Very diplomatically. I do not mean to be funny about it because it can be a very serious issue. But it is also a very sensitive issue.
I talk about pelvic floor muscles in my classes and how they form the bottom of the ‘core cylinder’. If all is well, they function well with the rest of them. But even a posterior pelvic tilt can cause uneven pressure on the pelvic floor leading to imbalances and subsequent problems. Not to mention pregnancies and other issues.
Even though there are well-known exercises like Kegel, I tend to refer people to physical therapists specializing in pelvic floor dysfunction. Once people muster up the courage to talk about problems, I feel that they need to see an expert who can diagnose the cause and has specialized knowledge to deal with it.
My clients strengthen their pelvic floor with every exercise they do. I encourage all my clients to tighten those muscles that stop them from going to the bathroom (both #1 & #2), whether they’re squatting, jumping, doing pushups, walking or anything else. This teaches better awareness that these muscles exist as well as providing stability throughout their body by engaging their entire core. It also teaches the person to keep those ‘bathroom muscles’ engaged in any position, as most people have an easier time tightening them while sitting as opposed to standing, etc. Apply the same principles to the pelvic floor that you would use with any other muscle group- use progressive overload to increase the muscle’s tone and strength.
Most women that have been pregnant have learned about Kegels, and a lot of men can benefit from them as well. Kegels basically ask that you tighten your ‘bathroom muscles’ for longer and longer periods of time, from 5 seconds to 10 to 30 and beyond, and then using various tempos (elevator up, elevator down, elevator to 2nd floor, etc.).
I’ve had success with many post-reproductive women, elderly and other clients that have improved their quality of life by strengthening the pelvic floor. Many people don’t realize the importance of a strong pelvic floor until they start having problems (like incontinence or other issues). As with any other body part, preventative maintainence should be practiced even if the pelvic floor seems to be strong enough. It can be really encouraging to know that many pelvic floor issues are correctable without surgery by using those muscles, although only your doctor can tell you what your body will need.
Most people have heard about Kegel exercises and have been told to contract and hold. One other very effective exercise is Pilates with the ring. The Pilates ring can be placed between the knees (either bent or with legs extended) and the contraction of the pelvic floor is very strong and beneficial.