7 ejercicios de terapia de ejercicio eficaces para fortalecer el piso pélvico

Doing regular strength training? Good for you. But there’s one surprising area your strength training sessions might be neglecting: your pelvic floor. Not so familiar? Your pelvic floor is a group of muscles and tissues that stretch like a hammock from your pubic bone in front of your body back to your tailbone. 

Your pelvic floor supports your bladder, bowel, and sexual organs, so strengthening pelvic floor muscles can help reduce pelvic pain, improve your bladder control and bowel control, and may even improve your sexual health. 

Read on to learn the best pelvic floor physical therapy exercises to strengthen your pelvic floor and physical therapists’ tips for pelvic floor muscle training.

Exercises for Pelvic Floor Strength

Your pelvic floor is made up of layers of muscles, ligaments, and fascia (or connective tissue) — just like the structures in your ankles, shoulders, knees, and hips. That’s why pelvic floor exercises and physical therapy to strengthen your pelvic floor make sense.

The following exercises recommended by Hinge Health pelvic floor physical therapists are a great way to keep your pelvic floor muscles and your entire core strong and healthy. You will see Kegel exercises, the most well-known kind of pelvic floor strengthening exercises, as well as other exercises to help strengthen your pelvic floor and related muscles.

These exercises are most effective when you coordinate them with diaphragmatic breathing exercises. The general rule for breathing with pelvic floor exercises is to inhale during the “rest” portion of the exercise and exhale during the “hardest” part, when the muscle is contracting.

Hooklying Kegels are one of the best ways to strengthen your pelvic floor muscles, improve bowel and bladder control, and provide support to organs in your pelvis. 

How to do it:

• On a yoga mat, lie comfortably on your back with your knees bent and your feet flat on the floor. Inhale slowly. 

• Slowly exhale while you contract your pelvic floor muscles and hold for three to five seconds. It might feel like your muscles are being gently pulled up and into your body as you hold this position. You are using the muscles you would use to stop the flow of urine or prevent yourself from passing gas.

• Inhale as you slowly release the contraction and relax your muscles. 

• Build slowly up to 10 repetitions, three times a day.

This simple movement strengthens the core and buttocks muscles, which in turn strengthen and support the pelvic floor. Bridge exercise is a great way to coordinate your breathing with your pelvic floor, core, and lower body muscles.

How to do it:

• On a yoga mat, lie comfortably on your back with your knees bent and your feet flat on the floor. 

• Inhale and then slowly exhale while you push through your feet to raise your hips off the floor. Make a straight line with your torso and thighs. Focus on squeezing your pelvic floor and butt muscles as you hold this position.

• Inhale and relax your hips back to the floor as you release your pelvic floor and butt muscles.

Squats improve strength in your pelvic floor, leg, and butt muscles and overall balance. 

How to do it:

• Stand with your feet a comfortable distance apart.

• Exhale as you reach your hips back while bending your knees like you’re sitting in a chair.

• Hold the squat position as you focus on squeezing your thigh and hip muscles. Continue exhaling. 

• Push through your feet to straighten your knees and return to standing.

Internal hip rotation helps to increase strength and mobility in your hip and pelvic floor muscles. 

How to do it:

• Sit comfortably in a chair and inhale.

• Slowly exhale while sliding one foot off the floor and rotating it away from your other foot. Your thigh and knee should remain in the same position while your foot rotates to the side.

• Inhale and relax your foot back to the floor.

Seated abdominal bracing helps strengthen your pelvic floor and other core muscles and improves stability.

How to do it: 

• Sit upright in a chair with your feet flat on the floor and inhale slowly. 

• Exhale slowly while squeezing your abdominal muscles. 

• Inhale slowly as you relax your abdominals.

Alternating pelvic tilts help to strengthen and stabilize your core and pelvic floor muscles that may have stretched or weakened during pregnancy.

How to do it:

• Lie on your back with your knees bent and your feet flat on the floor.

• Tilt your pelvis forward while arching your back.

• Tilt your pelvis backward and press your back into the floor while tucking your tailbone.

• Return to your starting position.

Standing Kegels strengthen your pelvic floor muscles in a challenging position that works against gravity. This exercise can improve bowel and bladder control and provide support to organs in your pelvis.

How to do it:

• Begin standing tall with your feet about hip width apart and a soft bend in your knees.

• Inhale to prepare and then exhale as you squeeze and lift the muscles between your pubic bone and tailbone toward your head.

• Inhale to release and relax the muscles, keeping your butt muscles relaxed and your spine neutral.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Strengthening Your Pelvic Floor and Your Core 

The best pelvic floor exercise program includes more than just Kegels. That’s because your pelvic floor muscles are actually a part of your core, which includes your diaphragm, abdominals, and spinal muscles. Together, these muscles are important for pelvic health, balance, flexibility, and stability. And they’re all connected, so weakness in one area can lead to symptoms in another.

Problems with any part of your core can lead to pelvic floor disorders (PFDs) with common symptoms like pelvic pain, leaking urine when you sneeze or cough (urinary incontinence),  fecal incontinence (leaking feces), sexual problems, and more. Pelvic floor weakness can be related to injury, pregnancy and childbirth, chronic coughing or constipation, obesity, poor lifting techniques, and more. 

Doing Kegels only strengthens one part of your interconnected core muscles. This is why it’s important to do pelvic floor exercises like squats, bridges, and pelvic tilts (all above), because they all work different muscle areas in and around your core that affect your pelvic health.

Benefits of Pelvic Floor Exercises and Physical Therapy

Because your pelvic floor muscles support your bladder, bowel, rectum, and reproductive organs, strengthening these muscles can help improve pelvic symptoms. A pelvic floor physical therapist can help you target the right muscles to address your symptoms. 

