How to Tell If You Need Pelvic Floor Therapy

Hiya Gorgeous!

I have something really special to share with you today! My incredible colleague and friend, Ashley, recently told me about her experience with pelvic floor therapy after the birth of her (adorable) baby. Our conversation was a wakeup call for me. For one, it was a reminder that pelvic floor health is something I haven’t paid enough attention to in my own life—not because I don’t care, but because I’ve been focused on other areas of my health.

My chat with Ashley also made me realize that we haven’t covered this topic here on kriscarr.com. Well, today’s the day!

I know so many folks facing pelvic floor issues who feel like they’ve run out of options. And it’s not just in my circle—over 30 million women in the US alone deal with pain during sex or exercise, incontinence and other symptoms associated with pelvic floor dysfunction. But surprisingly, many OBGYNs and other health professionals aren’t well-trained in this area.

As a result, pelvic floor issues often go undiagnosed or untreated, or docs recommend pills or painful surgeries without offering any alternatives. And prevention? Well… when was the last time your doctor talked to you about your pelvic floor?

If you (or someone you know) are experiencing pelvic floor issues, here’s the truth: You are NOT out of options. You make the decisions about your health and you CAN heal. This topic tends to be hush hush, but it’s time to break the stigma because your health—all of it—matters.

So today I’m covering the basics. We’ll talk about what your pelvic floor is, what it does and what kinds of issues can come up. Then I’ll share some resources about pelvic floor therapy and bust a few myths about Kegel exercises.

Welcome to pelvic floor 101, toots—class is officially in session!

What is your pelvic floor?

Your pelvic floor is a group of muscles and tissues located at the base of your pelvic area. Both males and females have pelvic floor muscles, but we’ll focus on the female side of things today. This superstar group of muscles acts like a sling to support organs such as your bladder and bowels. It plays a big role in continence (the ability to control bowel and bladder movements) and sexual function.

What is pelvic floor dysfunction?

While researching this topic, I learned that there are a few types of pelvic floor issues—and the words disorder and dysfunction can actually mean different things in this context (though some resources use the terms interchangeably—confusing, I know). Let’s go over each one and the associated symptoms so you know what to look out for.

Pelvic floor dysfunction is a condition that causes pelvic floor muscles to contract when they should relax. While there’s still a lot to learn about what causes it, pelvic floor dysfunction has been associated with childbirth, traumatic injury to the pelvic area and damage to the pudendal nerve (source). Folks with this condition may experience constipation, painful intercourse or urination, urinary incontinence and lower back pain, among other symptoms (source).

Pelvic floor disorders occur when the pelvic muscles become weak or damaged. This can happen as a result of childbirth, but not just to those who deliver vaginally. That’s a common misconception, so it’s important to understand that people who give birth via C-section can experience it too (source). Genetics, long-term pressure on the abdomen (from chronic coughing or carrying extra weight, for example), pelvic surgery and radiation treatments are among the other causes of pelvic floor disorders (source).

There are three types of pelvic floor disorders…

Fecal incontinence

Fecal incontinence is the inability to control the bowels. Someone experiencing fecal incontinence may have trouble making it to the bathroom in time. While the chance of having this issue increases as we age, it’s not exclusive to older peeps—it affects over 5.5 million Americans of all ages and sexes.

Obstructive defecation

This pelvic floor disorder means it’s hard to pass poop (ouch!). Those experiencing obstructive defecation might have to strain a lot to complete a successful bowel movement or have trouble going even if they feel the urge.

Pelvic organ prolapse

Think of your pelvic floor like a hammock for your pelvic organs (I like to imagine mine swaying in the breeze!). When the muscles and tissues that make up the hammock become weak or loose, they can’t support those organs as effectively—just as a traditional hammock can’t support us well when the rope that holds it together weakens. This can cause the organs to drop or press into/out of the vagina, aka pelvic organ prolapse.

Females with pelvic organ prolapse may feel or even see a bulge coming out of their vagina. Other symptoms include leaking urine (ever pee a little when you laugh or sneeze?), as well as pelvic pressure, pain and other discomfort that tends to get worse during sex, physical activity or just over the course of the day (source).

