What is Your Pelvic Floor? How Does it Relate to Strength Training?

Kirsten Dell, DPT recently joined us for an engaging workshop on pelvic health and its crucial connection to strength training. The session combined theoretical knowledge with hands-on practice, giving attendees practical tools to improve their training and overall movement quality. Whether you're an athlete, fitness enthusiast, or someone curious about pelvic health, this workshop recap offers valuable insights into how pelvic floor function affects everything from daily activities to athletic performance.

What is Pelvic Health? How Does it Relate to Strength Training?

Watch the full workshop recording above, or read on for key insights and takeaways from Dr. Dell's comprehensive session on pelvic health and strength training.

Disclaimer: This blog post summarizes the speaker's insights but doesn't replace professional medical advice. Always consult a healthcare provider for personalized pelvic floor health guidance.

About Kirsten:

Dr. Dell graduated from the University of Missouri with a Doctorate in Physical Therapy and began practicing at an outpatient clinic specializing in orthopedics and pelvic health. Her caseload has primarily focused on treating all aspects of pelvic health, with a particular passion for chronic pelvic pain and postpartum care. Dr. Dell is currently working to expand the pelvic health services offered at UofL Health and make them more accessible to patients.

Who Will Benefit From This Information?

This workshop's insights are valuable for:

  • Strength athletes looking to improve stability and performance
  • Runners seeking better core control and injury prevention
  • Fitness enthusiasts wanting to optimize their training
  • Anyone experiencing unexplained back or hip pain
  • Those interested in improving their balance or movement quality
  • Postpartum individuals returning to exercise
  • Athletes working on performance enhancement

The principles covered apply to all fitness levels, from beginners to advanced athletes. As Dr. Dell emphasized in the workshop, "You are all athletes... every single one of us can improve our hip stability and core stability."

Workshop Highlights

During our hands-on session, Dr. Dell challenged common misconceptions about pelvic health and shared surprising insights about core stability. A key revelation was that approximately 85% of pelvic floor issues stem from excessive tension rather than weakness. "Everything has to do with the pelvis," Dr. Dell emphasized, "our whole body sits on our pelvis."

What is Your Pelvic Floor?

The pelvic floor is a group of muscles that form the foundation of your core.

Dr. Dell explained its five essential functions (the "5 S's"):

  1. Support: The pelvic floor muscles act like a hammock, holding your organs in place.
  2. Sphincteric Function: These muscles control the opening and closing of your urethra (urination), vagina, and anus (defecation).
  3. Sexual Function: Pelvic floor muscles contribute to sexual arousal and function.
  4. Stability: A strong pelvic floor is essential for overall core stability and movement.
  5. Sump Pump: Proper pelvic floor function helps move fluids throughout the body.

These functions are also known as the 5's

There are three layers to the pelvic floor, each with specific functions.

Three Layers of the Pelvic Floor

  1. Superficial Layer: This is the outermost layer, closest to the skin's surface. It surrounds the external genitalia and is involved in functions like sexual response.
  2. Fascial Layer: This middle layer houses the sphincters responsible for controlling urination and defecation. It's also rich in nerves and can be a source of pain if affected by entrapment.
  3. Deep Layer: This is the innermost layer, and it's the one we often focus on in pelvic floor rehabilitation. It contains the muscles responsible for contracting and relaxing to support the organs.
Muscles of the Pelvic Floor. The pelvic floor muscles support the pelvic organs, resist intra-abdominal pressure, and work as sphincters for the urethra, rectum, and vagina. English labels. From OpenStax book 'Anatomy and Physiology', fig. 11.19.

