If you’ve heard of the pelvic floor, you’ve likely also heard of Kegels — exercises that strengthen the muscles that support the pelvic floor organs, including the uterus, bladder, and rectum. Kegels contract and relax these muscles to keep them functioning at their best.
But Kegels aren’t the end all be all for a healthier pelvic floor. In part, that’s because in order to do a Kegel properly, you need to contract the muscles and release them — which is actually fairly difficult to do (most people just contract). And if you’re not doing Kegels correctly, then, well, you’re not getting the full benefits of the exercise
“There’s this myth of the tight vagina,” Jennifer Lang, M.D., an OB-GYN and gynecologic oncologist said at the Wine & Gyn panel earlier this month hosted by #BlogHer20 Health in a discussion about pelvic floor health. “But we don’t want a tight vagina — we want a supple, functional pelvic floor that can contract and relax.”
To maintain a healthy pelvic floor, the muscles need to work through lots of different ranges of motion, Marcy Crouch, P.T., D.P.T., a physical therapist and founder of Restorative Pelvic Physical Therapy explained at the panel.
Here, other top ways to keep your pelvic floor in tip-top shape, according to panelists at the event and outside experts who specialize in pelvic floor rehabilitation.
1. Start Pelvic Floor Physical Therapy
Pelvic floor physical therapy involves working with a physical therapist who is specifically trained in rehabilitating the pelvic floor muscles. Through working with a pelvic floor therapist, you can have your muscles examined and get a training plan (myofascial release to loosen the muscles of the pelvic floor or exercises to strengthen the area, for example) to improve muscular range of motion and coordination, pelvic floor physical therapist Rachel Gelman, P.T., D.P.T. tells SheKnows.
“Pelvic floor physical therapy works beautifully for the majority of pelvic floor disorders. It is first-line treatment for urinary incontinence, pelvic organ prolapse, pelvic pain, and pain with sex,” Lauren G. Rascoff, M.D., an assistant professor in obstetrics and gynecology at the University of Colorado School of Medicine, tells SheKnows.
In fact, in many countries around the world, women are offered pelvic floor physical therapy following a vaginal delivery, since birth can cause a lot of stress to the area, Lang noted on the panel.
Rascoff notes that anyone who’s had a vaginal delivery can benefit from pelvic floor therapy — even for preventative purposes.
“We should be rehabbing bodies and vaginas after delivery just like we would be rehabbing an ACL or shoulder injury,” Crouch said. “Whether you’re two days or 20 years from your delivery, it’s still important to treat the body in this effective way.”
2. Tailor a Workout Plan to Your Needs
A pelvic floor therapist can help you understand your baseline (for example, whether you’re on the tighter or looser side), which is key in figuring out the best exercises to focus on when you work out.
There are lots of exercises that help strengthen your pelvic floor and address issues such as incontinence or even too-tight muscles. Squats, for example, are a natural form of movement and can be beneficial for the pelvic floor. Kegels (if you’re doing them correctly) can help, too, but without being evaluated — and knowing what particular issues you have — it’ll be hard to know exactly what types of exercise you’d benefit from most. After all, if your pelvic floor is too tight, Kegels (especially if you’re doing them incorrectly) could make your symptoms worse.
Often, when it comes to fitness, variety — and making time for many different activities including running, Pilates, jumping on trampoline, or strength training — is key, said Crouch.
One post-workout habit to pick up? A cool-down. “A lot of surrounding muscles attach at the pelvis and can impact the pelvic floor, so taking care of the external muscles is important for pelvic floor health,” explains Gelman. “After exercise, using a foam roller or massage stick on the thigh muscles can help promote blood flow and decrease muscle guarding [when muscles contract causing an area to tighten up].”
No matter what you’re doing, though, investing in the right gear (including something like Depend Silhouette® Underwear) can help keep you dry on the go while giving you the freedom to move and rehab.
3. Speak Up
Millions of people experience bladder leakage. It’s common. But, Crouch explained on the panel: “Just because everyone is peeing doesn’t mean it’s normal and we should accept that as our quality of life.”
If you’re experiencing incontinence, pelvic pain, discomfort during sex or an inability to control urine or bowels, bring those symptoms up to your doctor. “You have a voice; you can ask for help,” said Crouch.
Of course, doctors need to do a better job, too. “We need to do a much better job of asking women what’s going on with their bodies,” said Lang. “As a woman, as a mother, your health doesn’t just get swept to the side the minute that baby comes out.”
Don’t like the answer you’re getting or don’t feel like you can be open and honest with your doctor? Look for another one. “Advocate for yourself and keep at it until you figure out the right path for you. Find your people, ask for help, and know that you’re not alone,” said Lang.
4. Switch Up Your Undies
If you’re experiencing overactive bladder leakage or adult incontinence and noticing wet underwear, you might turn immediately to an XL menstrual pad to soak up the mess. But when left to soak all day, that’s not so great for your skin and can contribute to even more irritation, Crouch said at the event.
A better bet to keep you dry? Something like Depend Silhouette® Underwear, which has shapewear fabric for invisible comfort and delivers unbeatable protection.
5. Stay Hydrated
If you’re leaking left and right, you might be tempted to cut down on drinking water to manage incontinence and how much fluid you’re losing. But that’s not your best bet. After all, hydration is crucial for overall health. “Also, if the urine is too concentrated due to a lack of water intake, that can irritate the bladder wall and lead to urinary dysfunction,” Gelman explains. “So staying hydrated is important for bladder health.”
Water intake is also important for bowel function — and constipation can contribute to pelvic floor dysfunction which can cause urinary incontinence, she says. So, despite any leaking you might be experiencing, make sure to keep up with your fluid intake. Your pee should be a clear-ish pale yellow color.
6. Find Some Zen
Stress can play a big role in pelvic floor health, says Gelman. “Muscles go into protective mode in times of stress, which typically means they are in a guarded or tightened position.”
Tight pelvic floor muscles can negatively impact the bladder, colon and uterus, too, she says. “Using different mindfulness techniques, apps, or guided meditations are great ways to help manage stress.”
7. Form Healthy Bathroom Habits
“Having good bowel movements is really important for better pelvic floor health,” explains Gelman. When it comes to No. 2, putting a step stool under your feet can promote proper bowel positioning. “This is important because constipation, pushing, or straining with bowel movements can contribute to or cause pelvic floor muscle dysfunction,” she says. “Being in a squat-like position is the optimal pelvic floor position for defecation.”
As for No. 1? Try to keep a good schedule of how often you’re going. You don’t want to be holding it for hours on end, explains Rascoff. Try to pee every three hours or so, she suggests.
Dr. Gelman ad Dr. Rascoff were not part of the Wine & Gyn panel hosted by #BlogHer20 Health and Depend.
This post was created by SheKnows for Depend®. Visit Depend.com to learn more.