The status of pelvic floor muscle training for women

Abstract

There is no consensus on the amount of exercise necessary to improve pelvic floor muscle (PFM) function. We reviewed the pathophysiology of PFM dysfunction and the evolution of PFM training regimens since Kegel introduced the concept of pelvic floor awareness and the benefits of strength. This paper also describes the similarities and differences between PFM and other muscular groups, reviews the physiology of muscle contraction and principles of muscle fitness and exercise benefits and presents the range of protocols designed to strengthen the PFM and improve function. We also discuss the potential application of new technology and methodologies. The design of PFM training logically requires multiple factors to be considered in each patient. Research that defines measures to objectively quantify the degree of dysfunction and the efficacy of training would be beneficial. The application of new technologies may help this process.

Prevalence and Normalization of Stress Urinary Incontinence in Female Strength Athletes

“…A clear benefit of pelvic floor physical therapy for SUI has also been demonstrated in elite female athletes ( 23 ). Historically women were guided to Kegel exercises (voluntary contraction of the pelvic floor muscles with an inward lift) to increase tone of levator ani muscles, and therapy focusing on pelvic floor musculature is most supported in the literature ( 16 ). Practicing contraction of pelvic floor muscles slightly before or at the same time as sports-specific motions that increase intra-abdominal pressure is known as the Knack Principle.…”

“…Practicing contraction of pelvic floor muscles slightly before or at the same time as sports-specific motions that increase intra-abdominal pressure is known as the Knack Principle. Physical therapy for SUI is evolving to address increased strength, endurance, and specific control of the abdominal wall muscles, diaphragm, lumbar musculature, and hip flexors, extensors, and rotators in addition to the pelvic floor muscles ( 16 ). Pelvic floor physical therapy techniques have resulted in measurable improvements in pelvic floor muscle size and tone ( 4 ), reduction in SUI in experimental settings ( 11 ), and self-reported reduction of SUI during activity ( 9 ).…”