Pelvic Floor Exercises: Why are they important?

The pelvic floor can be considered the core of female health for a reason; it is a complex entity through which a woman gives birth and, for example, feels sexual pleasure. The muscles of the pelvic floor support our internal organs, especially the uterus and bladder, and are also connected to other muscles in the body, up to the jaw and toes. The pelvic floor muscles also keep urine in the bladder and stool in the bowel. If the function of the pelvic floor is disturbed and the muscles do not work as they should, women may experience a range of symptoms and disorders. Like the muscles responsible for the function of our lungs, the muscles of the pelvic floor are also constantly at work, and we may not pay attention to them.

However, the function of the pelvic floor has a direct connection to our overall wellness, and on the other hand, the well-being of our mind affects the function of the pelvic floor. It is therefore important to actively maintain good pelvic floor health, especially after childbirth, as our pelvic floor affects not only our physical health but also our overall emotional health.

Weak pelvic floor muscles: Symptoms and causes

The muscles of the pelvic floor are a key part of our body's functionality and well-being, but they often get little attention. However, weak pelvic floor muscles can cause many symptoms and ailments. For this reason, it is worth exercising the muscles of the pelvic floor regularly, and in some cases it is also recommended to consider pelvic floor physiotherapy, which can be of great benefit in mapping the condition of the pelvic floor and performing the right exercises.

Weak pelvic floor muscles can manifest in many different ways, and their symptoms can vary from person to person. Below are some common symptoms that weak pelvic floor muscles can cause:

Urinary incontinence

In urinary incontinence, a small amount of urine escapes involuntarily. It most commonly occurs during exertion, sneezing or coughing (stress urinary incontinence). Urinary incontinence can also occur when there is a strong urge to pee, just before going to the bathroom. The pelvic floor muscles are part of the supporting structure of the bladder and urethra, and weakness can lead to decreased urinary retention. Weak pelvic floor muscles often manifest as urinary incontinence, but gas leakage, pain or discomfort in the pelvic floor area are also common. On the other hand, tight pelvic floor muscles can also cause pain or urinary incontinence.

Recurrent urinary tract infections

Weakness of the pelvic floor muscles can increase the risk of urinary tract infections. Many women suffer from urinary tract infections and yeast infections caused by antibiotics and their cycles. Frequent urinary tract infections may increase the tension in the pelvic floor and the urethra, contributing to the reoccurring cycle of infections.

Pain and discomfort in the pelvic area

Weak muscles can cause pain in the pelvic area, back and even lower abdomen. This pain can be constant or occur especially during physical exertion. Pelvic floor pains are problems with many causes and often affect many areas of life. The pains can be very localized or occur more widely in an unspecified area. The pain sometimes flares up in certain positions or, for example, when sitting or moving. Pain can also come and go and be related to stress, diet and hydration, menstrual cycle phases or many other factors.

Pelvic floor pain can be the result of many different factors, and weak muscles can be one of them. Here are some of the most common causes of pelvic floor pain:

Muscle tension: excessive muscle tension in the pelvic floor area can cause pain and discomfort. Weak muscles may be more susceptible to tension.

• Pelvic floor muscle overuse: overloading or overexercising without adequate recovery time can lead to muscle irritation and pain.
• STDs: certain STDs can cause pelvic floor pain.
• Pelvic organ problems: pelvic floor muscle weakness can be related to problems with pelvic organs such as the uterus, bladder, or intestines, such as prolapse.
• Treatment options for pelvic floor pain: treating pelvic floor pain depends on its cause and severity. Common treatment options include physiotherapy, strengthening the muscles of the pelvic floor, e.g. with the help of kegel exercises and medical treatment such as muscle relaxants.

Learn more: Managing Back Pain after a C-Section: Tips and Relief

Problems related to sex

The pelvic floor muscles play an essential role in sexual function for both men and women. All muscles have special nerve endings within them that respond to stretch; if, however the nerve endings in the pelvic floor have been damaged, e.g. due to surgery, scar tissue or other damage, this may impact the sensation felt during intercourse. Additionally, if the pelvic floor has been weakened or if it is under constant tension, this may also impact how we feel. In short, the muscles of the pelvic floor significantly affect your own and your partner's sexual experience. By training the muscles of the pelvic floor, a woman´s vaginal sensation can be increased and her ability to achieve orgasm can be boosted. A tight pelvic floor, on the other hand, may even make intercourse difficult or painful. It's also worth keeping in mind that regaining sexual desire after childbirth is very common, and in practice it can take up to 6-12 months before sex life returns to normal.

