When most people hear the words “pelvic floor,” they may think of pregnancy, childbirth or women’s health. But the pelvic floor is relevant to everyone — women and men — across every stage of life.
In fact, your pelvic floor has more in common with your glutes, abdominal muscles or quadriceps than you might realise. It is made up of skeletal muscle and, like other muscles in the body, it can become stronger with appropriate training, weaker with disuse and change as we age.
Understanding and looking after your pelvic floor can play an important role in maintaining continence, confidence, physical activity and quality of life.
What Is the Pelvic Floor?
The pelvic floor is a group of muscles and connective tissues that form a supportive sling or hammock at the base of the pelvis.
These muscles help support the bladder and bowel, as well as the uterus in women, and contribute areas such as to bladder and bowel control.
Your pelvic floor also needs to respond quickly to changes in pressure. When you cough, sneeze, laugh, lift something heavy, run or jump, the pelvic floor works with other muscles to help maintain support and continence.
Because these muscles aren’t visible and we don’t generally think about them during everyday movement, they can easily be overlooked — often until symptoms develop.
Why Physiotherapists Care About the Pelvic Floor
Pelvic floor physiotherapy fits naturally within physiotherapy because, at its core, we are assessing and treating muscle function, movement and coordination.
The pelvic floor consists of skeletal muscle connected to the pelvis and controlled by the nervous system. Importantly, it needs to be able to both contract and relax appropriately.
Just like other muscles, pelvic floor muscles can present in different ways.
This is why pelvic floor exercises aren’t necessarily a one-size-fits-all solution.
A physiotherapist with appropriate training can assess your symptoms and muscle function before developing an individualised exercise and management program.
What Happens to the Pelvic Floor as We Age?
We know that muscle mass, strength and function gradually change as we get older. Age-related loss of muscle mass and function is known as sarcopenia, and it can affect muscles throughout the body — including the pelvic floor.
Over time, changes to muscle strength, endurance, connective tissues and nerve function may affect how effectively the pelvic floor responds to everyday demands.
For example, the ability to produce a quick, strong contraction when you cough, sneeze, laugh or jump may decline. Hormonal changes, particularly around menopause, can also influence the tissues supporting the pelvic region.
This can contribute to symptoms such as urinary leakage, urgency or reduced pelvic support.
However, common does not mean inevitable. Experiencing leakage as you get older doesn’t mean you simply have to accept it.
Men, This Applies to You Too
Pelvic floor health isn’t only a women’s health issue.
Pelvic floor dysfunction in men may occur for several reasons, including prostate surgery, chronic straining, persistent pelvic pain, changes associated with ageing and other medical or lifestyle factors.
Pelvic floor rehabilitation is particularly important for some men undergoing prostate surgery, where appropriately prescribed pelvic floor muscle training can form part of both pre-operative and post-operative rehabilitation.
If you’re experiencing urinary leakage or other pelvic symptoms, it is worth discussing them with your healthcare professional rather than assuming they’re simply something you need to live with.
Train It Like Any Other Muscle
The good news is that pelvic floor muscles can respond to appropriate training — including later in life.
The principles are similar to strengthening and rehabilitating other muscles in the body:
- Specificity: Exercises need to appropriately target the pelvic floor, including both contraction and relaxation.
- Progressive loading: Strength, endurance and coordination can be gradually progressed as your capacity improves.
- Consistency: Like any strengthening program, improvements require regular practice over time.
- Correct technique: Technique matters. Some people unintentionally hold their breath, excessively brace their abdominal muscles or bear down rather than correctly contracting and lifting the pelvic floor.
- Individualisation: Not everyone needs the same exercises. Your program should reflect your symptoms, strength, coordination and goals.
A physiotherapist can help determine whether strengthening, relaxation, coordination training or a combination of approaches is most appropriate for you.
Don’t Wait for a Problem to Start Thinking About Your Pelvic Floor
We regularly talk about maintaining leg strength, cardiovascular fitness, balance and bone health as we age. Pelvic floor strength deserves a place in that conversation too.
Learning how to correctly activate and relax your pelvic floor and incorporating appropriate exercises into your routine may help support bladder and bowel function and allow you to continue exercising and participating confidently in everyday life.
And if you’re already experiencing symptoms such as leakage, urgency or changes in bladder or bowel control, don’t dismiss them as simply “part of getting older.”
There may be strategies that can help.
At Motion Health, our physiotherapists can assess your individual needs and help develop an appropriate exercise and management plan.