What Is Your Pelvic Floor? (And How To Strengthen It)

If you're pregnant or have given birth, your pelvic floor might be the most important set of muscles you've never heard of. Here's what it is, the problems a weak pelvic floor can cause, and how to strengthen it.

Stephanie Stamas, PT, DPT, ATC, PRPC
Stephanie Stamas, PT, DPT, ATC, PRPC
Mom of a 2yo and 4yo. Doctor of Physical Therapy. Pelvic Floor Expert.
Last updated
January 26, 2023

It seems like you go your whole pre-kid life without hearing about your pelvic floor, and then bam - as soon as you're pregnant it becomes a front-and-center topic of conversation. It can be a lot to learn, so here’s a brief rundown: 

The pelvic floor is the group of muscles in the bicycle seat area of the body. The muscles form a sling that goes from your pubic bone in the front to your tailbone in the back and are considered part of the deep core. The pelvic floor muscles serve four main functions:  Sphincteric, Sexual, Supportive, and Stabilization. 

Sphincteric: The anal and urethral sphincters are part of the pelvic floor. These muscles need to relax and open up to empty the bowel or bladder and tighten to prevent any unwanted accidents.  

Sexual: During sexual arousal, the pelvic floor muscles relax and open up to allow for penetration and increase blood flow into the area. After orgasm, the pelvic floor muscles act as a suction pump. They rhythmically contract and relax to pump out the blood in the perineum so that it doesn’t pool in the area. 

Supportive: The pelvic floor muscles help to support and lift the pelvic organs that rest above them.

Stabilization: The pelvic floor is part of the deep core system that co-contracts to provide stability to the pelvis and spine. 

There are three layers to the pelvic floor and 14 muscles in total. Each muscle has a specific job but also works with the others as a whole. 

The first, most superficial layer is called the urogenital triangle. It plays a large role in sexual function and pleasure. It also includes the external anal sphincter that is responsible for bowel continence. The second layer, the urogenital diaphragm, contains the muscles that allow for bladder continence (preventing you from leaking pee). The deepest layer is the Levator Ani. These are the group of muscles that sling from the front to the back. They’re larger muscles and contribute greatly to the supportive and stabilization role of the pelvic floor.

If there is weakness in the pelvic floor, you should strengthen the muscles! Research shows that specific pelvic floor training is the best way to gain strength. Your pelvic floor may be weak if you’re experiencing: 

  1. Stress incontinence: Leaking urine when you cough, laugh or sneeze
  2. Fecal Incontinence: Leaking feces
  3. Feeling like something is falling out of your vagina (prolapse)
  4. Difficulty achieving orgasm
  5. Inability to keep a tampon in your vagina

If you have any of these symptoms, starting kegel (pelvic floor strengthening) exercises may be indicated. The surest way to know is by seeing a pelvic floor physical therapist for an evaluation.

If you want to get started strengthening, the best way to find the right muscles is by practicing stopping the flow of urine next time you’re on the toilet. Once you’ve identified how to contract the muscles, now you have to practice off the toilet.

Here’s a simple protocol:

Quick Flicks: Quick contraction, hold x 2 seconds, release. Repeat 10 times, 3 times/day.

Endurance Holds: Slow contraction, hold x 10 seconds, release. Repeat 10 times, 3 times/day.

If it’s too hard to do Kegels, vaginal weights may be a better alternative. They have been shown to be equally beneficial and may fit better into a mom’s lifestyle.

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