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Natural Awakenings Milwaukee Magazine

7 Tips to Have a Healthy Pelvic Floor

Dec 01, 2021 12:00AM ● By Dr. Brenda Heinecke
Pelvic floor issues such as incontinence, pain with intercourse, pelvic organ prolapse and pelvic pain are very common for women. For example, studies referred to in a 2019 article at indicates that up to 70 percent of women suffer from urinary incontinence, with the higher numbers aligned to increased age. While these issues are common, they are not normal and not something that women have to accept as part of “getting older” or “having a baby”. Follow these tips to minimize issues and keep the pelvic floor healthy.

1  Improve Posture

Poor posture has bigger implications than its effect on the neck or back; it also impacts the pelvic floor. Sitting in a slouched position places the pelvis in a posterior pelvic tilt, which causes the pelvic floor muscles to tighten. The same happens with standing while clenching the buttocks. Tight pelvic floor muscles lead to pain, leaking and even back pain.

2  Stop Hovering

Hovering over the toilet seat causes the pelvic floor muscles to actively contract, at which point elimination occurs through contracted—not relaxed—muscles. This eventually leads to leaking during other activities such as running and jumping.

3  Reduce Constipation

Constipation makes elimination more difficult, and can result in straining and pressure on the pelvic floor muscles. Over time, repetitive straining leads to pelvic organ prolapse and incontinence. To avoid constipation, aim for at least 64 ounces of water, 30 to 40 grams of fiber per day, and a good toileting position.

4  Practice Diaphragmatic Breathing

Diaphragmatic breathing is one of the most important “exercises” for proper pelvic floor function. During diaphragmatic breathing, the diaphragm lowers (relaxes) during the inhalation phase to let air in, and then lifts (contracts) during exhalation to push air out. The pelvic floor follows this same movement pattern which allows the pressure within the abdomen to remain fairly constant.

If this is not occurring regularly, it will lead to poor coordination as well as tightening of the pelvic floor muscles. When this happens, kegels will make it worse and lead to more issues. That is why diaphragmatic breathing is recommended rather than kegels for a healthy pelvic floor.

5  Avoid Bladder Irritants

Certain compounds are irritating to the bladder, including caffeine, alcohol, carbonation, artificial sweeteners, and foods and drinks with acidic properties. Bladder irritants are known to contribute to urinary urgency, leaking and pelvic pain.

An example of this is the need to use the bathroom more frequently after drinking a cup of coffee. The bladder gets irritated from the caffeine and acidic properties and wants to get rid of it. Identifying patterns, decreasing irritants, and drinking water after ingesting a bladder irritant can all help minimize the irritant’s effect.

6  Practice Proper Vulvar Hygiene

Using the right hygiene products and practices can make a big difference in regards to pelvic pain, pain with intercourse and recurrent infections. The only thing necessary to “clean” the vulva is water. Soap and douching actually kill the good bacteria inside of the vagina, which increases the risk for infection. Poor quality lubricants also contain chemicals that alter the vaginal pH, causing increased pain and tissue sensitivity as well as infection risk.

7  See a Pelvic Floor Physical Therapist

Research referred to in a 2015 article has shown pelvic floor physical therapy to be an effective method for resolving issues such as incontinence, urgency and pelvic pain. Most pelvic floor issues are complex and often require more than one simple intervention. If the issues haven’t been resolved with exercise or modification, it is time to seek help from a professional.

Dr. Brenda Heinecke, owner and pelvic floor physical therapist at Revitalize Physical Therapy, specializes in helping women through a hands-on, personalized, cohesive approach to living a healthy and active life. She works with women in all stages of life—preconception, pregnancy, postpartum, menopause and everything in between—to resolve common pelvic floor issues. For more information, call 414-708-8066 or visit