Your pelvic floor is a collection of muscles situated within the pelvic bowl that connect the urogenital organs, hips, pelvis, lumbar spine, abdominal cavity, core musculature and diaphragm. These muscles help control bladder, bowel, sexual activity, and they facilitate childbirth by resisting the fetus as it descends causing the baby to rotate as it passes through the pelvic girdle. Your pelvic floor also helps you maintain optimal intra-abdominal pressure.  

Pelvic Floor Anatomy and Function

As active participants within the pelvic and abdominal canister, the pelvic floor muscles facilitate multiple bodily functions, including:

  • urination

  • defecation

  • sexual activities

  • birthing

  • spinal and lumbo pelvic/hip control and stability

  • breathing

Since multiple complex anatomical connections coexist and function interdependently within the pelvis, and are regulated by the same control centers in the Central Nervous System, any problem in one area can affect another. For example, women with pelvic pain or incontinence are often troubled by other coexisting issues such as low back or hip pain, and abnormal breathing patterns.

Both the diaphragm and the pelvic floor muscles contribute to stabilization of the spine, hips and pelvis during breathing, and when engaged in sexual activity or excretory function. In order for these systems to successfully co-function, sensory awareness must be in place. However, because of the anatomical location of the pelvic floor muscles, a visual representation of their function is unavailable, and we have to rely on our proprioception and interoception for sensory messaging.

Isolated Motor Blindness

Sadly, many people have a diminished awareness of the internal mechanisms of their bodies, and find it difficult to rely on their senses for information, a condition called isolated motor blindness. Contributing to motor blindness are excessive sitting that weakens the pelvic muscles, and stress, which causes the pelvic floor muscles to contract in response to anxiety.

Western toilets also contribute to isolated motor blindness of the pelvic region, because they support the body weight and reduce activation of the pelvic floor muscles. The more natural position of squatting to eliminate waste provides daily training of the pelvic floor muscles. Countries who still use old-style modes of defecation are shown to have fewer low back problems than countries who use Western toilets.

Training the Pelvic Floor Muscles

Training of the pelvic floor muscles is a beneficial addition to any fitness routine. The end goal is not to strengthen the pelvic floor muscles per se, but to cultivate an awareness of how to consciously contract and relax them.

Muscle relaxation is a neurologically active process, so attention must be paid to that initially. Pelvic floor relaxation is intimately connected to proper breathing, which improves oxygen metabolism, minimizes muscle fatigue and leads to improved performance.

People who are unable to feel their pelvic floor may benefit initially from gentle isolated strengthening, to help increase awareness of the pelvic muscles. A variety of insert-able feedback tools are available to facilitate pelvic floor strengthening.

Pelvic floor exercises activate the deep spinal stabilizers, improving muscle efficiency by not over-recruiting global stabilizers, thereby improving performance while reducing the risk of overuse injuries and low back pain.

Pelvic Strengthening for Women’s Health

Strengthening the pelvic floor is important for women suffering with incontinence use or different types of pelvic prolapse. Pelvic floor muscles are no different from other muscles in the human body, and they need to be conditioned for strenuous activities like childbirth.

Before beginning a pelvic floor strengthening program, consult with your health care provider to establish the current condition of your pelvic floor. This can be accomplished with diagnostic ultrasonography, to establish the modulus of pelvic muscle function. Unfortunately, a simple clinical examination cannot provide the same detailed results obtained from rehabilitative diagnostic ultrasound imaging (RUSI).

Incorporating Pelvic Floor Exercises into Your Workout

To incorporate pelvic floor exercises into your workout, it is important to focus on the state of pelvic floor contraction while lifting weights or performing other physical activities. This can be done by paying attention to your genitals and anal sphincters. If you find yourself squeezing them at all times, or while moving, you are most likely using too much weight, or you are not yet strong enough to safely and effectively perform that particular exercise. The same can be applied to the number of reps: If you find yourself squeezing your pelvic floor toward the end of your set, it is time to stop.

Raising awareness of your pelvic floor muscles can help you exercise more safely and effectively, improving performance and reducing your risk of injury. Paying attention to the state of relaxation of your pelvic floor during exercise provides a sort of litmus test for the overall effectiveness and safety of your exercise routine.