You can watch for symptoms of a weak pelvic floor or use two different tests to determine the strength of these muscles.
Image Credit: LaylaBird/E+/GettyImages Like any other muscle in your body, your pelvic floor can be strong or weak. But unlike other muscles, it can be hard to gauge its strength. After all, you can’t lift a dumbbell with your pelvic floor, so how can you know it’s in good shape?
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Here, Carolyn Wright, PT, DPT, a pelvic health physical therapist at Bespoke Treatments, shares tips on how to test — and build — strength in your pelvic floor.
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What Is the Pelvic Floor?
Before we can talk about the strength of your pelvic floor, let’s define what exactly it is: muscles and tissues arranged like a sling across your pelvis, per the U.S. National Library of Medicine (NLM).
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The pelvic floor has five main purposes, per Wright:
Sphincteric: The pelvic floor muscles contract to prevent leaking urine and feces and relax in order to eliminate them. Support: These muscles act as a basket to support the pelvic organs, including the bladder, rectum and uterus. Stability: They help stabilize your pelvis and hips. Sexual: They help you achieve arousal and orgasm. Relaxing the pelvic floor is essential to allow for penetration for people assigned female at birth (AFAB). For people assigned male at birth (AMAB), the pelvic floor plays a role in getting an erection as well as ejaculating, according to the Cleveland Clinic. Sump-pump: The muscles of the pelvic floor move blood and lymph through the pelvis and toward the heart.
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How Do You Know if You Have a Strong or Weak Pelvic Floor?
When your pelvic floor muscles aren’t up to snuff, they won’t be able to perform the essential functions above, such as holding in urine. As a result, you’ll likely feel as if something’s amiss. Weak pelvic floor muscles can also lead to pelvic organ prolapse, which is when “pelvic organs drop or press into or out of the vagina,” per the Office on Women’s Health (OASH). You may be able to see or feel this, according to OASH. It can also cause difficulty inserting a tampon.
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The best way to know if you have a strong or weak pelvic floor is to measure the strength of the muscles (more on that in just a moment).
What Exercises Weaken the Pelvic Floor? Many things can lead to a weakened pelvic floor, from aging to overuse to pregnancy.
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Certain exercises put stress on pelvic floor muscles and can cause your pelvic floor to weaken, per the Cleveland Clinic. That includes contact sports, heavy weight lifting and exercises the Cleveland Clinic describes as jarring, such as running and jumping.
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What Does It Feel Like When Your Pelvic Floor Is Weak? Common Signs
A weakened pelvic floor can lead to symptoms around going to the bathroom, as well as during sex. Symptoms of a Weak Pelvic Floor Here are some common symptoms of a weak pelvic floor, per Wright:
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Accidentally leaking urine when you exercise, cough, sneeze or laugh Having a strong urgency to urinate and not making it to the bathroom in time Needing to urinate frequently (8+ times/day and/or more than once overnight) A feeling of heaviness, drooping, bulging or discomfort in the vagina or rectum Pain in the pelvic area and/or discomfort during sexual intercourse
How Do You Test Pelvic Muscle Strength? “Pelvic floor muscle strength is most accurately assessed with an internal vaginal examination conducted by a licensed physical therapist who specializes in pelvic health,” Wright says.
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However, there are two tests you can do at home to glean a general idea of your pelvic floor's muscle power.
- Internal Vaginal Self-Assessment
Lie on your back with knees bent and one or two pillows supporting your head. Alternatively, you can lie on your side with a pillow between your knees for comfort. Insert one clean index finger (with lubricant if you prefer) into the vaginal canal to the base of the middle knuckle. Contract your pelvic floor (think about “stopping the flow of urine”).
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"A strong pelvic floor contraction will have a squeeze and an upward 'lift' where you feel some amount of tension when you try to remove your finger from the vagina," Wright says. "The ability to hold the lift for 10 seconds demonstrates good pelvic floor muscular endurance," she adds.
- External Self-Assessment
Lie on your back with knees bent and one or two pillows supporting your head. Alternatively, you can lie on your side with a pillow between your knees for comfort. Place your four fingers over your perineum (the area between the vaginal canal and the rectum). Contract your pelvic floor as if you are stopping the flow of urine.
If your pelvic floor muscles are strong, “you should feel the area under your fingers lift and pull upward,” Wright says. Also, “there should be no additional pressure toward your fingers if you are contracting correctly,” she adds. How to Strengthen Your Pelvic Floor If you think your pelvic floor may be weak, Wright recommends trying one of the following pelvic floor-strengthening exercises:
- Kegels
Start by lying on your back in a comfortable position. Lift your pelvic floor as if you are stopping the flow of urine. Start by contracting for 2 seconds and relaxing for 2 seconds. Aim for 3 sets of 10 to 15 repetitions and increase duration to 10-second holds. If you find yourself fatiguing, try performing less repetitions, or perform each set at different times of the day, i.e. morning, afternoon and evening. As this exercise gets easier, perform while sitting or standing.
