When it comes to building muscle in your body, you’re probably hoping for two things: greater strength and better mobility. This is just as true for your pelvic floor as it is for bicep curls or leg day. Training our muscle groups isn’t really about aesthetics, after all – it’s about boosting functionality and allowing us to thrive in our bodies. 

For women, the pelvic floor is a crucial part of core strength and overall functionality. If your torso is a soda can, your pelvic floor is the bottom of it, maintaining proper pressure and keeping everything where it belongs. When your pelvic floor is weak or out of balance, a number of symptoms can pop up! 

I treat women with pelvic floor issues all the time in my office. It’s a very common problem, and there’s no shame in it! Typically, pelvic floor dysfunction shows up in three ways: 

• Pelvic floor tension, which is caused by muscles being too tight
• Pelvic floor weakness, which is caused by a lack of muscular strength in the pelvic floor
• Poor pelvic floor coordination, which occurs when pelvic floor muscles can’t be activated in the appropriate manner or at the right time 

These can also show up in any combination of the trio above. Traditionally, all three of these problems were treated the same way, and you probably already know what it is: kegels. This was touted as the pelvic floor fix-it-all strategy, and while kegels do have their place, we now know that pelvic floor dysfunction needs a more comprehensive treatment. Full body strengthening and mobility are an important part of pelvic floor strength! But before we dig into strengthening, let’s talk about why pelvic floor weakness occurs in the first place. 

Why do pelvic floor muscles weaken? 

It’s no secret that pregnancy changes your body in countless ways. Your pelvic floor is no exception. Over the course of pregnancy, the weight of your growing uterus and growing baby cause it to stretch. Your pelvic floor actually stretches up to 3x its resting length during vaginal delivery. This is normal! 

But just like elastic or rubber bands, overly stretched muscles become weak. And even if you don’t have a vaginal delivery, your pelvic floor loses roughly 25% of its strength just during pregnancy. So yes, pelvic floor PT is needed for c-section deliveries and vaginal deliveries alike!

5 signs you have a weak pelvic floor

Wondering if your pregnancy affected your pelvic floor? Today, let’s dive into some common symptoms and diagnoses that affect many postpartum women. 

Pelvic Organ Prolapse

As the bottom of your body’s “soda can,” pelvic floor muscles are designed to physically support the weight of the pelvic organs. When the muscles and ligaments in your pelvic floor loosen or weaken, your organs may shift from their original positions, causing pelvic organ prolapse (POP). 

I’ve written about this condition in detail on the blog, but here’s a quick list of symptoms you may be experiencing with POP: 

• Pressure, fullness, or discomfort in your pelvis
• Seeing or feeling a bulge in your vagina
• Urinary incontinence or bowel dysfunction
• Finding it difficult or impossible to insert tampons
• Pain and pressure during sex

Not every woman with POP will experience every symptom, and these symptoms may show up gradually rather than suddenly! It’s also true that pregnancy isn’t the only cause of POP. Around 40% of all women ages 45-85 years have evidence of POP, and many of them never develop symptoms. But if you are experiencing any of the above, it’s probably time to seek treatment.

Fecal Incontinence

This condition is lesser known – and definitely less discussed – than its counterpart, urinary incontinence. But it’s a symptom that affects a number of women, so I think it’s important to talk about it! Let’s destigmatize it, so that we can help women find relief. 

Fecal incontinence usually occurs in women who have suffered a third or fourth degree perineal tear during delivery. These degrees of tearing affect the pelvic floor muscles that assist in bowel control. If your PF muscles have been damaged or weakened by tearing during labor, they have a hard time holding back bowel movements or passing gas. 

If you’re experiencing this symptom, there’s no need to be embarrassed. A pelvic floor PT can help you recover and heal, helping you regain bowel function through physical therapy and lifestyle changes.

Urinary Incontinence

This may be the most commonly known symptom of pelvic floor dysfunction. It affects so many women, sometimes because of pregnancy and postpartum, and other times simply because of weakness that occurs as we age. 

Your pelvic floor muscles support both bowel and bladder function. They wrap around your urethra, which helps them assist in preventing flow of urine when they’re contracted and allowing you to pass urine when they relax. When these muscles are weaker, you may notice that you’re unable to control leakage. This happens most often alongside increased abdominal pressure, which happens with: 

• Jumping
• Laughing
• Sneezing
• Coughing
• Running

Pelvic floor PTs treat urinary incontinence all the time – truly. Make an appointment with one in your area to begin regaining strength.

Urinary Urgency

Have you ever noticed yourself needing to pee and finding that you simply cannot hold it until you put your groceries away or finish folding the laundry? It’s typical to urinate 5-8x per day for healthy, hydrated people. But often, women find themselves needing to urinate once per hour, if not more. 

Urinary urgency is caused by pelvic floor dysfunction, but the culprit could be one of two causes. Overactive pelvic floor muscles and weak ones both cause this! An individualized exam will tell your provider which one is causing your urgency, and they can treat you appropriately once they’ve determined the root cause.

Vaginal Flatulence

Colloquially known as “queefing,” vaginal flatulence happens when weak pelvic floor muscles allow air to get trapped within the vaginal canal. Once the air is trapped, the muscles also have a hard time preventing it from exiting – often at the most inopportune moments. I know this can feel super embarrassing, but it’s common, and it does not have to be the new normal for the rest of your life.

How to strengthen your pelvic floor

If you’ve recently given birth, know that your pelvic floor has stretched to accommodate your baby, and that’s a good thing. As you move through postpartum, there’s plenty you can do to restore strength and function. My course, Movement through Early Postpartum, offers education on all of these topics, and provides postpartum safe moments to help you build strength in your pelvic floor and restore proper mobility over time. 

Working on pelvic floor weakness is not about doing as many kegels as you can. Instead, it should be about coordinating your pelvic floor muscles while you perform functional full body movements such as lunges and squats. The body does not work in isolation! 
My course is a great place to start, but if you’re experiencing any of the 5 symptoms above, I always recommend an in-person, individualized exam by a pelvic floor PT. You can experience full functionality even after pregnancy, so don’t lose hope. Find a provider close to you to reclaim your strength and mobility!

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