Fitness in Focus: The Pelvic Floor
Thank goodness we all have a built in floor, the pelvic floor. Otherwise, our bladders and rectums would be dragging around on the ground in a gruesome fashion. Like our built in abdominal walls, some floors are built stronger than others. A weak floor tends to sag. A strong floor holds up a full bladder or a 9 pound baby. How strong is your floor?
The strength of the pelvic floor is related to two primary muscles that compose a structure called the Levator Ani. The thickest muscle lies in the middle of the floor and the urethra, vagina, and rectum pass through it. This important floor muscle is called the pubococcygeus muscle. The smaller muscle which lies in the outer reaches of the pelvic floor is called the iliococeygeus muscle. Without these muscles, neither the bladder nor the rectum would remain inside the abdominal cavity for very long. And weakness of these muscles is associated with many common medical conditions.
An unfortunately common condition caused by a weak pelvic floor is incontinence. Leakage of either urine or fecal matter is no laughing matter at all. Women are especially prone to incontinence because pregnancy and childbirth wreck havoc on the integrity of the female pelvic floor by stretching out the muscles beyond no return and occasionally damaging the nerves which control the floor.
A poorly functioning pelvic floor can cause more than just incontinence and effects more than just women. Erectile dysfunction has been linked to weakness in the pelvic muscles. Those men who have had prostate surgery may also experience urinary incontinence due the fact that the pelvic floor muscles have been damaged. Another common medical condition associated with weak pelvic muscles is low back pain because these muscle work in conjunction with the abdominal wall to support the low back. With so many types of potential problems on account that the pelvic floor is weak, it is a wonder why more people are not including these muscles into the regular exercise routine.
Granted, exercising these internal muscles is not as easy as doing a biceps curl. A little more thought needs to take place in order to turn on these muscles. Many people turn to traditional Kegal exercises for pelvic floor retraining. However, most people do Kegal exercises incorrectly. Usually people erroneously use the wrong muscles or dangerously stop the flow of urine midstream. Stopping and starting the flow of urine as an exercise is not a good routine to get into because that can lead to involuntary urinary retention. You want the urine to flow out and keep flowing until it is all out. No, the practice of urinary retention is not the best way to familiarize yourself with your pelvic floor. Instead, when the bladder is completely empty, squeeze the pelvic floor muscles as if you needed to stop the flow of urine or bowel. This maneuver requires a lifting the floor towards the head, not it out pushing it out towards the floor. Do not hold your breath, bear down, or tighten the stomach, buttocks, or thighs.
Beyond these Kegal-type exercises are other exercises like the “pelvic clock”. Most importantly, the pelvic floor exercises need to be done correctly. Please consult a professional if you are not sure. A professional can use additional methods like biofeedback to help you isolate a pelvic muscle contraction. The addition of biofeedback can be an extremely helpful way to reconnect to your floor. The best pelvic floor rehabilitation professionals know this to be true and utilize biofeedback extensively to get someone on the right pathway to a stronger pelvic floor.
A strong floor is as important as a strong wall. Both offer support to one another and all the surrounding structures as well. Such a variety of medical conditions are caused by weak abdominal and pelvic muscles. More people should be targeting all of these muscles in the regular exercise routine in order to prevent future problems that could be slightly embarrassing. No one likes an embarrassing moment, so just take care of your floor and it will take care of you.
Christina Lasich, M.D., wrote about chronic pain and osteoarthritis for HealthCentral. She is physiatrist in Grass Valley, California. She specializes in pain management and spine rehabilitation.