Loosen Up Down There! The Truth About Pelvic Floor Flexibility and Incontinence
Pelvic fitness is not just about Kegels - stretching your pelvic floor muscles is crucial to avoid troubles like laugh-induced leaks and discomfort in your lady parts.
Pelvic floor issues are common but not normal.
You probably have heard about doing kegel exercises or getting our lower abdominal muscles stronger to help the pelvic floor, but have you ever heard how important it is to stretch your pelvic floor muscles? *Psst- This is where you say, “NO!?!? And WHY?? Is that important??? How can I have never heard about that????”
Well, tightness in the pelvic floor muscles can cause various problems, including constipation, incomplete bladder emptying, pelvic pain, painful intercourse, and urinary leakage. Yep, you can pee yourself a little bit because you are too tight. I will explain it, and it will make sense, I promise.
What are Your Pelvic Floor Muscles?
The pelvic floor muscles stretch from the pubic bone in the front to the tailbone in the back and support your bladder, uterus, and rectum like a basket or hammock. Check out my last post if you want more information on what makes up the pelvic floor. One aspect of the pelvic floor muscles I didn’t discuss last week was that they have layers, and depending on what is tight, there will be different ways to stretch and relax your muscles.
Photo credit Visible Body Software. Mediocre hand-drawn arrows all me.
Signs Your Pelvic Floor May Be Too Tight
Pain in the pelvic region is one of the signs of tight or tense pelvic floor muscles. Just like shoulder tension can cause headaches and achiness in the neck and shoulders, tightness in the pelvic floor can lead to discomfort and achiness in the hips, near the tailbone, and around your pubic bone.
Other medical health professionals can help, such as your OBGYN, women’s health Physical Therapist (widely available in most Western countries), or urologist. These professionals can help to rule out that your pelvic pain and discomfort is something other than a tight pelvic floor. Not all medical providers are made the same. If your problems are brushed off as usual, SEE SOMEONE ELSE. As I said before, pelvic floor problems are common but not normal.
Common Reported Signs with Pelvic Floor Tightness
Pooping💩 Problems: Symptoms can include having to significantly push and strain during bowel movements, feeling like you can’t get all of your bowel movement out, thin stools, and painful bowel movements.
Peeing Problems: Symptoms can include having to significantly push and strain with peeing, having a splayed stream, meaning your pee splits into two or more streams, and having discomfort with urination. Sometimes, individuals might have gone to see a doctor because they thought they had a bladder infection, but the burning discomfort is actually due to tightness in the pelvic floor.
Sexual Health Issues: Pain during intercourse, discomfort with using or placing a tampon, and discomfort during pelvic exams done by your doctor are signs of pelvic floor muscle tension.
Pelvic Pain: Experiencing tailbone pain, pain with sitting, throbbing or heaviness in the pelvis, or unresolved hip or hamstring pain can point to a tense pelvic floor.
If any of these symptoms ever get worse after abdominal strengthening or especially after Kegals, it's a sign that you should focus on relaxing your pelvic floor muscles before attempting to strengthen them. You can start a stretch program even if you want to see another medical provider about any of these symptoms.
How You Can Pee Yourself When Your Muscles Are Too Tight??
Oh, this is a good question because it can be hard to understand.
Example: Try This at Home🙌
Try to touch your right fingers to your right shoulder. Most people can do this depending on the size of their shoulder muscles. If you can’t touch your shoulder with your fingers, get as close as possible without straining and hold it there. This is a biceps curl. Now, with your right fingers touching your shoulder, quickly and forcefully try to tap your palm to your shoulder. Your palm probably can’t tap your shoulder, AND you can’t be that quick because of the starting position of your right arm.
Now, take your left arm and straighten the elbow out all the way. Now, quickly and forcefully move your palm to your shoulder from the straight position. Mine can touch when I do this. I was also fast enough that I slapped the left shoulder. This is because the muscle was taken from a position where it can really create some force. We put the left arm at a mechanical advantage and the right arm at a mechanical disadvantage when asking it to contract (shorten).
If your pelvic floor is tight and contracted, like a bicep in a near-full contraction position, it leaves little room for further tightening, so basically, you can’t contract very much, and you can’t contract it very fast. Pee gets out before you can squeeze enough to hold the pee inside.
Real Life Example
Now, it is time for me to win the vulnerability award with honest confession time. I have done sports in the past, especially when I was younger, before kids, because I had more time. I liked to think I was in good shape while pregnant and after because I exercised. When my youngest turned one, I joined CrossFit because it is important for women to lift weights to maintain bone health. I hate lifting on my own, so I joined a group of people to cheer me on with lifting.
I promptly started peeing myself on all jumping activities all the time. Jumping jacks, box jumps, jump rope. If it had jump in the name, a little pee would squeeze out every time, EVEN if I went to the bathroom right before we started. My arch nemesis was jumping rope. I remember one particular workout where I didn’t look at the workout before we left the house, and I wore light blue exercise pants. It was SO embarrassing. I was uncomfortable enough that I seriously considered leaving in the middle of the workout.
After that workout, I vowed to be better about getting those Kegals done so I would never pee myself again. I did as many as I could remember to get in a day, but they NEVER helped. I started avoiding workouts with the jump rope. It wasn’t until I went to an advanced course for Women’s Health Physical Therapy on the pelvic floor that I understood why I had unexpected pee escaping despite my best efforts—I was too tense.
What to do about Tight Pelvic Floor Muscles
I started doing two stretches while brushing my teeth at night. I hate brushing my teeth so much, and don’t even get me started on flossing. I like to combine these activities with something else I need to get done. I call them in-between time exercises. You can find this time when you are waiting for something to finish microwaving or while you are waiting for your kids to finish their bath. Pick your two stretches and get them done in your in-between time.
Here is a video with options for you to pick from. Pick the two you can do without pain, but that still feels like a stretch. Stretches are not exactly comfortable, but often, they feel like something your body needs. The biggest thing I need you to do while doing the stretches is BREATHE. Don’t hold your breath. You are putting the pelvic floor under tension when you hold your breath, and that, my friend, is the opposite of stretching it out.
Take Away
If your pelvic floor muscles are too tight, relaxing and releasing your pelvic floor muscles will be a process that requires getting those in-between stretches done during your day and breathing while you do them. It's important to understand that kegel exercises, which are often recommended, may not be the only exercise your pelvic floor needs. As you get more stretching in, you might be peeing a bit more if your pelvic floor is not used to contracting quickly and with power. In the next post, we will go over strengthening that you can start combining with stretching so you can go to that class, jump with the kids, and sneeze without concern.
D.I.G. Deep
Get Deliberate
Write down what your in-between times are each day. Maybe it is waiting in the car pick-up line. Maybe it is while you prep ingredients for dinner. The goal is to find three 30-60 seconds in-between times when you can stretch.
Get Inspired
46% of women stopped exercise they had previously participated in due to their Pelvic floor symptoms. Urinary incontinence had the largest impact; 41% with UI, followed by 37% with pelvic organ prolapse, and 26% with bowel incontinence stopped at least one form of exercise.
You are not alone but don’t have to be a part of this statistic.
Get Going
If you live somewhere where you can see a Women’s Health Physical Therapist do it. They can take one-on-one time to chat about your symptoms and work with you. If you don’t have that option, please continue to read this series, and I will give you the information you need to get going. Find a friend and commit to work on your pelvic floor together.