Pelvic floor physical therapy is a comprehensive treatment that may include exercise, relaxation techniques, behavioral training, lifestyle modifications, biofeedback training, and more. You can see a physical therapist in person or use a women’s health program like Hinge Health to access a PT via telehealth/video visit.

Pelvic floor muscle exercises and physical therapy can help:

• Improve bladder control and reduce urinary incontinence and post-void dribbling

• Reduce urinary urgency and frequency (overactive bladder)

• Improve bowel control and reduce bowel incontinence

• Relieve pelvic pain

• Reduce symptoms of pelvic organ prolapse

• Relieve pain with sex and improve sexual function and response, including arousal, orgasm, and satisfaction

• Provide better support for your body during everyday movements like standing, walking, and running

What to Avoid During Pelvic Floor Exercises

Common mistakes people make with pelvic floor strengthening exercises include:

• Contracting other nearby muscles.  Focus on contracting only the pelvic floor muscles while keeping the muscles of your stomach, thighs, and buttocks relaxed.

• Holding your breath. Breath holding increases the pressure in your abdomen and can stress your pelvic floor and lead to pelvic floor dysfunction. 

• A full bladder. This increases stress on your pelvic floor. It also increases the pressure on your urethral sphincter that controls the flow of urine from your bladder. Empty your bladder before doing pelvic floor exercises.

• Overdoing it. Your pelvic floor muscles can be overtaxed. This can make it difficult to relax your pelvic floor to urinate or have a bowel movement and can lead to other pelvic symptoms. 

• Pain. Stop if you feel pain in your abdomen, back, or hips while performing pelvic floor exercises. If you’re doing pelvic floor exercises correctly, they shouldn’t hurt.

Pelvic Floor Muscle Strengthening vs. Relaxing: What’s the Difference?

Some pelvic issues are due to tight (instead of weak) pelvic floor muscles. These conditions benefit from exercises that focus on relaxing the pelvic floor rather than strengthening it. Some signs of a tight pelvic floor include: pelvic pain or pain with sex, difficulty starting a stream of urine, slow urine stream, urinary urgency and frequency, and more. 

Overdoing pelvic floor strengthening exercises can actually make some pelvic symptoms worse, especially if you have tight pelvic floor muscles. So it's a good idea to see a doctor or pelvic floor physical therapist if you have concerns.

When to See a Doctor

See your healthcare professional if you experience pain with pelvic floor exercises. Pelvic pain could be a sign that you’re doing exercises incorrectly or overdoing them. Pain could also be a sign of another health condition, like an overactive or tight pelvic floor or a urinary tract infection.

PT Tip: Remember ‘It’s Not Just Kegels’

Kegel exercises can be an important part of a pelvic floor strengthening program, but they shouldn’t be your whole program. Kegels involve consciously contracting or squeezing your pelvic floor muscles like you do when you’re trying to stop the flow of urine. 

“If you’re thinking that pelvic floor muscle strengthening is just Kegel exercises, think again,” says Kandis Daroski, PT, DPT, a physical therapist at Hinge Health. “A well-rounded pelvic floor exercise program addresses all the body areas that may contribute to your symptoms,” she adds. “It will include exercises that strengthen other parts of your core, including your abdominal, hip, glute, and back muscles.” 

How Hinge Health Can Help You

If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you. Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Ramalingam, K., & Monga, A. (2015). Obesity and pelvic floor dysfunction. Best practice & research. Clinical obstetrics & gynaecology, 29(4), 541–547. doi:10.1016/j.bpobgyn.2015.02.002

2. Cho, S. T., & Kim, K. H. (2021). Pelvic floor muscle exercise and training for coping with urinary incontinence. Journal of exercise rehabilitation, 17(6), 379–387. doi:10.12965/jer.2142666.333 

3. Dumoulin, C., Hay-Smith, E. J., & Mac Habée-Séguin, G. (2014). Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. The Cochrane database of systematic reviews, (5), CD005654. doi:10.1002/14651858.CD005654.pub3

4. Grimes, W. R., & Stratton, M. (2021b). Pelvic Floor Dysfunction. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559246/ 

5. Huang, Y. C., & Chang, K. V. (2022). Kegel Exercises. In StatPearls. StatPearls Publishing. 

6. Khosravi, A., Riazi, H., Simbar, M., & Montazeri, A. (2022). Effectiveness of Kegel exercise and lubricant gel for improving sexual function in menopausal women: A randomized trial. European journal of obstetrics, gynecology, and reproductive biology, 274, 106–112. doi:10.1016/j.ejogrb.2022.05.022 

7. Massery, M (2013. Soda pop can model [Video]. YouTube. https://www.youtube.com/watch?v=IeiKhMmjDGc

8. Myers, C., & Smith, M. (2019). Pelvic floor muscle training improves erectile dysfunction and premature ejaculation: a systematic review. Physiotherapy, 105(2), 235–243. doi:10.1016/j.physio.2019.01.002 

9. Siegel A. L. (2014). Pelvic floor muscle training in males: practical applications. Urology, 84(1), 1–7. doi:10.1016/j.urology.2014.03.016 

10. Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology, 31(6), 485–493.doi:10.1097/gco.0000000000000584 

11. Williams, A. M. M., Sato-Klemm, M., Deegan, E. G., Eginyan, G., & Lam, T. (2022). Characterizing Pelvic Floor Muscle Activity During Walking and Jogging in Continent Adults: A Cross-Sectional Study. Frontiers in human neuroscience, 16, 912839. doi:10.3389/fnhum.2022.912839