Practical Applications for Strength Training

The workshop featured several foundational exercises that participants practiced, including:

  1. Proper Breathing Mechanics:
    1. Diaphragmatic breathing exercises
    2. Learning to coordinate breath with movement
    3. Understanding the relationship between breathing and core activation
  2. Core Activation Exercises:
    1. Bridge variations with proper pelvic positioning
    2. Anti-rotation exercises in half-kneeling positions
    3. Standing stability work with resistance bands
  3. Key Training Principles:
    1. Exhale during effort (like lifting or pushing)
    2. Focus on quality over quantity
    3. Maintain proper pelvic position during exercises
    4. Integrate breathing with movement

Try this at home

Quick Breathing Check Exercise:

1. Lie on your back with one hand on your stomach, one on your chest

2. Breathe in through your nose, focusing on making your stomach rise while your chest stays relatively still until the end

3. Exhale out of your mouth like you're trying to blow out a candle

4. Practice for 2-3 minutes before bed

Note: Your stomach should rise on inhale and fall on exhale. If your chest is moving more than your stomach, keep practicing!

Common Misconceptions Debunked

During the workshop, Dr. Dell challenged several widespread beliefs about pelvic health and core training:

  • Myth: "Just do more Kegels"
  • Reality: Many people actually need to focus on relaxation rather than more tension. About 85% of Dr. Dell's cases involve excessive tension, not weakness.


  • Myth: "Six-pack abs mean a strong core"
  • Reality: Visible abs aren't functional and sometimes indicate overuse of surface muscles rather than proper deep core activation.


  • Myth: "Stability means tightness"
  • Reality: True stability often requires learning to relax certain muscles while properly engaging others. As Dr. Dell demonstrated, sometimes we need to "let go" to find real stability.

What are symptoms of pelvic floor dysfunction?

Pelvic Health Physical Therapy often addresses symptoms that may be hard to talk about including:

  • Urinary and Fecal Incontinence: Leaking urine or stool due to weak or dysfunctional pelvic floor muscles.
  • Prolapse: When organs like the bladder or uterus descend from their normal position due to weakened pelvic floor support.
  • Painful Intercourse: Tightness or weakness in the pelvic floor muscles can contribute to pain during sex.

Other common reasons to seek out a Pelvic Floor Physical Therapist Include:

  • Pregnancy care
  • Recovering from childbirth (postpartum)
  • Pelvic pain
  • Painful period cramps
  • Pelvic floor dysfunction (male and female)
  • Pelvic organ prolapse (when organs in the pelvis slip down from their normal position)
  • Back, hip, sacral or coccygeal pain

Key Takeaways

  • The pelvic floor is a vital group of muscles that plays a significant role in our health and well-being.
  • The workshop demonstrated that pelvic health exercises can be incorporated into any fitness routine.
  • Pelvic floor dysfunction can manifest in various ways, including incontinence, prolapse, and pain.
  • Pelvic floor physical therapy can help address these issues and improve pelvic health.
  • Whether you're an experienced athlete or just starting your fitness journey, these fundamental principles can enhance your training results and overall movement quality.

Ready to improve your core stability and movement quality? Here are your next steps:

1. Start incorporating the breathing exercises shared above into your daily routine
2. Pay attention to your breathing patterns during your next workout
3. Consider scheduling an assessment with a pelvic health physical therapist if you're experiencing any symptoms discussed

For those interested in working with Dr. Dell or learning more about pelvic health physical therapy, contact our team at 573-443-1495 for referral information.

References

  1. Betts, J. G., Young, K. A., Wise, J. A., Johnson, E., Poe, B., Kruse, D. H., Korol, O., Johnson, J. E., Womble, M., & DeSaix, P. (2022). Muscles of the Pelvic Floor The pelvic floor muscles support the pelvic organs, resist intra-abdominal pressure, and work as sphincters for the urethra, rectum, and vagina. Anatomy and Physiology 2e. OpenStax. Retrieved from https://openstax.org/books/ana....

Steven Mack is founder and a Certified Strength and Conditioning Specialist at the private training studio, Simple Solutions Fitness. He consults for Stronger by Science, a leader in fitness research dissemination, and is a former Mizzou football walk-on. Steven dedicates his professional life to helping people through his writing, speaking, and role as a personal trainer.