- Adductor Ball Squeeze
Lie on your back or side or sit in a chair with your feet on the floor and knees bent to 90 degrees. Place a soccer ball, yoga block or thick pillow between the knees. Squeeze the ball using your inner thighs (adductors) and think about contracting your pelvic floor simultaneously. Hold for 3 to 5 seconds. Aim for 3 sets of 10 to 15 repetitions.
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3. Bridge With Adductor Ball Squeeze
Lie on the floor with your knees bent, feet flat on the floor and palms facing down. Place a soccer ball, yoga block or thick pillow between the knees. Squeeze the ball/yoga block between your knees. Contract your glutes and pelvic floor as you raise your hips off the ground. Your upper back and shoulders should stay resting on the ground and your knees, hips and shoulders should ideally form one straight line. Aim for 2 to 3 sets of 10 to 15 repetitions.
Note: While Kegels get mentioned frequently in any conversation about pelvic muscles, they’re not the only strategy — take a look at more daily pelvic floor health tips from experts. How Long Does It Take to Strengthen Pelvic Floor Muscles? Within weeks or months, you can expect to see results from Kegel exercises, per the Mayo Clinic. Along with the exercises above, you can try this workout for your pelvic floor and glutes — or, go with this workout for your pelvic floor and abs. But consistency is key for results: Aim to do Kegel exercises two to three times each day, according to Memorial Sloan Kettering Cancer Center. When Should You See a Pelvic Health Physical Therapist? While home exercises can be helpful, they’re also notoriously easy to mess up. Many people mistakenly squeeze the wrong muscles — like their abs or glutes — instead of their pelvic floor. That’s why if you suspect your pelvic floor is weak, it’s best to see a pelvic health specialist who can make sure you’re performing the exercises correctly. “Pelvic health physical therapists have advanced training in treating conditions such as incontinence, pelvic organ prolapse, pregnancy/postpartum exercise, pregnancy-related pain, diastasis rectus abdominis, painful intercourse and pelvic pain conditions,” Wright says. As specialists, they can properly assess your issue and develop an individualized treatment plan. “Additionally, if you’ve had only partial success with physical therapy for other conditions, such as chronic low back pain, hip pain, hip adductor/hamstring strain or coccydynia,” it’s quite possible that a weak pelvic floor may be — in part — to blame, Wright says. In this case, once again, consulting with a pelvic health physical therapist might be a good idea. Tip Need help locating a pelvic floor specialist? Resources like PelvicRehab.com and the Academy of Pelvic Health Physical Therapy can help you find a qualified pelvic health therapist in your area.
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references
U.S. National Library of Medicine: "Pelvic Floor Disorders"
Cleveland Clinic: "Pelvic Floor Muscles"
Cleveland Clinic: "Kegel Exercises (Pelvic Floor Exercises)"
Mayo Clinic: "Kegel exercises: A how-to guide for women"
Memorial Sloan Kettering Cancer Center: "Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health"
Office on Women's Health: "Pelvic organ prolapse"
Is this an emergency?
If you are experiencing serious medical symptoms, please see the
National Library of Medicine’s list
of signs you need emergency medical attention or call 911.
references
U.S. National Library of Medicine: "Pelvic Floor Disorders"
Cleveland Clinic: "Pelvic Floor Muscles"
Cleveland Clinic: "Kegel Exercises (Pelvic Floor Exercises)"
Mayo Clinic: "Kegel exercises: A how-to guide for women"
Memorial Sloan Kettering Cancer Center: "Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health"
Office on Women's Health: "Pelvic organ prolapse"
Is this an emergency? If you are experiencing serious medical symptoms, please see the National Library of Medicine’s list of signs you need emergency medical attention or call 911.
You can watch for symptoms of a weak pelvic floor or use two different tests to determine the strength of these muscles.
Image Credit: LaylaBird/E+/GettyImages
Image Credit: LaylaBird/E+/GettyImages
Need help locating a pelvic floor specialist? Resources like PelvicRehab.com and the Academy of Pelvic Health Physical Therapy can help you find a qualified pelvic health therapist in your area.
U.S. National Library of Medicine: "Pelvic Floor Disorders"
Cleveland Clinic: "Pelvic Floor Muscles"
Cleveland Clinic: "Kegel Exercises (Pelvic Floor Exercises)"
Mayo Clinic: "Kegel exercises: A how-to guide for women"
Memorial Sloan Kettering Cancer Center: "Pelvic Floor Muscle (Kegel) Exercises for Women to Improve Sexual Health"
Office on Women's Health: "Pelvic organ prolapse"
