvic floor therapy, administered by trained physical therapists, offers personalized treatment plans to address pelvic floor dysfunction, including hypertonic pelvic floor conditions where the pelvic muscles become excessively tight. These may include:

  • Pelvic Floor Exercises: Guidance on performing specific exercises to target and strengthen pelvic floor muscles, while avoiding the common mistake of inadvertently tightening the buttock muscles instead of the pelvic floor muscles. Therapy can help correct this to ensure effective engagement and strengthening of the correct pelvic muscles.

  • Biofeedback: Utilizing specialized equipment to provide visual or auditory feedback on pelvic muscle activity, aiding in proper exercise technique and helping patients distinguish between the pelvic muscles and the buttock muscles.

  • Manual Therapy: Hands-on techniques such as massage or manipulation to release tension and improve muscle function in both the pelvic muscles and the hypertonic pelvic floor.

  • Education and Lifestyle Modifications: Providing information on healthy bladder and bowel habits, dietary recommendations, and posture correction techniques to support pelvic floor health. For those with a hypertonic pelvic floor, seeking advice from a women's, men's, and pelvic health physiotherapist is recommended to address the complex underlying causes and symptoms such as difficulties in bladder and bowel emptying, painful intercourse, and pelvic pain.


Pelvic floor therapy plays a crucial role in addressing pelvic floor dysfunction and improving overall pelvic health. By understanding the importance of pelvic floor muscles and seeking appropriate therapy when needed, individuals can mitigate the risk of pelvic floor disorders and enjoy better quality of life. Remember, it's never too late to start pelvic floor exercises and prioritize your pelvic health.


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