How to Strengthen Your Pelvic Floor: Exercises to Relieve Pain & Increase Kegel Strength

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Struggling with pelvic floor weakness or pain? Learn how to strengthen your pelvic floor with these kegel exercises and therapeutic tools that provide a safe and effective strategy for healing, whether you need support post-pregnancy, have incontinence, prolapse, or simply want to strengthen your muscles.

How to strengthen your pelvic floor

This guest post is by Dr. Amanda Olson, who earned her Bachelor of Science degree from Pacific University in 2005, and a Doctorate Degree in Physical Therapy from Regis University in 2008, graduating as a member of the Jesuit National Honor Society.

She holds a Certification of Achievement in pelvic floor physical therapy (CAPP-PF) through the APTA, and the Pelvic Floor Practitioner Certification (PRPC) through the Herman and Wallace Pelvic Institute. She is also a certified Stott Pilates instructor and RRCA certified running coach, which she finds useful in curating treatment approaches.  

Dr. Olson teaches internationally on various pelvic health topics including pelvic floor dysfunction in runners. She has written several physical therapy continuing education courses, newspaper and magazine articles on pelvic floor dysfunction, and running. 

She is the president and chief clinical officer of Intimate Rose where she develops pelvic health products and education, and authored the book Restoring the Pelvic Floor For Women. She is passionate about empowering women and men with pelvic health issues including pelvic pain, incontinence, and pre and post-partum issues. Over to you, Dr. Olson!

Dr. Amanda Olson in a pink shirt

Conditions affecting the female pelvic floor can be distressing and confusing.  Unfortunately, incomplete and inaccurate information about these conditions abound. 

Many pelvic floor issues are caused by one of two things: weakness or tightness.  While Kegel exercises are often mentioned as a one-size-fits-all strategy for pelvic floor conditions, they are not always the correct first approach and for some diagnosis could make pelvic pain worse. In this article, we will demystify and explain pelvic conditions and introduce the correct ways to treat them.

What Makes the Pelvic Floor Weak?

The pelvic floor muscles, which form a sling-like structure in the lower pelvis, support the pelvic organs and surround the vaginal wall.  Weakness or underactivity in these muscles can lead to issues such as urinary incontinence (leaking of urine) or pelvic organ prolapse, which is when the pelvic organs collapse into the vaginal wall. 

Pelvic floor muscle weakness most commonly results from pregnancy, vaginal delivery, and age, but can also be the result of a traumatic injury, chronic constipation, obesity, or pelvic surgery. 

Pelvic floor weakness does not typically cause pain; rather, symptoms are more likely to include the inability to control urine, especially with higher impact activities or during sneezing, coughing, and laughing.  Symptoms of pelvic organ prolapse may include a feeling of bulging or heaviness in the perineum or vagina.  

Intimate Rose's Kegel Exercise System

Pelvic Floor Treatment Strategies: Kegel Exercises

Treatment of pelvic floor weakness is where Kegel exercises come in.  Kegels are specific strengthening exercises for the pelvic floor muscles.  While the concept is simple, performing these exercises correctly can be a little tricky since the movement is subtle. 

To get started on Kegel exercises, keep these things in mind:

  • The pelvic floor muscles form a sling-like structure in your lower pelvis, surrounding the urethra, vagina, and rectum. To contract these muscles, visualize that sling lifting up and in.
  • If you are unsure of which muscles to contract, think about the muscles used to stop the flow of urine. You can try stopping the flow of urine when on the toilet to learn what a Kegel exercise feels like, but only do that once. If done repeatedly, it could lead to problems with the urinary tract.
  • Kegel exercises are easiest to initiate when laying down, so you do not have to fight gravity. As these become easier, progress to performing them while sitting, then when standing.
  • Make sure not to contract your gluteal muscles instead of the pelvic floor- that is a common way for the body to compensate when the pelvic floor muscles are weak or fatigued.
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Once you have achieved the ability to perform Kegel exercises in various positions, you can add resistance using vaginal weights such as the Intimate Rose Kegel Exercise System (use the code ROOTANDREVEL to get 10% off!). Just like any other muscle, adding resistance helps build more strength in the pelvic floor. 

What does it mean if I have pelvic pain?

Pelvic pain is another common form of pelvic floor dysfunction.  Pain in the pelvic floor muscles can lead to pain with urination, intercourse, using a tampon, or during a pelvic exam. 

Just like other muscles in the body, pelvic floor muscles can become tight and develop painful knots, known as trigger points. Pelvic floor tightness can have physical causes such as injury or poor posture or it can be caused by emotional factors, which can cause unconscious tensing and clenching of the pelvic floor.

In the case of pelvic floor tightness, performing Kegel exercises is not the best initial strategy, since further tensing of these muscles could worsen pain.  Instead, treatment strategies include using vaginal dilators, trigger point release wands, and pelvic release exercises:

Intimate Rose Pelvic Wand
  • Vaginal Dilators: Vaginal dilators are specific tools in a variety of sizes that allow you to gradually stretch and release the pelvic floor muscles. Dilators are a gentle way to train the brain and the muscles of the pelvic floor to relax during insertion.  Dilator therapy is best performed in combination with relaxed breathing, which encourages the muscles of the pelvic floor to open and relax. (Intimate Rose's dilators are the only FDA registered vaginal silicone dilator and are used in the official Academy of Pelvic Health training courses!)
  • Vaginal Trigger Point Release Wands: Trigger points in the muscles of the pelvic floor can cause pain at rest, in addition to during sex.  To release these tight knots, a specially designed trigger point release wand can be used either vaginally or rectally to access these hard-to-reach muscles. When you move the wand around the pelvic floor, trigger points can be identified as particularly painful spots. By applying gentle pressure to these spots for 1-2 minutes, the trigger point will release. This should be done daily. 
  • Pelvic Release Exercises: Gentle stretching exercises that mobilize the hip can help you learn to consciously release the pelvic floor muscles and retrain your body to let go of tension. 

A pelvic physical therapist can help guide your treatment plan and make sure you have the tools you need for your specific condition.

Thank you, Dr. Olson, for sharing your wisdom with us! Use the code ROOTANDREVEL to get 10% off your purchase at Intimate Rose!

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