Why Is Building Pelvic Floor Strength So Important?

Pop quiz: which group of muscles performs a vital role in our bodies but is often misunderstood or ignored until there’s a problem? Yep, it’s time to throw a spotlight on our pelvic floor.

It’s hard to understate how important your pelvic floor is – yet many of us don’t know nearly enough about what it does, let alone how to look after it.

Let’s change that!

Why does your pelvic floor matter?

Think of your pelvic floor as a super supportive sling of muscles and ligaments which stretch from your tailbone to your pubic bone, and from side to side between your sit bones. If you’re finding it hard to visualise what it looks like, check out this video from the Continence Foundation of Australia.

Together these muscles work against gravity every single day to keep those essential pelvic organs, such as the uterus, bladder and bowel, in place.

That’s why being able to contract and relax your pelvic floor muscles plays a key part in bladder and bowel control – and in increasing sexual pleasure.

Pretty cool design, right? Yet most of the time we don’t even stop to think about how much we depend on our pelvic floor doing a great job - that is until your pelvic floor is struggling and the impacts become impossible to ignore.

Signs your pelvic floor isn’t working as well as it should

A pelvic floor disorder (PFD) can occur when our hard-working pelvic floor muscles are weakened, stretched or sometimes, too tight.

This 2015 research published in Current Opinion in Obstetrics and Gynecology estimated that a quarter of American women suffer from at least one PFD

Signs your pelvic floor may need attention include:

• If you leak urine – even just a few drops - when you cough, jump or sneeze, you’re likely experiencing stress urinary incontinence (SUI). Studies such as this 2017 report in the International Urogynecology Journal identify SUI as the most common urine complaint amongst women

• Accidentally passing wind or leaking from your bowel

• Not getting to the toilet in time, or feeling like you can’t empty your bowel or bladder

• Suffering a prolapse, which is when one of the organs normally held in place by your pelvic floor sags down into your vagina. You might feel it as a bulge or a heaviness 

• Painful sex

If you're unsure if what you're experiencing relates to your pelvic floor, always consult your doctor or a trained pelvic floor specialist. But don't ignore it!

What causes a weak pelvic floor?

There are a range of reasons why many women and those assigned female at birth suffer (often in silence) from pelvic floor problems, including:

• Pregnancy and childbirth – one in three Australian women who’ve had a baby have wet themselves

• Weight gain

• Falling estrogen levels after menopause

• Chronic constipation or coughing – both of which can cause straining and pressure on the pelvic floor

• Regular heavy lifting

Women who exercise at a high intensity can also be at risk. This 2020 meta-analysis published in the Journal of Human Kinetics found that female athletes often suffer from leakage and that high-impact sport can increase the risk of stress urinary incontinence for many women.

Now for the good news

At Sweat we love to celebrate the resilience of the human body – we see the evidence every day of the amazing things it can do.

A perfect example is the power of specific and simple exercises to strengthen weak or stretched pelvic floor muscles and to prevent these problems from happening in the first place.

Even better, these exercises don’t require any equipment and can be done anywhere, anytime – try a set now!

The American College of Physicians recommends pelvic floor muscle training as the first-line treatment for any woman experiencing urine leakage.

But the key to success with pelvic floor exercises (known as Kegels) – and something people often find tricky at the start - is the correct technique:

• Start by lying down or sitting to do these exercises, before progressing to standing as your strength improves

• Relax your thighs, buttocks and stomach

• Keep breathing normally and don’t clench

• Squeeze and lift your back passage as if you are stopping wind

• Hold for up to five seconds

• Relax for five seconds, with a definite sense of relaxing the pelvic floor

• Do three sets of up to 10 Kegels – and stop when your muscles get tired

If you’re finding it hard to get these right, consult a pelvic floor specialist.

But don’t give up - this 2015 report published in Obstetrics & Gynecology found that the lifetime risk of surgery for either stress urinary incontinence or pelvic organ prolapse in women is 20% by the age of 80.

So it’s definitely in your best interests to prevent problems with your pelvic floor in the first place.

Which exercises should you avoid?

If your pelvic floor is weak, there are a few exercises you may need to be cautious about until your muscles are stronger.

High impact exercise, such as running or skipping, can put extra downward pressure on the pelvic floor, as can deep squats and heavy weights, while exercise such as swimming can be more supportive.

The Continence Foundation of Australia recommends 10 steps for protecting your pelvic floor, including:

• Breathing out whenever you lift, push or pull

• Keeping your feet no more than hip width apart for standing exercises will help you to activate your pelvic floor 

• Always activating your pelvic floor before and during resistance exercises

Check with your healthcare provider for advice on pelvic floor safe options which suit you.

Which exercises should you try?

Sweat has Pilates, barre and yoga programs and on-demand workouts available which include low-impact movements and exercises that include exercises that are great when executed whilst engaging your pelvic floor muscles.

Remember: these workouts alone won’t help to strengthen your pelvic floor but do include movements designed to assist you in engaging this group of muscles.

If your healthcare provider has cleared you to return to exercise after having a baby, we recommend easing back in with a post-pregnancy program.

Kayla Itsines’ Post-Pregnancy program includes four foundation weeks that focus on rebuilding your core and pelvic floor strength before progressing into more complex movements while the first four weeks of Kelsey Wells’ PWR Post-Pregnancy program focus on the transverse abdominis and pelvic floor activation.

Creating a routine to build pelvic floor strength

The evidence from a range of studies, such as this 2019 review in American Family Physician, is clear: Kegels do work, both as prevention and as treatment.

But they need to be done effectively – and they need to be done every day.

Awareness and seeking help is so important: the 2018 National Poll on Healthy Aging in the US found that while 50% of women over 50 couldn’t completely control their bladders, two-thirds had never spoken to their doctor about what was happening, and only 38% were doing Kegels.

So let’s make this common issue something we are unafraid and unembarrassed to talk about, to make sure everyone knows how to achieve a stronger pelvic floor.

Building pelvic floor strength can be as easy as making Kegels a normal part of your day: think of doing a set every time you brush your teeth or when you’re stuck at a red light.

After all, we make time to regularly check our social media or sit down to enjoy a cup of coffee. So why wouldn’t we set aside a few minutes every day to do three sets of Kegels?

The rewards can be life-changing!