“The pelvic floor is the home of a crucial set of muscles, tissues, ligaments, nerves, and blood vessels that contribute to overall core strength and hold key organs like the bladder, bowel, and (for those who have it) the vagina and uterus in place,” explains Emily Sauer, founder and CEO of Ohnut.
- Corey Silbert Hazama, DPT, physical therapist in New York City
- Emily Sauer, Emily Sauer has always been passionate about creating catalysts that spark human connection. While developing Ohnut (an intimate wearable designed to help women and couples who experience deep dyspareunia), she co-founded the Lady Bits League, founded the Pain Perception Project,...
But it’s more than a hammock to keep everything in. “Beyond support for our pelvic organs, the pelvic floor allows us to control urination and defecation, helps with sexual functioning like orgasms, acts as a sump pump for our blood and lymph by contracting and pushing fluids back up against gravity, and helps to stabilize the pelvis and lumbar spine,” adds pelvic physical therapist Corey Silbert Hazama, DPT, OCS, CFMT.
That’s a lot of responsibility. And yet many of us have weakness, or tightness, or other issues in the area: A 2022 study of 25,000 women found that 32 percent had at least one pelvic floor disorder.
“Any change in bowel or bladder function needs to get evaluated,” warns Dr. Hazama. “There can also be indications to get your pelvic floor muscles evaluated if there is long-standing hip pain, upper hamstring pain, or lower back pain that has been treated traditionally but has not changed.”
7 everyday habits that are damaging your pelvic floor
What causes these pelvic floor issues? The culprits are more common than you might think.
1. Crossing your legs
As I write this, my legs are crossed, a big no-no, according to Dr. Hazama. (Note: Quickly uncrosses legs.) “Talking the knee-over-knee kind, depending on which way you cross, it forces one side to rotate the pelvis forward onto the side of the leg crossing over,” she says. “This creates a rotation through the pelvis and also changes the position of the sitz bones to be uneven.”
Another issue is that we all have a preferred side. "This creates a pattern of pelvic asymmetry that makes it difficult to reverse and return to the other direction," Dr. Hazama says.
2. Sucking in
During my formative years, I remember watching a video made by an unqualified YouTuber who encouraged fans to walk around sucking it in to "trick the body into becoming skinny." While I’m glad to be past that phase, sucking it in all the time can damage your diaphragm, since the habit doesn't allow it to expand fully. “This prevents the pelvic floor from expanding and descending—and we need that motion,” says Dr. Hazama. “Also, if you’re not using your diaphragm for breathing, you’ll typically use your neck muscles, which can lead to neck pain.”
3. Squatting over public toilet seats
“To urinate fully, we need the pelvic floor to relax,” says Dr. Hazama. “When hovering over a toilet, we use all our leg muscles to keep us from falling—which results in our pelvic floor muscles contracting to assist with stabilization.”
She adds that power peeing is a no-go as well. “Our only job when we pee is to relax the muscles and sphincters around the bladder and let the detrusor do its job,” she says. “When you increase the intra-abdominal pressure to push the pee out, you could inadvertently be contracting the muscles you want to relax.”
4. Wearing too-tight waistbands
Similar to sucking it in, wearing extra tight waistbands can physically block the diaphragm from expanding fully, says Dr. Hazama. But the issues go beyond the diaphragm. “It can constrict and create tension and immobility of abdominal muscle fascial layers, leading to organs gliding and sliding against each other.”
5. Regularly donning high heels
As a five-foot girl, I definitely love heels during social situations. But Dr. Hazama warns against overdoing it. “Heels result in hyperextending the knees and pushing the pelvis forward,” she says. “Maintaining an unnatural posture for long periods can result in an adaptively shortened posterior pelvic floor and conversely lengthened anterior pelvic floor, leading to bowel and bladder issues.”
Slouching has the same effects as wearing heels. “When we slouch, we change the shape of our torso,” says Dr. Hazama. “This posturing inhibits core muscles and changes the symmetry of the pelvic floor, which can lead to pain.” Improving your day-to-day posture isn’t just about aesthetics—it could actually help relieve pelvic health symptoms.
7. Straining to poop
It’s tempting to “give it our all” when we’ve got an internal traffic jam down there. But this impulse can backfire, according to Dr. Hazama. “When tightening around your buttocks, holding your breath, or sucking in your abs to push out a poop, it puts a lot of pressure on our pelvic floor muscles,” she says. “Straining could potentially put yourself into a tucked position, which adds tension and possible injury to the pudendal nerve.”
Instead, try to relax during this time to allow the pelvic muscles to move out of the way. And if you often feel tempted to strain, take stock of whether you might need to make a lifestyle or diet change to help BMs come more easily.
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