The NEED To Know About Your Pelvic Floor
A few weeks ago I went to an event at the new Lululemon store in Chicago. They partnered with LOLA - a women’s sexual and menstrual wellness company - to host a Period Support Group. I got the invitation in my email because I use the LOLA subscription for my monthly delivery of period supplies (it is amazing and I HIGHLY recommend) and immediately signed up to go to the event. A Period Support Group? Right up my ally! Talking about periods and women’s health is truly my happy place. It was an awesome event to be in a room with 40 other women talking about what we go through as menstruating women with a monthly cycle, hormonal struggles, mood swings, PMS, and the list goes on. Talking about this stuff really is what I live for.
So all the period talk was great and everything, but what really shocked me was the questions that were posed to the panel. It became clear that NOBODY knows what the pelvic floor is, what it does, how it functions, and like anything about it at all. Hearing these questions was grinding my gears because I talk about this stuff every day with women, and I know there is a huge lack of information regarding all things pelvic floor and pelvic health related. But for some reason, being in that audience with young 20-30 year old women and hearing the questions about their pelvic floors just got me going. Let’s break down some of the common questions that I heard.
What is the pelvic floor?
The pelvic floor is a group of muscles. That’s all it is - muscles. If you sit in a butterfly position on the ground and look down at your groin, that’s exactly where the pelvic floor is located. They are muscles that run from your pubic bone to your tailbone. There are three layers of muscles that are responsible for holding up some of your most important organs: your bladder, bowel and uterus. There are three openings or holes that are in the pelvic floor: your urethra, your anus, and your vagina. Your pelvic floor is responsible for your daily activities of peeing, pooping, and sex (okay, maybe not daily). I promise I will get into much more detail about the pelvic floor as time goes on. This is just your super simple explanation of what the pelvic floor is and where it is located.
How do I know if I have pelvic floor issues?
Do you have hip pain, SI joint pain, groin pain or back pain that hasn’t resolved with traditional physical therapy or other forms of treatment?
Do you leak pee, poop or gas?
Do you have pain with sex?
Do you avoid using tampons because they hurt?
Do you avoid going to the gyne because it hurts?
Do you have constipation, painful periods, recurrent yeast infection or UTI symptoms?
If you answered YES to any of the above, there is a chance you that your pelvic floor is contributing to what you are experiencing.
What are kegels and should I be doing them?
Kegels are a pelvic floor muscle contraction - like a biceps curl but for your vagina. You can do one right now. Squeeze the muscles around your vagina like you’re picking up a blueberry. Now relax and set the blueberry back down. I do use that cue a lot… but in all seriousness - it actually is kinda hard to do a proper kegel. A large percentage of women actually push out instead of lifting up which is not ideal.
To answer the question about whether or not you should be doing kegels - it depends. I prescribe them to most of my patients but with some major caveats. Most women I see have pelvic floors that hold too much tension and just doing straight up kegels all day is not going to help and in fact might actually hurt. A tense or tight pelvic floor can contribute to any of the symptoms I mentioned above.
Imagine that instead of doing a biceps curl from a fully straight arm to a fully bent arm, you are starting at a 90 degree bend in the elbow, thus, not strengthening your muscles through the full range. This is what happens when the pelvic floor is already tight. It isn’t able to fully relax down to the resting position. Not being able to relax the pelvic floor and continually tightening the muscles with kegels can lead to more issues and more tightness rather than resolving your problems. I teach women how to do kegels and focus on the relaxing aspect of the exercise, rather than the contracting part.
So, it’s a hard question to answer. I will say if you are unsure if you should be doing them or if you are doing them correctly, please see a pelvic PT for a consult and get your pelvic floor checked out!
My vagina holds stress?
Do you have knots in your shoulders or neck and feel that you constantly hold tension there? Your pelvic floor can have the same kind of “knots” and tension. Just like you can hold tension in your neck, you can hold tension in your pelvic floor. This is the reason why the pelvic floor muscles would be tight and not necessarily in need of kegels, but rather relaxation training techniques and other techniques to release the tension in the muscles.
But wait, don’t I want my vagina to be TIGHT?
Truthfully, I have gotten this question from patients more than once and then I also heard someone ask at the event. The answer is no - a tight vagina (thus a tight pelvic floor) is not ideal. But I hear your concerns! What I say is that you don’t want your vagina to be “tight.” You want it to be controllable. You want to know how to relax it when you want it to be relaxed and contract it when you want it to be tightened.
Why don’t I know about the pelvic floor?
Honestly - I don’t know. Our society does not place value on educating young women about their bodies, their cycle, their hormones, or their sexuality. We dismiss female problems as just that… “female problems.” It is time for the conversation to change!
Want to know more about your own pelvic floor health? Connect with me! This really is my jam & I would lo
ve to work with you.
- Mar