The awareness of pelvic floor health in men has slightly increased in the last year, but not enough. The pelvic floor is a group of muscles that supports the bladder, bowel, sexual organs, and lower intestines. Unlike what you may think, it is not a free-standing structure. A weak pelvic floor can lead to a variety of problems such as:
- Urinary incontinence
- Difficulty with bowel movements
- Sexual dysfunction
- Lower back pain
- Hip pain and
- Pelvic pain
While there are many factors that can contribute to a weak pelvic floor, lower back, hip, and pelvis issues are common causes that are typically not addressed when it comes to the treatment of pelvic floor dysfunction. In this blog, I will be talking about the signs of a weak pelvic floor and the role that posture and lifestyle choices play in contributing to pelvic floor weakness.
How Do I Know If I Have Weak Pelvic Floor Muscles?
There are many signs and symptoms of pelvic floor dysfunction which are explained in detail in the blog: “Pelvic Floor Dysfunction Symptoms‘. There are many reasons why the pelvic floor can get weak. Aside from medical reasons such as surgery/trauma, common factors such as dysfunctional breathing and movement are often overlooked in the medical field.
Incontinence
One way to determine if you have a weak pelvic floor is to pay attention to any signs of incontinence. If you leak urine when you laugh, cough, or sneeze, this could be a sign of a weak pelvic floor. Incontinence can also occur during physical activity or exercise. While incontinence is the most common ordinary sign of weak pelvic floor muscles, there are other subtle signs and symptoms that are usually overlooked.
Lower Back, Hip, and Pelvic Pain or Issues
Another way to determine if you have a weak pelvic floor is to pay attention to your lower back, hips, and pelvis. Pain in these areas can be a sign of weakness in the pelvic floor muscles. The pelvic floor is interconnected with the lower back, hips, and pelvis. Imbalances in these areas can contribute to weakness in the pelvic floor.
Poor Posture
Poor posture can put unnecessary pressure on the pelvic floor muscles, leading to imbalances and weakness. Slouching is perhaps the most common presentation thanks to our sedentary lifestyle. When we slouch, we put additional weight on the pelvic floor, which can cause weakness over time. To maintain a healthy pelvic floor, it’s important to practice good posture which is easier said than done. Think about when you were told to sit up when you were a kid. It worked until you got distracted! Right? The question is why do we even end up with poor posture and what happens at the brain, joint, and muscle level that leads to poor posture. Sitting up straight and avoiding slouching can help take the pressure off the pelvic floor muscles so watch this video to see what happens when our functional movements become dysfunctional.
Lifestyle
Lifestyle choices can also impact the pelvic floor. For example, dehydration can lead to constipation, which can put pressure on the pelvic floor muscles. Drinking plenty of water to stay hydrated can help prevent constipation and promote healthy bowel movements. Eating a diet high in fiber can also help prevent constipation and promote healthy bowel movements. Fiber helps to bulk up stool, making it easier to pass without straining. Straining during bowel movements can weaken the pelvic floor muscles, so it’s important to eat a diet that promotes healthy bowel movements. Poor posture can interfere with the flow of fecal matter over time; the combination of poor posture and constipation can lead to over-engagement of certain muscles in the pelvis which can lead to the weakness of the pelvic floor.
What Common Exercises Lead To Pelvic Floor Dysfunction?
There are a number of exercises commonly performed at the gym that can put excessive strain on the pelvic floor muscles, leading to weakness over time. These exercises typically involve high-impact movements, heavy lifting, or exercises that place excessive pressure on the abdominal area.
Squats and Lunges
These exercises can put a lot of pressure on the pelvic floor, particularly if they’re performed with heavy weights. To reduce the risk of pelvic floor strain, it’s important to use proper form and avoid excessive weight. This is what functional movement is all about which is not just for exercises but for all movements. It is important to understand what functional movement is and why it is the only right way to get to the root of dysfunction in all of our movements that lead to pelvic floor dysfunction and beyond.
Abdominal Crunches
Crunches and sit-ups can put pressure on the pelvic floor muscles, particularly if they’re performed with poor form. It’s important to engage the pelvic floor muscles during abdominal exercises to help support the area and reduce the risk of weakness.
High-impact Activities
Activities like running and jumping can put a lot of pressure on the pelvic floor, leading to weakness over time. To reduce the risk of pelvic floor strain, it’s important to wear supportive clothing and avoid activities that put excessive pressure on the area, and work on becoming functional vs dysfunctional in our patterns of movement before participating in high-impact activities.
Heavy Lifting
Lifting heavy weights can put a lot of strain on the pelvic floor, particularly if proper form is not used. To reduce the risk of pelvic floor weakness, it’s important to use proper lifting technique and avoid excessive weight.
It’s important to note that not all exercises will cause pelvic floor weakness in everyone. The impact of exercise on the pelvic floor will depend on a number of factors, including individual anatomy, pre-existing pelvic floor issues, and the intensity and frequency of exercise. However, it’s important to be aware of the potential risks associated with certain exercises and take steps to reduce the risk of strain on the pelvic floor.
What Postural Presentations Are Red Flags For Pelvic Floor Dysfunction?
Postural presentations that place excessive pressure on the pelvic floor muscles can contribute to weakness over time. In men, several postural presentations can lead to pelvic floor weakness. These include:
- Anterior pelvic tilt: This is a postural presentation where the pelvis tilts forward, causing the lower back to arch excessively. This can put excessive strain on the pelvic floor muscles, leading to weakness over time.
- Rounded shoulders: Rounded shoulders can cause the upper back to round forward, leading to poor posture and excessive strain on the lower back and pelvis. This can contribute to pelvic floor weakness over time.
- Forward head posture: This is a postural presentation where the head juts forward, causing the neck to round forward as well. This can cause the shoulders to round forward and put excessive strain on the lower back and pelvis, contributing to pelvic floor weakness.
- Swayback posture: This is a postural presentation where the lower back curves excessively inward, causing the pelvis to tilt forward. This can lead to excessive strain on the pelvic floor muscles, contributing to weakness over time.
- Sitting for extended periods: Sitting for extended periods can cause the pelvic floor muscles to become weak and deconditioned. This is because sitting puts pressure on the pelvic floor muscles, causing them to become strained and overworked over time.
Should You Do Kegels For A Weak Pelvic Floor?
There are 2 scenarios that lead to a weak pelvic floor. One is a de-conditioned muscle that becomes weak and the other is when a muscle is overworked and tight, leading to exhaustion and weakness. Kegel exercise is NOT for tight muscles that lead to dysfunctional movements and weakness. With that said, most often people don’t quite know how to practice Kegels and the instruction of holding the urine and then letting go and repeating is NOT a good one to follow. The best instruction I have for men is the one shared in the video below:
The most effective way to jump-start the Kegels is the Emsella Chair which I recommend for many of my patients with pelvic floor dysfunction. At 400 Kegels a minute, no one can beat this chair which is FDA-approved for incontinence.
If you are told you have a weak pelvic floor or are not happy with the treatments you have received, and you want to see if the comprehensive pelvic floor dysfunction treatment at my clinic is right for you, contact me.
Dr. Shakib