Pelvic Floor Contractions for Back Support


Pelvic Floor Contractions

Older woman doing pelvic floor exercises

SilviaJansen / Getty Images

A successful exercise program—whether to stabilize your core, beautify your biceps, or strengthen muscles—will "overload" specifically targeted muscles so they grow stronger.

Just like your abs or biceps, your pelvic floor muscles need exercise. Keeping pelvic floor muscles healthy and strong can not only enhance sex but help develop a strong core and a healthy back, as well.

According to Dr. Pauline Chiarelli, physiotherapist, continence advisor, professor, and author of Women's Waterworks: Curing Incontinence, you can take steps towards developing strong pelvic floor muscles, as well as maintain strength for a lifetime.

To do this, you must first identify the muscles, and then assess them for strength and endurance. After that, challenge them to grow stronger. 

And finally, keep up the good work in order to maintain strength over the long term.


Precautions to Take

A pelvic floor contraction is a squeeze of the muscles of the bottom in an inward and upward direction. This is the action we all perform when we are controlling our bowels and bladder, including stopping the flow of urine.

Don't do pelvic floor contraction exercises while you are also emptying your bladder, nor use stopping the flow of urine as a strengthening exercise for the pelvic floor muscles. Use it only as a way of finding and assessing the muscles (as described on the next slide).

Chiarelli explains that the complexities of a functioning bladder go beyond the muscular control offered by the pelvic floor (or any) muscles. While the pelvic floor muscles do influence bladder control, they are not in charge of its entire workings. This means that stopping the flow of urine as a regular practice may alter the function of your bladder for the worse, she says.

Note: Some pelvic floor weakness (and thus incontinence) is caused by pelvic floor muscles that are constantly tight and contracted. In this case, you'll need to learn to relax the pelvic floor before working on strengthening the muscles.Starting right away to tighten the muscles more would actually do more harm than good.


Find the Inward Squeeze

Stopping the flow of urine is a good technique for finding out how the pelvic floor muscles feel when they contract. This is the first step in creating and maintaining a pelvic floor strengthening program. If you are able to stop the flow of urine completely and instantly, you are ready to embark on the exercise program. If not, the finger test described below will help you to recognize your pelvic floor contractions. (We'll use this test in the next section.)

Pelvic Floor Contractions - Women

Insert 2 fingers into your vagina and contract.

Pelvic Floor Contractions - Men

Insert one finger into the rectum and tighten your muscles around it.

When you find your inner squeeze, it will feel like the opposite of bearing down to make a bowel movement. It is a drawing in and up around your inserted fingers. You can aim to bring your tailbone and your pubic bone together, and while you may not notice this actually happening, using the image might get your pelvic floor muscles into a working contraction.

While you are doing this test, continue breathing—holding your breath alters the way in which muscles are being used, and defeats the purpose of the test.

Take heart, the contraction you feel may be small, but once you are able to locate a contraction you are ready for the pelvic floor strengthening program.


Determine Strength and Endurance of Your Pelvic Floor Contractions

This step is an assessment of pelvic floor muscle strength and endurance.

First, test yourself for the length of time you can hold a pelvic floor contraction. To do this, repeat the finger test, but this time count the number of seconds you can hold the muscles up in the inward squeeze. This is a measure of muscular endurance, or how long can your pelvic floor muscles go before they begin to tire.

After you know the length of time your pelvic floor muscles can endure, the next test is for the strength of the contraction. In other words, how many of these contractions can you perform before the muscle becomes fatigued? Perform as many of them as you can. Count as you go and take note of the number.

The third step is to clock how much rest you need between your contractions.

The final step in the strength and endurance assessment is to test for the performance of fast working muscle fibers of the pelvic floor muscles. To do this perform inward upward squeezes just as fast and as hard as you can, and count the number you can do before fatiguing. Do not stop for a break until you are done with the whole set.

Make note of all these measurements so that you can see how you progress with the strengthening program.

Chiarelli recommends seeing a urinary continence specialist if you have not been able to locate the contraction of your pelvic floor muscles at any time during this assessment.


The Pelvic Floor Strengthening Program

The goal for the pelvic floor strengthening program is to hold 10 slow squeezes for 10 seconds each, 3-6 times per day. Once again, it is OK to start right where you are at. By writing down the numbers from your assessment, you can increment as you go along. It is a matter of challenging yourself to do more contractions and/or to increase the amount of time you hold them.

Both activities will result in stronger pelvic floor muscles, so increment either or both, until you reach 10 squeezes held at 10 seconds 3-6 times each day. Repeat the finger test every few days to help you monitor your progress. When the finger test shows you that your pelvic floor muscles are stronger, add one or more seconds and/or a few more reps to your program.

Here are a few other exercise programs that may enhance your pelvic floor strengthening efforts:


Lifetime Maintenance of a Healthy Pelvic Floor

Chiarelli has several recommendations for maintaining a strong pelvic floor for a lifetime. If you remember to do them, maintaining your new pelvic floor strength won't take much time out of your day.  

  • While in the shower perform an inner squeeze for 6 seconds. Keep doing the squeezes the entire time you are in the shower.
  • Every time you finish emptying your bladder do 3 strong inner squeezes, holding for 5 seconds each.
  • Practice pelvic floor muscle contractions as you make love. This will enhance your sex life while it helps your back!

Tips and Considerations

Many people, especially in the beginning of their program, will have some problems isolating the pelvic floor muscles from the other muscles of the hips and pelvis. This is understandable, as the outer hip muscles are large and powerful.

A key to success is to learn to recognize the feeling of just the pelvic floor muscles contracting, without the buttock muscles. To remove the buttock muscles from the movement you can practice pelvic floor contractions while standing with your legs wide apart and your heels out wider than your toes (a toed-in position of the feet). (But don't do this if it increases your back pain.) Once you are confident that you can perform pelvic floor contractions without using your butt muscles, you'll likely be able to perform them correctly in whatever position you wish.

As with any exercise program, starting your pelvic floor strengthening program too vigorously can be a potential source of injury, fatigue, or frustration. Accept the strength level you have now and build slowly but consistently. Keeping track of the number of reps and seconds held as you go will allow you to increment the level of challenge in a sane and results-oriented way over the long term.

The most well-known pelvic floor exercises are Kegels. The exercises presented here are essentially that. 

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By Anne Asher, CPT
Anne Asher, ACE-certified personal trainer, health coach, and orthopedic exercise specialist, is a back and neck pain expert.