Learn more: Postpartum Sex: How your Pelvic Floor Health affects sex life after pregnancy

What can cause pelvic floor muscle weakness?

Numerous factors can lead to pelvic floor muscle weakness. These include:

1. Pregnancy and childbirth

The birthing process is particularly demanding on the pelvic floor muscles. The effect of childbirth on these muscles can vary depending on the way of delivery and individual factors, but most postpartum women experience changes in their pelvic floor after childbirth. Pregnancy and childbirth stretch and weaken the muscles of the pelvic floor, and especially during childbirth, the muscles can be under considerable strain. Hormonal changes during pregnancy also prepare the tissues of the pelvic area for stretching. Vaginal birth often causes damage to the muscles, connective tissue and nerves of the pelvic floor, which may cause incontinence, prolapse and sometimes impact your sexual experience.

Learn more: Lola&Lykke Experts Answer: What happens to your core after pregnancy?

2. Aging

Aging of the pelvic floor muscles can lead to their weakening. Aging causes a decrease in muscle strength and mass, especially after the age of 40. Hormonal changes can also affect the health of the pelvic floor as a woman ages.

3. Overweight

Being overweight increases the strain on the pelvic floor muscles and can lead to their weakening over time.

4. Chronic constipation

Constant constipation and hard bowel movements can increase pressure on the pelvic floor area and weaken the muscles.

5. Overloading

Repeated heavy physical exertion, such as lifting heavy objects, can also weaken the pelvic floor muscles. Hard and intensive physical exercise may also cause tightness of the pelvic floor muscles, with in particular impact sports and running putting a lot of pressure on the pelvic floor.

Learn more: Lola&Lykke Experts answer: What is a Pelvic Floor Check-up, and why you need it

Pelvic floor muscle training

Pelvic floor muscle training is an important part of our well-being and has numerous health benefits, such as improving bladder control, promoting sexual health, and preventing and treating back pain. In this section, we will focus on how to start a pelvic floor muscle workout and what kind of movements are most beneficial for training the pelvic floor muscles.

The muscles of the pelvic floor must first be identified

Before you can start training the pelvic floor, you need to locate and identify the muscles of the pelvic floor. The muscles of the pelvic floor form a trampoline in the pelvic floor, which supports a large part of the entire body's weight. The longitudinal pelvic floor muscles run between the pubic bone and coccyx, and the transverse pelvic floor muscles run between the ischial bones.

The transverse pelvic floor muscles are located between the buttocks. You can recognize them, for example, by sitting flat on a hard bench, or if it feels awkward to find the bones this way, you can put your hands under your buttocks, and you will feel the bones for sure. Between these ´sitting´ bones are the transverse pelvic floor muscles. Similarly, if locating the longitudinal muscles of the pelvic floor located between the pubic bone and the coccyx seems difficult, it is worth probing the pubic bone in the middle of the lower abdomen, the lower edge, and the coccyx between the buttocks.

Follow a proper exercise technique

If you are not familiar with pelvic floor exercise or are not sure if you know how to activate the right muscles, you should start with simple activation exercises.

Do this by relaxing the muscles of your thighs, bottom and abdomen (tummy). Squeeze in the muscles around the front passage as if trying to stop the flow of urine. Squeeze in the muscles around the vagina and suck upwards inside the pelvic. Squeeze in the muscles around the back passage as if trying to stop passing wind.

You can then start doing light contractions of the pelvic floor muscles, e.g. 10 light muscle activations in a row. Remember that especially when just starting pelvic floor exercises, it is important to only do light muscle contractions.

