For the Love of Kegels,
What is Pelvic Floor Dysfunction (PFD)?

If you have joined a fitness program in the last, I don’t know, 100 years — you have observed this scenario:

The warmup ends and the workout moves into the cardio circuit. During the second round of jump squats, jumping jacks, or burpees – a woman nonchalantly jogs in the direction of the restroom. A quick minute later she is back, with an emptied bladder and fresh panty liner in place. Ready to get back in the routine.

At the end of the workout two other women laugh about modifying jump squats because they “totally knew they would pee if they did another round” and the woman walks out feeling comforted. Adding this scenario to her list of new realities of motherhood. Yippee….

But is it “normal”? And what is “it” really?

It is a muscle group called the pelvic floor, and it is responsible for supporting the abdominal and pelvic organs while also helping to close-off, or contract, all things deemed lady bits (urethra, vagina, and anus). Let’s not leave men out though, because they too can suffer from pelvic floor dysfunction (PFD).

Pelvic Floor Muscles act as a hammock of support.

Ideally the pelvic floor muscles are toned, supporting the body throughout the day and able to contract quickly when sneezing, laughing or working out. But unfortunately this isn’t always the case as hormone changes, poor posture, and yes childbirth come into play.  A lack of support can lead to bladder leakage, fecal incontinence or unintentional flatulence, or even organ prolapse.

But wait, there’s more!

The pelvic floor can also be overly tense in what Dr. Brianne Grogan, PT, DPT refers to as “Hulk Vagina”. And while at first glance, a part of me wants this diagnosis for its super powers alone – it’s really not one to be green with envy over. An overactive pelvic floor can lead to painful intercourse, the inability to initiate or drain the bladder and reoccurring pelvic pain. This scenario receives far less spotlight so many have never heard of PFD related to over-stimulation. When it comes to intercourse following childbirth, there isn’t a lot of talk about the changes to the postpartum female body and what to expect – if your care provider does not hit on this topic at the 6-week checkup, then seek out a conversation with your postpartum doula. The important note is that pelvic pain during daily activity, strenuous workouts, or intercourse should not be ignored.

Let’s do a little kegel test, compliments of Dr. Bri. “Picture your pelvic floor as an elevator. Close the imaginary elevator doors (i.e. squeeze your pelvic floor muscles around your vagina and anus) and then lift the ‘elevator’ up to the third floor. Next, allow the ‘elevator’ to descend (i.e. relax/release your pelvic floor contraction), and then open the ‘elevator’ doors all the way (completely relax the pelvic floor).

Were you able to sense a difference between the contraction and relaxation phase? Could your pelvic floor ‘elevator’ go up AND down? If it can go up, but not down then you may be experiencing hyper stimulation.

Is it strong enough?

You want to position your body (via good posture) such that your pelvic floor muscles are always at the right level of ‘on’ to SUPPORT your pelvic organs and be able to quickly turn ‘extra on’ when needed.” And you want to ensure that your pelvic floor has the strength to withstand the physical exertion of your workout program as well.

If any of the symptoms above have been relatable to you, then I want you to know you are not alone! And there is help available. To learn more about women’s physical therapy and how a trained pelvic physical therapist can provide support you may contact Fort Wayne Doulas or one of the local PT’s listed below.

Have a happy, healthy day!

Certified Pelvic Physical Therapists
in Fort Wayne, IN

Margaret Bronson – Pelvic Physical Therapist at Parkview

Nicole Bobay – Pelvic and Orthopedic Physical Therapist at ProTailored

Sources for this blog include Dr. Brianna Grogan