The pelvic floor has a significant responsibility to help support our 3 pelvic organs and to hold enough tension to help control our bladder. The muscles that run from our pubic bone back to our tail bone, that span the area between our two sit bones, and that encircle the three openings from our pelvic outlet are our pelvic floor muscles. These muscles are “on” throughout our day, working against gravity and intra-abdominal pressure. They are expected to be consistent, but lack the sheer bulk to ever be “big, strong” muscles. So when many of you have asked me about various “Kegel exercisers” that you have read about or seen advertised that help strengthen these pelvic floor muscles, my answer is consistently that you don’t need them. There are a couple of ways you can enhance the strength of your pelvic floor muscles beyond the 2-step Kegel exercise.
The first is to strengthen the muscles that co-contract with the pelvic floor. Strengthening your pelvic floor can occur through improving the coordinated muscle activation of all the muscles attached to the pelvis. These muscle groups that all work together are: your low back extensors (multifidi), your low abs (transversus abdominus), your inner thighs (adductors), and your deep hip rotators (hip external rotators such as gluteus medius, obturators, etc.). Learning how to co-contract all of these muscles will significantly help the strength and function of your pelvic floor.
The second way to strengthen the pelvic floor muscles beyond what you can achieve through a 2-step Kegel exercise, is through internal electric stimulation. An electric stim unit helps improve your pelvic floor strength by maximizing the number of muscle fibers recruited. Often as we age, through prolonged inactivity or following muscle trauma, we are not able to voluntarily activate all of the available muscle fibers. These “dormant” fibers can often be re-awakened through artificial stimulation. An electric stimulation machine can jump start these fibers and get them firing voluntarily again. You can seek out a women’s health physical therapist in your area to begin an electric stimulation program or, if you prefer, you can order a home unit. The Kegel 8 home electric stim unit is the most popular device discussed on the prolapsehealth.com website. This website features many women who have tried several different treatments for weak pelvic floor muscles and give their candid review.
The final way to progress strength of your pelvic floor is to focus on your posture. It is important to keep a healthy tension in the muscle fibers that make up your pelvic floor, and holding neutral spine posture ensures optimal position for your pelvic floor, making it more effective. I will refer you to one of my previous posture blogs ( http://hab-it.com/blog/?p=191 ) to help you understand the importance of how we position our body throughout our day to maximize muscle activity.
All of these methods that you can use to strengthen your pelvic floor beyond the 2-step Kegel exercise are the perfect focus when rehabilitating your pelvic floor. Adding additional weight or resistance to these strengthening exercises is too much for this relatively thin group of muscles and will more than likely result in muscle spasms, poor muscle substitution patterns, and/or significant muscle fatigue that can all lead to increased symptoms. You can’t make a thin group of primarily endurance muscles into big bulky muscles no matter how hard you try.