The direction of pelvic floor muscle training is always upwards, towards the center of the body. In training, the direction of the contraction (upwards) is important, as is the fact that the uppermost muscles - buttocks, thighs, and abdominal muscles - do not get involved in the tension. For this reason, it is good to do pelvic floor muscle contraction exercises gently, at about 20-30% of the maximum power. Too much force during the contraction easily directs the exercise to the upper muscles, so the muscles of the pelvic floor do not benefit from the exercise or your pelvic floor might get too tense.

Start with basic movements

You can do pelvic floor muscle exercises while lying on your back, sitting, or standing. You can also test which position feels best to you.

1. Contract the pelvic floor muscles lightly. Imagine that you are holding a small ball inside you.
2. Hold the contraction for 10 seconds.
3. Pause between contractions for 10 seconds and think about space and relaxation in the pelvic floor.
4. Repeat the exercise 5-10 times.
5. Remember to end the exercise by relaxing the muscles of the pelvic floor.

You can also combine pelvic floor exercises with a breathing technique. Relax the pelvic floor with an inhale and start contracting the muscles with an exhale.

Maximum strength training of the pelvic floor muscles

You can do the pelvic floor maximum strength exercise while lying down, sitting or standing. Again, choose the position where the exercises feel most comfortable to you.

1. Contract the pelvic floor muscles strongly: close the anus, urethra and vagina and lift them in and up.
2. Aim for a powerful lift. Hold the contraction for 5 seconds.
3. Pause between contractions for 10 seconds, take a few slow breaths in and out, and remember to relax your muscles.
4. Repeat the exercise 5-10 times.
5. Always relax the pelvic floor muscles at the end of the exercise.

How often should you train the pelvic floor?

Pelvic floor muscle training is easy to add to your daily routine and can be of significant benefit in nurturing your well-being. In training the pelvic floor, regularity is key. You should exercise the pelvic floor 3-5 days a week, taking at least 1-2 rest days/week. Even with regular training for a month, you should already get results and notice strengthening in the pelvic floor, e.g. so that training and muscle identification is easier. However, even after a month, you should continue the pelvic floor exercises for at least another month, after which the exercises have often become somewhat automatic.

You should vary the exercises every day so that the muscles of the pelvic floor get a different exercise. For example, you can contract the pelvic floor muscles before lifting a child or shopping bag, even if the weight is light. This way, you can do many pelvic floor muscle exercises during the day, and little by little the exercises will become a normal part of everyday situations. 

Tightness of the pelvic floor muscles

Just like the rest of the body, the pelvic floor also easily accumulates tension, e.g. as a result of stress, immobility or cold in winter. Gritting your teeth at night can also tighten the pelvic floor muscles. In addition, bad posture can easily expose the pelvic floor to tension. Bad posture presses the middle body together, weakening the function of the diaphragm. Good posture, on the other hand, enables the expansion of the lungs and diaphragm in the abdominal cavity during inhalation.

The diaphragm and breathing are connected to the pelvic floor, and if the movement of the diaphragm becomes restricted, the muscles of the pelvic floor will not move with breathing in their full range of motion either. If the muscles do not get enough movement, it may in turn cause muscle tightness in the pelvic floor.

The body may also have fascia tension and, for example, tension caused by c-section, episiotomy or other scars. In addition, high-intensity exercise, where the pelvic floor is under a lot of stress, can cause tightness in the pelvic floor muscles. Such high-intensity sports include, for example, running or ball sports and jumping, where the shock is directed at the muscles of the pelvic floor with a much stronger force than, for example, in walking.

Tight pelvic floor muscle symptoms

Along with exercise, relaxing the muscles of the pelvic floor is important, because tightness of the pelvic floor muscles may cause similar symptoms (for example, urinary incontinence) as weak muscles. Overstretched pelvic floor muscles are indeed a common problem, especially for women who move a lot.

Tight pelvic floor muscles often manifest as urinary incontinence and an increased need to urinate. If you go to the toilet more often than every 3-4 hours, the reason may be a tight pelvic floor. Also, various pelvic floor pain conditions and, more broadly, pain in the pelvic area, such as the lower back and buttocks, can be symptoms caused by tight pelvic floor muscles.

