How to Build a Better Pelvic Floor

What’s the most important strengthening exercise for women over 50? The squat? The dead-lift? Hip strengthening? These are all great exercises for functional strength, but I would argue that exercises of equal importance (and ones that can be done concurrently with other activities) are the ones that nobody will ever see you doing – pelvic floor strengthening.

The pelvic floor is an extremely important group of muscles that acts like a sling or hammock to support the uterus, bladder, and bowel. The pelvic floor muscles also have an important role in controlling bladder and bowel functions and are a key player in pleasure during sex.

Painful sex is one of the biggest complaints of peri and post-menopausal women. In some studies, almost 60% of post-menopausal women reported pain during sex. Although the pain is typically attributed to lowering levels of estrogen, it can also be related to changes in pelvic floor function.

Researchers believe that painful sex for many older women may be the result of overactive pelvic floor muscles.[1] If you find sex painful and have not had any relief with other methods (e.g., vaginal estrogen), I would recommend that you see a specialist pelvic-floor physiotherapist. 

Why focus on the pelvic floor?

Strengthening the pelvic floor is a good idea for almost all women, but especially for those over the age of 50. A strong pelvic floor not only helps with better bladder control and sexual function, it can also make any strength-training exercises that you are doing more targeted and effective overall.

I have spent the better part of the past year nursing a chronic pain condition from a hip injury. I have tried many different treatment modalities with little success until I was referred to a female physiotherapist who uses pelvic floor training to get to the route of the problem. I am finally seeing some improvement in my symptoms and have come to realize just how important these tiny exercises are for all of us.

Just like any other muscles in our body (stand up flappy triceps), the pelvic floor can lose mass and become weaker over time. For example, women over 60 have been found to have thinner pelvic floor muscles when compared with younger women. If you’ve had children, done a lot of high impact activity, lifted heavy objects on a regular basis, or been through menopause, your pelvic floor is likely weaker then it once was.

Traditionally pelvic floor exercises were used only as rehab treatment or for those who had recently had a baby. These days, practioners are promoting the idea that a strong pelvic floor is extremely important for core stability and for an overall strong foundation. Even if you have no issues related to injury, strengthening your pelvic floor can improve the effectiveness of other lower body exercises that you may be already be doing (including those for balance).

How do I find my pelvic floor?

One method that many people use to locate their pelvic floor is by stopping the flow of urine mid-stream when on the toilet. That tightening sensation that allows you to stop the flow is the tightening of your pelvic floor. A note of caution: this exercise should only be used to identify the pelvic floor muscles and shouldn’t be used for pelvic floor exercise practice; practicing the urine-stopping technique too often can lead to problems with properly emptying your bladder.

Once you have identified where the pelvic floor muscles are, you’re ready to start exercising them. Here’s what you need to know:

Things to know about pelvic floor exercises

1. Start by lying down: Sometimes it’s easier to do pelvic floor exercises lying down. This is just to begin – honestly, you’ll be doing pelvic floor work with a drink in your hand in no time. 

2. Don’t hold your breath: Also, make sure that you don’t tighten your bum, stomach, or upper leg muscles while you are doing the exercises.

3. Repeat: Try engaging (squeeze the muscles and suck them upwards inside the pelvis) and then relaxing your pelvic floor muscle about 10 times in a row. A helpful visual for relaxing the pelvic floor is to think about releasing the area downwards as you are taking in a deep breath. After you have practiced for a while, you can try holding the squeeze for a few seconds.

4. Try to not tense your upper body while doing the exercises: Having a tense chest and shoulder region can negatively impact pelvic floor engagement.

5. Make pelvic floor exercises habitual: The best way to form an exercise habit is by connecting the exercise to an existing trigger. Pick an activity that is part of your routine and match it with your pelvic floor practice. This could be something like brushing your teeth, making your morning coffee or tea, or doing the exercises every time you wait at a stoplight in your car.

6. Be patient: You won’t necessarily experience noticeable results immediately. For changes in bladder function for example, some estimates are that improvements occur over the course of weeks. 

7. See a physio if necessary: If you find that you are unable to locate these muscles after trying a few times, you might want to visit a physiotherapist for additional assistance.

Pelvic floor exercises are small but mighty. If you are over 50, you will definitely want to add them into your routine.

Your sister in health,