Pelvic floor muscles provide support for the bladder, bowel and uterus, and play a crucial role in sexual function. This Women’s Health with Evolve column expands on their importance and how to optimise their effectiveness
The pelvic floor muscles, which are located at the base of the pelvis and offer support to the core while assisting with proper functioning of the bladder, bowel and uterus, have been receiving increasing attention over the past decade—and rightly so. Pelvic floor dysfunction impacts as many as one in three women at some point in their lives and there is a growing understanding that early intervention is key to prevention of any problems or improving of symptoms. However, the topic of the pelvic floor remains shrouded in mystery, confusion and taboo—what is it and what do we need to know?
What is the pelvic floor and why should we care about it?
The pelvic floor muscles are one of few muscle groups that are consistently ignored in workouts, rarely discussed in athletic communities and considered a "specific topic" to be addressed only by specialists working in that field. Many women (and men) don't know what the muscles are or how they work. Fewer than 50 percent of women effectively engage their pelvic floor according to research, yet in life stages such as pregnancy and menopause up to 59 percent of women experience symptoms relating to pelvic floor dysfunction. Likewise, in the athletic female population up to 80 percent of women who have never had children report pelvic floor symptoms of varying levels during activity dependent on the type and intensity of sport.
Dysfunction of the pelvic floor can contribute to symptoms such as sexual pain, lumbopelvic pain, incontinence (of urine, faeces or wind), voiding difficulties (incomplete emptying or constipation), pelvic organ prolapse and altered sexual satisfaction. While symptoms can have a significant impact on quality of life, pelvic floor physiotherapy has been shown to be effective in many cases.
Are Kegel exercises enough?
As the increase in awareness of the importance of the pelvic floor grows, so too does the "one rule fits all" idea that doing daily Kegels (squeezing and lifting the pelvic floor) will solve all. Unfortunately, given so many people incorrectly engage and effectively relax these muscles, the idea that Kegels alone is the answer is misplaced.
Optimising the pelvic floor requires more than Kegels. There are two layers of muscles with different functions, and the pelvic floor is made up of both fast and slow twitch fibres, which means that to improve the function of the muscles, you need to tone both, training for both endurance and speed. Looking after the pelvic floor muscles also depends on how they are engaged in day to day activities, with our individual medical backgrounds, activity levels and anatomy placing different demands on our pelvic floors.