How to relax the pelvic floor muscles

• Breathing exercises are the most important means of relieving tension in an overstretched pelvic floor. Diaphragm breathing exercise is one of the best because it also gives movement to the muscles of the pelvic floor. You can aim your breath towards the pelvis with mental images. With the inhale, think of space and relaxation in the pelvic floor, and with the exhale, let the pelvic floor rise with the diaphragm.
• The hip flexors are connected to the pelvic floor via muscle membranes. Therefore, exercises that open the hip flexors are also effective and may increase the elasticity of the pelvic floor.
• A bouncy ball can be of great benefit when relaxing the pelvic floor. Sit on an exercise ball and roll your hips on it casually. You can also rock your hips from side to side or forward and backward, move as you feel good.
• Calming the nervous system is crucially important for pelvic floor relaxation. Try meditation, mindfulness, and breathing exercises to relax your pelvic floor muscles.

Lean more: Pelvic Floor Massage: A Comprehensive Guide to Improve Pelvic Health

Pelvic floor muscle training equipment help to strengthen the pelvic floor

There are many aids available for training the pelvic floor muscles. The purpose of training balls is to exercise the muscles of the pelvic floor and maintain good muscle condition.

What are Bodyotics Kegel Weights?

Bodyotics Kegel weights are an innovative exercise tool specially designed to strengthen pelvic floor muscles and maintain pelvic floor health. Designed to be comfortable and safe to use, these weights offer more resistance than traditional Kegel exercises.

How do Kegel exercises help strengthen the pelvic floor muscles?

With the help of Kegel weights, you can enhance the training of the pelvic floor muscles in many ways:

1. Added resistance: Kegel weights add resistance as you contract your pelvic floor muscles, helping to strengthen them more effectively.

2. Mindful training: weights allow you to be more aware of muscle contractions and relaxations, which helps develop better muscle control.

3. Faster progress: Using Kegel weights can speed up pelvic floor muscle strengthening and improve results compared to traditional exercises.

How to start training with Kegel weights

Please note that you should always start using Kegel weights with lighter weights, gradually increasing the resistance as the muscles get stronger.

Start training slowly and focus on proper technique. After inserting the kegel weight into your vagina, contract your pelvic floor muscles for 5-10 seconds, then relax your pelvic floor. As you continue to train your pelvic floor, you can use Kegel weights regularly as part of your exercise routine. You can do exercises with weights while sitting, standing or lying down. Kegel weights are also a good tool, e.g. when doing hip lifts, breathing exercises and other gym movements.

Tips for starting safe exercises

When starting pelvic floor exercises, you should consult a professional, e.g. Lola&Lykke's maternity physiotherapists will advise you free of charge on all questions related to pelvic floor health. If you have special health problems or are unsure whether exercise is right for you, talk to your doctor or physiotherapist before starting. During exercises, always remember to listen to your body; if you feel pain or discomfort during the exercise, stop immediately and talk to a professional if necessary.

Finally

Pelvic floor muscle training is an essential part of every woman's health routine. During pregnancy and after childbirth, the importance of these muscles is emphasized, as they are put to the test and most mothers notice changes in their pelvic floor after pregnancy.

It is important to remember that every birth and every woman's body is different. Therefore, it is recommended to discuss postpartum rehabilitation with a healthcare professional for individualized guidance and care.

The musculature of the pelvic floor is a voluntary muscle, just like, for example, the biceps muscle, and its regular training keeps it strong and elastic. However, training and achieving results requires patience! As everyone who has gone to the gym to work out after a break knows, if your muscle condition is weak at first, your body might get sore due to excessive training. But after some time, the results start to come, if you keep working out persistently. The same applies to pelvic floor muscle exercise. At first it may seem that no muscle is improving and no results are produced, but often after a month you start to notice the effects.

Correct training technique is also important in this sport, which is why it is recommended to use instructions or guidance prepared by an expert. To maintain the results, active training of the pelvic floor needs be done regularly, preferably almost daily in the future.

Age has not been found to be an obstacle in the rehabilitation of the pelvic floor, as regular pelvic floor muscle training has proven to be beneficial even in the elderly. So it's never too late to start!

Exercising the pelvic floor muscles is not only about promoting physical health, but also about increasing self-esteem and well-being. Regular exercise can help women feel more confident and enjoy a better quality of life after giving birth.