As a prenatal and postpartum fitness instructor, I end up talking about the pelvic floor a lot. Awareness of the pelvic floor is a critical component of women’s fitness, especially during the transition into motherhood, yet it’s something so few of us know much of anything about.
When I was in my late teens, I remember going on a pretty long medical adventure trying to figure out why sex was painful. I saw countless doctors, was insulted and teased, and took a few years to get to the bottom of it. Each doctor I saw “tested” my vagina, as they described it, and would make some vaguely inappropriate comment about how I was plenty tight, so that couldn’t be the problem.
But after wasting years and money and a lot of emotion, I finally saw a pelvic floor physical therapist. And you know what I learned? My pelvic floor was actually too tight. A little bit of support with teaching it to relax and BAM. Problem solved. This pain I’d lived with for most of my adolescence, along with a host of other issues, were resolved.
This was one of the first times I realized how deeply my doctors, even the well-meaning ones, had failed me. I had no idea what the pelvic floor was beyond that it had something to do with my vagina. I certainly had no idea that it could be overtight, or that it could affect other parts of my body as well. When I was preparing to give birth for the first time years later, I received zero instruction on how to prepare my body. At my 6 week check up, when I informed my doctor that I felt like a weight was falling out of my vag every time I took a walk, he waved me off and said “that’s normal, just do some squeezes, you’ll be fine.”
News flash: It wasn’t normal, and I was not, in fact, fine after doing my “squeezes”.
Women all over this country and many others are being woefully misinformed and under informed about their pelvic floor, despite the fact that it’s one of the most important muscle groups in the entire body.
I’m over it, y’all. Let’s set the record straight! Here’s all the stuff your doctor should have told you about your pelvic floor…but didn’t.
It’s about more than just reproduction When we hear the pelvic floor, most of us think of two things: sex and birth. But the truth is, the pelvic floor plays a critical part in breathing, posture, balance, strength, pressure management, digestion, and more. Writing it off as something you don’t need to deal with unless sex hurts or you tear during childbirth is a big mistake.
Dysfunction is common…but not normal Yes, it’s extremely common for there to be issues with the pelvic floor. The way we live our lives these days, complete with hours of sitting and slouching over our phones, kind of sets us on that path. Combine that with diets high in inflammatory foods, lack of effective daily movement, and a disconnection from optimal breathing patterns…you’ve got a recipe for a lot of dysfunction. But just because something is common doesn’t mean it’s normal! If you’re experiencing pelvic pain, low back or shoulder pain, chronic tension in your jaw, chronic constipation or diarrhea, leaking urine, painful sex, or feelings of pressure in your pelvis…something’s not right. And yes, there’s plenty you can do about it, whether or not your doctor takes you seriously.
Kegels aren’t that great Chances are, if you’ve talked to a medical professional or fitness-guru about the pelvic floor, you’ve heard of Kegel’s. These pelvic muscle squeezing exercises are often thrown out as a bit of a “hand-wave, leave me alone and stop asking questions” solution to pelvic floor issues - despite the fact that many women are doing them incorrectly and research has shown that they aren’t that effective in treating most pelvic floor dysfunction. Why are we told to just do Kegel’s every time we’re at a stop light if they aren’t that effective? It’s a far better use of your time to perfect your posture and breathing than it is to just sit squeezing your couch all day hoping something magical will happen.
You don’t need special equipment Ok, a bit of a caveat here - there is equipment that can be immensely useful in treating certain pelvic disorders. Pelvic wands like this one are awesome for releasing tension in places you can’t reach, pessaries can improve quality of life enormously for those experiencing prolapse, and even those pelvic weights have their place when used with professional guidance.
It doesn’t matter how you give birth I fell for this fairytale too, so if this gives you deja vu don’t feel bad - but having a cesarean birth doesn’t mean your pelvic floor is just as it was pre-pregnancy or pre-birth. Pregnancy, labor, and delivery wreak havoc on your pelvic floor no matter how you do it. You don’t have to tear to experience pelvic floor issues after birth, and sometimes scar tissue from a cesarean can cause issues with your pelvic floor, too. So even if you know you’ll be having a cesarean birth, it’s worth it to understand and prepare your pelvic floor…and to take your recovery seriously after baby arrives.
It can cause referral pain If you’ve ever thought “well sex doesn’t hurt and I don’t leak pee, my pelvic floor must be fine,” this is for you. Because we often don’t understand all the functions of the pelvic floor, it can be easy to misunderstand when it’s telling us something’s off. Sometimes an imbalance or dysfunction in the pelvic floor doesn’t show up in our crotch…but it does affect the surrounding muscles, which can lead to tension and pain elsewhere in the body. Low back pain is a common symptom of pelvic floor issues, as is shoulder and neck pain/tension, jaw tension, digestive issues, and more. Knowledge is power, friend. If you don’t understand your pelvic floor, you’ll be chasing your tail trying to treat these symptoms without addressing the root of the problem - your pelvic floor. Once you start taking pelvic health seriously, you might be shocked at the changes you experience in the rest of your body.
It’s actually more common for it to be too tight than too loose Like me, many women are told that since their vagina feels tight, their pelvic floor must be fine. But the reality is that our modern lifestyles predispose us to pelvic floors that are too tight far more often than too loose. When your pelvic floor can’t relax, it can’t do it’s job…and may rope in other muscles to compensate and throw them all out of whack too. In order to function optimally, the pelvic floor needs to be strong and flexible. Too tight muscles are often weak. This is another reason that just doing a bunch of Kegel’s won’t solve all your problems…it won’t do a darn thing if your pelvic floor is too tight. Learning to consciously release tension in the pelvic floor and teaching it to react like a flexible gymnast when called upon…that’s what you need to focus on.
You don’t need a special workout I always get funny looks when I say this, because I’m a fitness instructor, but most of what I teach in my pelvic floor workshops has nothing to do with exercise at all. Why? Because you don’t need a special workout routine or to do Kegel’s while squatting in order to revitalize your pelvic floor. Learning how to move effectively in your everyday life, understanding how to breathe optimally, and getting a hold on lifestyle and nutrition will do a lot more for your pelvic health than some specialized workout you only find time for twice a week. Are there ways to exercise that are better for the pelvic floor than others? Yes, and I love helping women find fitness and movement that works for their bodies. But is that the most critical component of pelvic health for most women? No, not by a long shot.
I could go on and on, and in my next pelvic floor workshop I’m sure I will! But this should be enough to help you realize that the healthcare and education system has let you down, sister. It’s my mission to help all women tap into the power of a healthy pelvic floor, and you’re no exception! It doesn’t matter what point you’re starting from…it’s always worth getting your pelvic floor evaluated and taking steps to support it in your daily life.
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