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Pelvic floor therapy is a technical term for an exercise program that aims to strengthen the muscles of the pelvic floor. Weakness in the pelvic floor can often be to blame for symptoms such as incontinence. Urinary incontinence affects almost 38% of Australian women and up to 10% of Australian men. 

As one of Atkins’ exercise physiologists specialising in women’s health, I regularly work with patients to manage symptoms associated with weak pelvic floors.  In today’s blog I’ll take you through what exactly the pelvic floor is, why it’s so important, and how you can introduce pelvic floor training into your daily routine.  

What is your pelvic floor? 

Your pelvic floor is like a hammock of muscles that sit between your pubic bone and your tailbone. The pelvic floor has several roles. It controls your urinary and bowel movements, and it’s essential for sexual function. Think of it as a support system for your bladder, your bowel and your uterus. To function efficiently, this hammock of muscles need to be able to contract, lift and hold, as well as relax.  

What is pelvic floor therapy? 

Pelvic floor therapy is a type of exercise therapy used in the rehabilitation and prehabilitation of the pelvic floor muscles. In a nutshell, it’s a collection of exercises we use to either prevent injury or dysfunction from occurring or relieve the symptoms associated with dysfunction. The main goal is to improve pelvic floor function through exercises, lifestyle modifications, and education. 

What causes pelvic floor muscle weakness 

Anyone can experience pelvic floor dysfunction – regardless of age, gender or genetics. However, certain groups are more likely to experience pelvic floor dysfunction. Conditions or events that may trigger a change in the pelvic floor include: 

• Stress urinary incontinence 
• Prolapse 
• Hormone changes (such as menopause) 
• Childbirth – particularly from prolonged labour 
• Obesity 
• Certain surgeries 
• Heavy lifting 

What are the benefits of pelvic floor therapy? 

Training the muscles of the pelvic floor can be beneficial in both a preventative and a restorative sense. A strong pelvic floor can help increase the resilience of the muscles following pelvic surgery. It can also reduce the risk of developing incontinence or prolapse.  

On the flip side, pelvic floor exercise therapy can help manage symptoms associated with the following: 

• Urinary incontinence  
• Stool Leakage 
• Stool urgency and frequency 
• Pelvic organ prolapse 
• Abdominal pain 
• Pregnancy pain 
• Pelvic pain 
• Polycystic ovarian syndrome (PCOS) 
• Endometriosis 

Who is pelvic floor physical therapy for? 

Many of us neglect our pelvic floor muscles until something goes wrong – even I am guilty of this. But proactively training and strengthening the muscles of the pelvic floor is something people of all ages can benefit from.  

I work with young gymnasts who are prone to stress incontinence, through to postmenopausal women who are adapting to the changes in their bodies. Pelvic floor physical therapy can be an effective treatment for: 

• Patients who have recently undergone abdominal, prostate, or pelvic surgery 
• Athletes who participate in sports that are prone to causing stress incontinence (gymnastics, athletics, dancing) 
• Individuals with an overactive pelvic floor 
• Post-menopausal women 
• Prenatal and postpartum mothers 

Men can benefit from pelvic floor therapy as well as women. The treatment is commonly misconceived as a women-only exercise. However, we often use pelvic floor training as a rehabilitation treatment plan following prostate cancer surgery.  

How to strengthen the pelvic floor 

The pelvic floor is actually considered part of your ‘core’. Many of us think of the core as another term for the abdominals. The core actually extends from the diaphragm to the pelvis and incorporates the abdominals, as well as the muscles of the pelvic floor and lower back. This is why many pelvic floor exercises may look and feel similar to exercises we typically associate with core strengthening.  

It can be difficult to isolate and voluntarily contract and relax the pelvic floor at first. This movement is often referred to as a ‘kegel’ exercise. These exercises can be performed daily. Try the steps below to practice contracting and relaxing your pelvic floor: 

1. Start by lying on your back, with your knees bent and feet flat. Take a gentle inhale breath for 5 seconds, breathing into your tummy, and gently exhale for 5 seconds.
2. Think of your pelvic floor like an elevator, with closing doors, a G floor, and1st floor.
3. Start your pelvic floor contraction by ‘closing the elevator doors’ like you are trying to stop the flow of urine.
4. Then, gently lift and contract the pelvic floor elevator up to the 1st floor.
5. Now relax your pelvic floor, by letting it down back to the G floor, and allowing the doors to open.
6. Repeat this up to ten times.  

While Kegels are a highly effective form of physical therapy exercises for the pelvic floor, it’s important to recognise that they aren’t a one-trick fix. A pelvic floor strengthening plan should incorporate exercises that work the surrounding muscles. It’s important to not only strengthen the pelvic floor, but the muscles around it too. This includes the transverse abdominals, hip adductors and abductors, and glutes. These exercises can be incorporated as part of a strength training program, and can be performed up to three times per week.  

Common exercises to strengthen these muscles, and in turn – the pelvic floor, include: 

• Glute bridges 
• Sit-to-stands 
• Clamshells 
• Bird dogs 
• Dead bugs 

Pelvic floor exercises for men and women are the same, despite the fact that they may be in response to different conditions. 

An exercise physiologist can help prescribe you a personalised pelvic floor therapy plan, tailored to your needs. If you’re seeking long-term relief from pelvic floor troubles, the solution is just a consult away.