Pelvic Floor Muscle Weakness

Underactivity/hypotonicity, or weakness of the pelvic floor muscles may contribute to urinary and fecal incontinence, as well as pelvic organ prolapse.

The pelvic floor muscles are a group of muscles that attach to the front, back, and sides of the bottom of the pelvis and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate, and rectum. They also wrap around your urethra, rectum, and vagina.

These muscles must be able to contract to maintain continence and to relax allowing for urination, bowel movements, and penetration.

How to Treat Pelvic Floor Muscle Weakness

When the pelvic floor muscles are weak, they need to undergo a structured strengthening program that does not include just doing a few Kegels at the kitchen sink or at the stop sign. Based on the principles of strengthening, you need to fatigue muscle, in order to get hypertrophy (make it bigger). On the opposite side of the scale, patients are also told that they need to do up to 1000 repetitions per day, which has no basis in exercise science. 

Please follow this to get a written description of how to perform pelvic floor contraction if you identify as a female or a male. However, please remember that the majority of people cannot find these internal muscles without at least one consultation with a physiotherapist. There are an increasing number of Pelvic Health Physiotherapists available in Canada that have the training to assess the pelvic floor through internal palpation.

Once an assessment of the pelvic floor is conducted, an individualized strengthening program will be designed for you based on the objective findings.

The research strongly supports that physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first step of treatment, before surgical consultation, for stress, urge, and mixed incontinence in women.

In Britain, the National Institute of Health has declared that every person considered for surgical correction of stress incontinence should first be seen by a pelvic health physiotherapist for conservative care. Only those that cannot successfully resolve symptoms with physiotherapy are considered candidates for surgery.