Pelvic floor muscles, just like all other skeletal muscles can get weak and the weakness is not necessarily as a result of aging or lack of working them out, after all, walking alone is meant to strengthen the pelvic floor. If weak pelvic floor was the name of a ‘chapter’ in a book, the book would have been called, ‘pelvic floor dysfunction’ and that is something to keep in mind when looking at issues related to the pelvic floor.
Where is the Pelvic Floor?
The pelvic floor is the inner lining of the pelvic inlet. The inside of your pelvis where the intestine, bladder, uterus, and ovaries or prostate reside. The pelvic floor, however, is heavily influenced by the alignment of the lower back, lower mid-back, sacroiliac joints, and the hips which is hardly ever given any attention to when it comes to issues related to weak pelvic floor muscles.
How Does the Pelvic Floor Get Weak?
There are many reasons why the pelvic floor can get weak. It is not gender or age-specific but the more the area is exposed to injuries or traumas, the more the chances of weakness. So for women, due to pregnancy, there are higher chances of insult to the area.
Our lifestyle and habits play a huge role in the strength and weakness of the pelvic floor and are perhaps the main reason why so many people have a weak pelvic floor without realizing it. You see, traditionally people think age, pregnancy, childbirth, obesity, and smoking are the only requirements for people who have a weak pelvic floor which is a part of a much longer list.
Who Gets Pelvic Floor Weakness?
People with any of the following should be ruled out for weak pelvic floor muscles and I am confident some of these items will shock you:
- Chronic lower back pain
- Chronic sacroiliac pain
- Hip(s) pain
- Poor posture
- Hunched back
- Difficulty breathing (due to whatever reason)
- Forward head
- Pectus excavatum/carinatum
- Overweight
- Scoliosis
- Pregnancy
- Device assisted Childbirth
- Pelvic or abdominal surgeries
- Trauma to the pelvis
- Chronic abdominal pain
- Smokers
What is the common mechanism of decline in the list above that leads to pelvic floor muscle weakness? The answer is: Breathing!
Anything that interferes with the biological breathing, the breathing that all babies automatically do without being coached, is the breathing we are designed to have. That is why all babies from all over the world, despite our many differences breathe the same way. The video below explains this in detail.
When it comes to the pelvic floor, every breath reinforces its strength when done right and weakens it when done dysfunctionally. Biological breathing is not yoga breathing, power breathing, or whatever types of breathing we hear these days. It is what we authentically do thus biological.
When Pelvic Floor Exercises Don’t Work
Weakness of skeletal muscles (pelvic floor muscles are skeletal) can be due to being overworked, exhausted, and weak, or not getting a chance to work so weak. So both situations of overworked and underworked lead to weakness.
If the pelvic floor muscles are spastic, they need to be loosened and the most logical place to start is trigger point therapy and manual internal work on the inside while working on the dysfunctional movement patterns that are feeding the spasm. Unfortunately, the internal work-up and some breathing coaching (most of which I disagree with) seem to be the only non-invasive treatment for this problem and the main reason why spastic pelvic floor cases take a long time to treat and the full resolution is almost never seen.
If pelvic floor muscles are non-spastic, they need to be strengthened with Kegel exercises but when we do Kegels, it is essentially the muscles of the pelvic floor impacting the vaginal canal or the penis that are worked out.
The most effective machine that will engage the pelvic floor muscles together is the Emsella chair providing 400 Kegels per minute. There are a few conditions that this chair is not suitable.
With both spastic and non-spastic pelvic floor leading to weak pelvic floor muscles, the areas impacting the pelvic floor MUST be addressed and evaluated. These areas directly impact the pelvis and pelvic floor and include the lower back, lower mid-back, hips, and sacroiliac joints of the pelvis. To understand why read my blog that explains this in detail.
What Are the Best Pelvic Floor Exercises?
My extensive blog on the exercises to watch out for and the ones to concentrate on is my go-to blog to answer this very important question. You can subscribe to my email list to receive email notifications about blogs and Youtube videos that are put out on a weekly basis.
Generally speaking, the worst exercises are abdominal crunches and isolated exercises because your body parts and muscles do not work in isolation. It is easy to be busy doing exercises and not every busyness means effectiveness. Let’s watch this video to see why I say that.
Nutrition and Weak Pelvic Floor
You ought to give the body what it takes to repair its tissues and to keep them strong. When it comes to the pelvic floor, hardly anyone talks about nutrition, and no, taking prenatal supplements and multi-vitamins simply don’t cut it! Read my blog on this subject and watch this video to learn what food and supplements to take and which ones to avoid for your pelvic floor.
There are many things you can do about your weak pelvic floor muscles that you should start doing now; contact me if you have any questions or need help with the parts of your pelvic floor dysfunction that are beyond your abilities.
Dr. Shakib
