Why Pelvic Floor Health Should be Discussed More


Because peeing when you sneeze is not necessary…

Prenatal massage was pioneered by the Medical Massage Group over 20 years ago in Manhattan when there were few options to treat the muscular pains experienced by pregnancy. The care and well-being of mothers has always been a focus at MMG since many of the physical issues of pregnancy and postpartum health have generally been overlooked by much of the medical community. One of the most important and widely overlooked topics is that of pelvic floor health.

While compromised pelvic floors can happen to men or women, for generations poorly performing pelvic floor muscles were the accepted aftermath of pregnancy and childbirth. Thus, slightly peeing when one sneezes or attempted the trampoline was thought to be normal for mothers and often no treatment was sought. In more severe cases of incontinence due to a weak pelvic floor, surgery was often the answer which sometimes had arguably worse side effects. At our practice we believe preventative medicine is the best medicine, and are ardent to be part of conversation concerning pelvic floor dysfunction as it applies to many of our patients who have gone through pregnancy and childbirth.


For starters, the pelvic floor refers to a group of muscles that act like a muscular cradle from the tailbone to the pubic bone holding up the bladder, the bowel, and the uterus (in females). Common causes which weaken the pelvic floor are associated with pregnancy, childbirth, and obesity which put excessive pressure on the muscles. Other cases stem from diastasis recti, prostate cancer treatment, straining of chronic constipation and even constant coughing. In some cases, lifestyle changes can prevent a weak pelvic floor. But, if symptoms have already occurred it is at least possible, in some cases, to prevent surgery with exercise and proper alignment.


  • leaking small amounts of urine when coughing, sneezing, laughing or running

  • failing to reach the toilet in time

  • uncontrollably breaking wind when bending over or lifting

  • reduced sensation in the vagina

  • tampons that dislodge or fall out

  • a distinct bulge at the vaginal opening

  • a sensation of heaviness in the vagina

  • Pain during intercourse

  • Organ prolapse: bladder or uterus

  • Pain in your lower back that cannot be explained by other causes


For many of our patients pregnancy and childbirth are not preventable circumstances, but research from biomechanist, Katy Bowman, advocates lifestyle changes that can prevent pelvic organ prolapse with circumstances which are preventable. After childbirth do not engage in high impact activities and never wear heels - we know, hearing this is more painful than actually wearing heels. Also, a sedentary lifestyle such as simply sitting too much on your sacrum, aka your bottom, derriere, tuchus, does your pelvic floor muscles no favors. Other preventive measures include maintaining a healthy weight, high fiber diets to avoid constipation and treating chronic coughs.


Addressing pelvic floor dysfunction requires consulting professionals that specialize in women’s health and pelvic floor rehabilitation. Before treatment begins one should have a full assessment including posture, pelvic alignment and an internal evaluation. Physical Therapy includes stretches and exercises to both release tension in the area and build back strength. Treatment also includes learning what not to do such as exercises or positions that can worsen the situation. Most of the exercises recommended include Kegels, reverse Kegels, bridge pose and squats. If you have experienced dysfunction we recommend first doing these exercises under the guidance of a professional as these muscles are harder to access than the muscle groups most are accustomed to working.

Pelvic floor strengthening is a lifelong commitment once afflicted, though a few daily exercise and attention to daily posture are welcome alternatives to surgery. At Medical Massage Group we are dedicated to keeping our clients informed when it comes to matters of their health and wellbeing. We work together with physical therapists and trainers who specialize in pelvic floor rehabilitation to achieve the best results for our patients.

Kristin Sewell