By Emily Caldwell, PT, DPT, OCS, Director | TAI Clackamas Physical Therapy

Core strengthening exercises are discussed frequently in the gym, in magazines and in health care. However, one crucial part of the “core” is often overlooked: the pelvic floor musculature. This group of muscles is organized in layers that run from the tip of the pubic bone to the tailbone. They work together with our abdominal and back muscles and the diaphragm to form a strong stable center from which we move during our day-to-day activities. The pelvic floor muscles serve several important roles including:

  • Support for the bladder and internal organs
  • Support of the spine and pelvis
  • Sphincter closure (closing the vaginal and anal openings)
  • Sexual function

Therefore, if the pelvic floor muscles are weak or if they cannot coordinate properly with the other core muscles during our daily activities, pain and incontinence can occur in both men and women. Previous lumbar and abdominal surgeries, trauma to the region, and pregnancy can all impact how these muscles are functioning.

The most commonly occurring types of incontinence include:

Stress urinary incontinence: The involuntary loss of urine during laughter, coughing, sneezing, lifting objects, or any movement that increases pressure on the bladder.
Urge urinary incontinence: Urine leakage that occurs as soon as you get the urge to go to the bathroom.
Mixed urinary incontinence: A combination of stress and urge urinary incontinence.
Overflow urinary incontinence: When the bladder is so full that it leaks urine. This may be continuous leakage that the person does not always feel, due to improper emptying of the bladder.
Fecal incontinence: The inability to control the bowels, leading to loss of stool from the rectum.

There are many ways that strengthening and improving the coordination of the pelvic floor muscles and core can help improve a person’s control of their bowel and bladder. When you strengthen the pelvic floor muscles, the bladder and pelvic region are better supported, which improves your ability to control bowel and bladder function and can also help with reducing pelvic and lower back pain. If you have difficulty with incontinence or if you have pain in the pelvis, lower back, or hips, you may benefit from a detailed physical therapy evaluation by a pelvic floor specialist to help you better participate in the activities you enjoy.