Ep.8: Pelvic Floor 101

Welcome back to the woven well podcast! Today we’re gonna talk a little about the pelvic floor. 

As you know, I’m a certified fertility care practitioner, and this topic can come up a lot - but I’ve found that a lot of ladies don’t actually know what the pelvic floor is! And I can’t blame them. It wasn’t that many years ago that I learned myself, and I feel like I’m constantly learning something new about it every time I talk with my physical therapy friends. So today, we’re going to introduce the pelvic floor, what it does for us, and what to do when it’s not working well. 

But to help us get started in envisioning the pelvic floor, let’s first take a break and imagine you’re approaching a hammock on the beach. it’s a warm summer day, you can feel the sun, and hear the waves, and feel the sand between your toes, and you’ve got your eye on that hammock stretched between two, great tropical trees. (This is actually pretty nice to think about. It’s still winter and cold right now.) 

But we’ve got a purpose here!  Now that you’ve got that hammock, held securely between two trees in your mind, let’s use that same image to imagine what our pelvic floor looks like. There’s no sand and no sun, but there is a hammock of muscles, supported by two strong bones - the tailbone and pubic bone. 

Those bones allow these muscles to gently support your bladder, vagina, and bowels especially. This shared system of muscles also means that they may influence the others a bit. This is why when you have a bowel movement, you may also see a cervical mucus observation afterward, for instance. 

But your pelvic floor supports other important areas of the body, as well. It’s also a big player in the support of your spine and your core! In fact, if you picture your “core” (you’ve heard about those if you’ve ever been to a yoga or pilates class!) If you picture those core muscles as a box - the diaphragm is the top of the box, and the pelvic floor is the bottom. So, your pelvic floor supports your entire core and helps to stabilize and support your spine. So it’s actively helping with the force used when you pick something up or if need to strain those muscles, like when you’re exercising. So - it’s no great surprise that the pelvic floor really is important! 

This may be old news to you, or it could be brand new. Like I said, it wasn’t that long ago that I started learning more about the pelvic floor, and I know that when I mention it to clients, it can sometimes be a new idea. 

So we have it down in theory, but it’s helpful to know how to identify these muscles on your own body. I think that the easiest way to do this is to stop your stream of urine the next time you go to the bathroom. Make sure it’s a setting where you’re able to sit on the toilet, not squat over it or anything, too. But after you’ve started to urinate, gently contract those muscles until the stream of urine stops. You don’t need to do this multiple times or to hold it for a long time - just a second or two of holding will help you identify the muscles we’re referring to and then you can relax again and let your bladder empty naturally. 

You could also choose to briefly tighten the muscles around the vagina - like if you were trying to push a tampon up into your body. Or you could gently tighten the muscles around your anus like you were trying to hold in gas. 

All of these muscles are a part of your body’s pelvic floor- and just knowing what they are and where they are is a great first step. 

Now, as to how these muscles help you on a daily basis - they allow you to use the bathroom easily and fully, have comfortable intercourse, lift weights and exercise, have a stable back and spine, support a pregnancy, and more. 

But guess what - life happens. And things in life can take a toll on these muscles, just like the other muscles in your body. 

If you don’t keep them strong, they’ll get weak and lose some of their function. This could look like leaking urine, having to constantly go to the bathroom, never feeling like you’re able to empty your bladder, or difficulty holding in gas. 

A significant life event that can take a toll on the pelvic floor muscles? Carrying a pregnancy and delivering a baby. This one may be the most commonly known scenario. I do think it’s being talked about more commonly after delivery. But you also don’t have to have had a baby in order to have issues!

There are many women, for instance, whose pelvic floor muscles are actually too tight - which leads to significant pelvic pain, with intercourse, or any pelvic activity. Sometimes it’s so intense that inserting a tampon or having a pelvic exam feel impossible.  

And really common things can affect your pelvic floor like exercising incorrectly, carrying your body differently after an injury, or even living with a chronic cough or sneeze. If you’re having any symptoms, don’t count yourself out. Pelvic floor therapy may be a really helpful resource. 

So how do you know if your pelvic floor needs a little support? Obviously If you’re struggling with any of the things we’ve mentioned so far but I know it can be helpful to hear them all in one place - so, if you’re: 

• experiencing pelvic pain including when attempting to insert a tampon or have a pelvic exam

• having pain with intercourse

• feeling a bulge or discomfort/heaviness when using the bathroom

• accidentally peeing a little when you cough, laugh, exercise, sneeze etc.

• not being able to make it to the bathroom in time

• or feeling like you constantly have to go to the bathroom

  then it’s a great idea to see a pelvic floor specialist!

I’m talking to you, too, ladies who delivered babies - whether it was last year or 30 years ago. This is not just “your new reality” that you’re stuck with. I’ve heard so many little jokes like that from older women. I’ve seen those depends commercials where they suggest that this is just a part of being a woman. Well - no, it’s not. There’s likely something that can be done - and that’s what we’re interested in. Getting these available resources into the hands of women. 

A pelvic floor specialist is actually a physical therapist who has advanced certification in pelvic floor rehabilitation. They can walk you through exactly what your pelvic floor issue is and then guide you through individualized pelvic floor exercises and a treatment plan to help correct the issue. 

I want to specifically mention that while there are lost of exercises available online and on Instagram, it’s really important that you work with a physical therapist that can assess your issues and give you a very specific plan for rehabilitation. Doing pelvic floor exercises incorrectly or doing the wrong pelvic floor exercises for your issue can actually be pretty bad for you and could make things worse - and we don’t want that. 

So find a local physical therapist in your area that specializes in this. And feel free to interview them! Ask them about their training and experience - ask for their certifications. Ask if they’ve had patients with your specific issue in the past. And make sure it’s someone you feel really comfortable with, because they will often want to do a gentle pelvic exam. 

Now, if you’re someone who has had this done before and you feel like you left with the same issues you began with - I highly recommend finding another pelvic floor specialist! They are not all the same - just like with obgyns, and fertility care practitioners, and nail technicians, and tax professionals. If you have a bad experience with one, it doesn’t mean all the others are the same way. 

I hope this has been a helpful Pelvic Floor 101, if you will. I realize there’s so much more we could dive into, and I hope to as we keep talking about more and more issues! But I’m excited to continue today’s episode next week when we’ll actually talk with a physical therapist who specializes in pelvic floor rehabilitation. It’s gonna be great. 

You’ll hear all about what to look for with pelvic floor issues, whether pelvic floor therapy could be right for you, and what to expect in your first appointment/how to get ready for it! So join us next week as we interview Dr. Rachel Moran. 

And, thank you so much for listening. If you’re enjoying the content here, it’d mean so much if you’d take a moment to write a review of the podcast on your podcast platform of choice. Turns out, that’s how they decide who gets suggested to other friends who may be interested. I’d love for more women to have access to this information. 
Thanks so much for joining today as we continue to explore together what it means to be woven well.