Beyond Kegels for pelvic floor strength

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Does an oncoming sneeze make you squeeze your legs together?


Do you know that a large majority of women suffer from bowel irregularities, painful sitting, painful intercourse, trouble controlling voiding, and it is all related to the strength of our pelvic floor? Beyond Kegels you can find relief from these common symptoms of pelvic floor dysfunction.  We are privileged to hear from Dr. Marie Bogh this week, who shares with us her expertise in this area...

As a physical therapist that specializes in pelvic floor rehabilitation, I am frequently asked what it is I actually do. Are you just teaching your patients Kegels? What should I be doing to help myself? Let’s dive in to what pelvic floor PT is and why it matters! 

 We use our pelvic floor on a daily basis, constantly. In order to sit, stand, walk, or even roll out of bed, you need your pelvis’s participation. Whether it is in load transferring, core support, or maintaining continence when the timing isn’t right, the pelvic floor is almost never in a truly passive state. The muscle tissue of the pelvic floor has the same fiber make up as all other skeletal muscle in the body such as your biceps, quadriceps, or calf muscle which inherently gives us the ability to voluntarily control it, but also allows it to become dysfunctional just like these other body regions.  So, when this specific body region does begin to show signs of weakness, pain, or dysfunction it needs to be addressed in a similar manner to restore function as we would for a knee injury or an ankle sprain. So why is it most individuals have never heard of this type of therapy? Do we not see dysfunction in this area as important to treat when it starts to act abnormally? Do we see this as just another sign of age or childbirth? 

 Rehabilitation of the pelvic floor aims to address symptoms including: urinary or fecal incontinence, urinary urgency, frequency of urination, constipation, uterine/bladder/rectal prolapse, pain with intercourse, pelvic girdle pain, coccydynia (tailbone pain), pregnancy/post-partum, and core weakness. Depending on the diagnosis and what is observed during the initial evaluation, a plan is developed to restore motion, strength, tissue relaxation, neural health, and/or continence.  During therapy sessions, patient come to expect internal examinations, use of biofeedback, pelvic floor strengthening or relaxation exercises, lumbar, pelvic, sacral, or coccyx spinal mobilizations to restore motion or proper alignment, and core strengthening exercises to reduce inappropriate stresses on the pelvic girdle system. 

One specific exercise that I work on with patients dealing with pelvic floor weakness is a classic bridge, with a twist. Envision lying on your back with your knees bent, back flat. Now, try engaging your pelvic floor by pulling your kegel muscles up and in toward your belly button like you are trying to stop the flow of urine. Then, pull your abdominals in toward your spine and lift your hips up off the floor toward the ceiling, engaging your glutes and hamstrings. Repeat. This is exercise is so effective at reducing incontinence issues and gives your whole lower body and core a good workout! 

For more information, tips, exercises prescriptions, or advice please feel free to reach out to my me via my email for an appointment in the office, or an additional exercise handout I have created just for SpOILedLife4u members!

Dr. Marie K. Bogh, PT, DPT



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