If you've heard of the pelvic floor, there's a good chance it's been in the context of pregnancy or childbirth. After all, the pelvic floor holds the uterus, which holds the baby, and after delivery, women can experience pelvic floor dysfunction.
Although all of that is true, it's only a sliver of what the pelvic floor is and why it's important, particularly for athletes.
The pelvic floor is a group of interlacing muscles that span the distance between the tailbone and the pubic bone, pelvic floor specialist Paul Tulikangas, M.D., director of urogynecology at Hartford Hospital tells Bicycling. These muscles support the bowel and bladder in men and women, and the uterus and vagina in women.
Because humans are upright, the strength and tone of the pelvic floor muscles are imperative in keeping the organs in place, Tulikangas explains.
The pelvic floor has a lot of responsibilities in the body, and with that comes some confusion. So we're here to set the record straight on the common misconceptions linked to this important group of muscles.
Men might be less likely to experience symptoms related to pelvic floor dysfunction-an umbrella term that refers to certain conditions, including incontinence, overactive bladder, painful intercourse, and pain while sitting-but they certainly have a pelvic floor.
Men are also less likely than women to seek medical attention for symptoms related to pelvic floor issues, Tulikangas tells Bicycling.
"Symptoms tend to occur in men over 50 and are often related to prostate disease," he says. "Those symptoms might be dribbling after urination, getting up more frequently at night to use the bathroom, and a slow stream."
Men may also struggle with erectile dysfunction or incontinence after a prostatectomy to treat prostate cancer."Pelvic floor therapy can be really helpful in those cases," Tulikangas says. Pelvic floor therapy is a form of physical therapy, with specialized therapists working to treat the strength and tone of the pelvic floor muscles.
The kegel exercise is an important tool in training your pelvic floor, but only if it's done correctly, explains Lauren Garges, P.T., W.C.S., director of the women's health program at St. Luke's University Health Network in Bethlehem, Pennsylvania.
Quick squeezes of the pelvic-floor muscles-those used to stop urine midstream-can strengthen the fast-twitch muscles that prevent leaking while sneezing, for example. Longer, slower, squeezes focus on slow-twitch muscles that are required to keep organs in place and prevent leaking during exercise or other movement.
To properly do a kegel exercise that focuses on those slow-twitch muscles: Breathe normally as you tighten your pelvic floor muscles for 10 seconds, then relax them for 10 seconds. Perform three sets of 10 repetitions a day.
If you can't fully relax your muscles, that might be a sign that your pelvic floor is too tight, Garges tells Bicycling.
"Squeezing can make [a tightness] problem worse," she says. For these people, many of whom present with feelings of pain in the pelvic floor, kegel exercises are not an appropriate form of treatment.
"Pelvic floor therapy is about strength and tone, as well as being able to relax those muscles," Tulikangas says.
Pelvic floor specialists and therapists want you to hear them loud and clear: Leaking is common but not normal. And because it can be an embarrassing symptom, many people-men and women included-don't seek medical attention to treat it.
"Throughout history, people have often tolerated many issues associated with aging," Tulikangas says. "For example, someone might have a bad knee and just use a cane. But now there is better medical intervention, and you can have a knee replacement and get back to vigorous activity."
The same can be said for urinary incontinence, he says. Aging might be a risk factor for leaking, but it can be addressed through pelvic floor therapy. The key is going to see your doc and chatting about the issue.
The high-impact nature of running adds another level of stress to the pelvic floor muscles. Ground reaction force, Garges explained to Runner's World in a previous article, is the force your body absorbs every time your foot hits the ground.
"You have gravity going down and ground reaction force coming up, and they meet at the midpoint in the pelvic area," she said. "Your pelvic floor muscles are absorbing a ton of impact, and when you have all of these forces hitting at once, if your pelvic floor has a deficit, that's when leakage occurs."
This is why docs sometimes recommend women who have recently had a child to ease back into running and take it slow in getting back to a regular run routine.
The bottom line with all these pelvic floor misconceptions: Don't be afraid to seek treatment if something is off or seems off with these group of muscles-including leakage in general, as well as leakage while running.