So when something's not right, say, when your pelvic muscles are tight or weak, you'll likely feel it. A weak pelvic floor can manifest in many ways, including urinary incontinence, constipation, painful sex, a back injury, or even pelvic organ prolapse (when a pelvic organ bulges into your vagina).
This is why keeping your pelvic floor strong and healthy is essential for many parts of your health. How to do so, though, isn’t always intuitive. In fact, certain daily habits that seem unrelated or harmless may actually be doing damage.
- Kristen Lettenberger, PT, DPT, CSCS, pelvic floor physical therapist at Bespoke Treatments and director of Bespoke Women
Here, Kristen Lettenberger PT, DPT, pelvic floor physical therapist at Bespoke Treatments and director of Bespoke Women, shares the what weakens pelvic floor muscles and what to do instead for a healthy pelvic floor.
Doing kegels all day
Imagine if you flexed your biceps all day? That repeated stress can weaken or even damage your muscles. The same thing can happen to your pelvic floor if it's overworked, even if you're doing exercises that are meant for a healthy pelvic floor—like Kegels.
Lettenberger says the muscles of your pelvic floor have more "endurance-type fibers," which means they work all day long to support the organs in your torso and stabilize your pelvis.
So if you're doing too many kegel exercises, you "can exhaust these muscles faster,” she says, which can result in increased tightness, weakness, and dysfunction.
What to do instead:
You can definitely still do Kegels, but try them in moderation. Maybe do 30 reps a day and split them up—10 in the morning, 10 in the afternoon, and 10 in the evening, says Lettenberger.
Or try switching up the speed of your Kegels, she adds. You can do a mix of longer contractions to build endurance (i.e., holds up to 10 to 30 seconds), and quick, brisk contractions to help improve muscle coordination.
Sucking in your belly
Sadly, most of us have sucked in our stomach at one time or another in an effort to change our appearance. Not only is this habit damaging to our body image, but it’s also harmful to our pelvic floor.
Sucking in your belly, also called abdominal gripping, “can lead to some pelvic floor dysfunction” says Lettenberger. Here’s why: When you suck in your belly, you don’t allow your diaphragm and core to move at their full range of motion, she says. This can put increased pressure on your pelvic muscles and cause tightness.
What to do instead:
While ab gripping may be a difficult habit to break, especially if you’ve been doing it a long time, try letting your belly breathe—literally. “Allow your belly to expand with your breath and naturally contract with your exhale,” Lettenberger says.
Holding your breath
We've all been there—unintentionally holding our breath when we're stressed, or purposefully holding it while doing something strenuous (like lifting something heavy).
But this habit can actually affect your pelvic floor. Turns out, “your pelvic floor works in unison with your breath,” says Lettenberger. As you inhale, your pelvic floor naturally relaxes, and as you exhale, it contracts.
And sometimes when we hold our breath, we unintentionally bear down. This becomes potentially harmful because it increases the pressure on your abdomen and pelvic floor, says Lettenberger.
What to do instead:
“Holding your breath doesn’t inherently harm your pelvic floor if you distribute the breath hold around the torso,” says Lettenberger. When heavy lifting, “try to fill your torso 360 degrees” without pushing into the pelvic floor, she says. To visualize this 360 breathing, “imagine filling a soda can, as opposed to squeezing a balloon,” she says.
Likewise, “if you find yourself holding your breath under stress, try taking a few diaphragmatic breaths, letting the pelvic floor fully relax and contract with inhales and exhales,” says Lettenberger.
"When we slouch, we limit the amount of movement into our diaphragm, which works in tandem with our pelvic floor."—Kristen Lettenberger, PT, DPT, pelvic floor therapist
Slouching
Poor posture can produce pelvic floor issues too.
“When we slouch, we limit the amount of movement into our diaphragm, which works in tandem with our pelvic floor,” says Lettenberger. As we've learned, when the diaphragm can’t move in its full range of motion, it places greater pressure on the pelvic floor.
When slouching, “we also tend to tuck our pelvis under us,” says Lettenberger. This causes more tension and tightness to occur in the pelvic floor muscles and can lead to pelvic floor dysfunction, she says.
What to do instead:
No one can maintain perfect posture all day long. But monitoring your slouching can help. “Try to catch yourself,” says Lettenberger. “Set a timer for every hour or so to give yourself a little reminder to straighten up,” she says. Take five to 10 deep, full breaths to reset. Or try exercises to correct your posture.
Wearing tight clothes
Believe it or not, what you wear can affect your pelvic floor health. “Very similar to breath holding or sucking in your belly all day, wearing tight clothing can restrict the movement of your abdomen,” says Lettenberger. Again, this increases intra-abdominal pressure, which can put additional strain on the pelvic floor.
What to do instead:
If something fits super snug, cuts into your midsection or makes it hard to breathe, it’s probably not a great garment for your pelvic health. When possible, try to limit the amount of time you wear very tight clothing, says Lettenberger. Not only will your pelvic floor thank you, but you’ll likely feel more comfortable, too.
Blowing your nose on the toilet
It’s hard to deny the convenience of blowing your nose when using the potty (the toilet paper and tissues are all within reach, after all). But this seemingly benign bathroom habit can be bad for your pelvic floor. “This is one thing I strongly suggest you try not to do,” says Lettenberger. Here’s why:
When you pee or poop, your pelvic floor needs to relax. But blowing your nose often causes the opposite effect. “As you blow your nose, you are putting an extreme amount of pressure onto those [pelvic floor] muscles,” says Lettenberger.
When done often enough, this bearing down can lead to pelvic floor dysfunction, she says.
What to do instead:
This solution is relatively easy: “Just wait to blow your nose until after you are done with the restroom,” says Lettenberger.
So, how can you tell if your pelvic floor is weak?
Some telltale signs of a weak pelvic floor include the following, according to Lettenberger:
- You leak when you sneeze, cough, or laugh.
- You frequently find it hard to control flatulence.
- You feel a heaviness in your pelvic floor toward the end of the day.
Weakness in your pelvic floor is often related to muscle tightness in that region, says Lettenberger. Like any other skeletal muscle, your pelvic floor muscles can get weak when overworked (i.e., routinely tense or under strain).
If you have any of these symptoms, you may benefit from seeing a pelvic floor therapist for treatment.
Tip: Need help locating a pelvic floor specialist? Resources like PelvicRehab.com and the Academy of Pelvic Health Physical Therapy can help you find a qualified pelvic health therapist in your area.
—medically reviewed by Andrea Braden, MD
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