What are the options for pelvic floor therapy?

Now that we’ve covered the types of pelvic floor dysfunction/disorders, let’s talk about solutions. Let me be crystal clear: Pelvic floor issues are NOT just a normal part of aging that we have to accept! They’re treatable and we have plenty of non-surgical routes to choose from. Don’t listen to the messages that say otherwise—they’re disempowering and just not true. I’ve heard and read countless success stories from folks who’ve tried pelvic floor therapy and found relief.

The following is not an exhaustive list, but it will give you an idea of some of the options available to you. Please note that I’m not including surgical or pharmacological treatments here, but that doesn’t mean you shouldn’t explore them with your doctor. All approaches have value (unless they cause harm, of course!) and the best treatment path is one that’s unique to you.

Biofeedback

During a biofeedback session, the person receiving treatment is hooked up to electrical sensors that read electrical impulses in the body and display them in a way that can be seen or heard. This can give us valuable information about bodily functions that we can’t easily feel or control. In the case of pelvic floor therapy, biofeedback can help us better understand pelvic muscles and how to properly exercise them (source).

Based on what I read, more research needs to be done to determine biofeedback’s place in pelvic floor therapy (one meta-analysis indicated that many existing studies aren’t totally reliable). The thing to keep in mind is that biofeedback is a training tool that supports other therapies, not so much a treatment in and of itself. If you’re curious, chat with an expert (look for someone certified by the Biofeedback Certification Institute of America) to see if it could be for you!

Physical therapy

Physical therapy for the pelvic floor can mean a lot of things—it really depends on the therapist you work with. It can involve some of the other therapies I’m covering today, as well as internal and external manipulation/massage of the pelvic area. This can be especially helpful for people dealing with pelvic floor dysfunction because it relaxes the muscles.

Pelvic floor physical therapy is a specialization within the broader field, so if you’re interested in trying it out, look for someone with one of these certifications from the American Physical Therapy Association: The Certificate of Achievement in Pelvic Physical Therapy (CAPP) or The Women’s Health Clinical Specialist (WCS). This site has a lot of helpful info and includes links for finding a certified practitioner in your area.

Yoga

Since many yoga poses engage your core, practicing can help strengthen muscles in and around the pelvic area. Check out this guided practice if you want to try it out. Or, talk to a trusted teacher at your studio if yoga is already part of your routine. Also, here are some helpful tips from Yoga Journal to keep in mind.

Kegel exercises

You may have heard of Kegels or even tried them yourself. People often try them and get discouraged because they don’t see results. There’s also a lot of confusing info about whether they really work. But it’s time to set the record straight: Kegels can be an incredibly powerful form of pelvic floor therapy—the key is to use the proper technique and a variety of exercises.

If you thought Kegels were just about repeatedly clenching and relaxing your pelvic muscles, you’re in for a surprise! There are actually THIRTEEN different types of Kegels (fun fact: reverse Kegels are a thing!). Think about it—when we exercise, we don’t just target one muscle with a single repeated motion because that wouldn’t help us build overall strength, balance and flexibility. The same goes for Kegels.

It’s also essential to tailor your Kegel exercises to your body and unique needs. I know that many folks in this community are curious about Kegels and want to learn more, which brings me to my next point…

You are the CEO of your health

One of the most important lessons I’ve learned from my health journey is that it’s up to us to be the CEOs of our own health. I hope this article helps you step into that power and take impeccable care of every facet of your well-being.

Please share this with someone who might benefit from reading it. Spreading the word about pelvic floor health will help break down the stigma and bring solutions to more people who need them. And, as always, I encourage you to supplement this info with your own research and advice from experts.

Your turn: Let’s TALK about our health challenges, whatever they are. Share with a doctor, close friend or trusted community—whoever you’re comfortable with. Don’t stuff it down or go it alone, because that could prevent you from getting the help you need. I want to support you and I have a feeling lots of others do too. Drop a ? in the comments below or say “I’m in” to let me know you’re with me!