When most people talk about strengthening their core, they’re talking about the abdominal muscles, the ones that make up a person’s “six-pack.” But when Pelvic Health Physical Therapist Megan Miller refers to the core, that’s only 25% of what she’s talking about.

“When you look at the muscles of the true core, there are four of them and only one is an abdominal muscle,” explains Miller.

The others make up part of the pelvic floor, an area not often talked about but with a lot of responsibilities.

“The jobs of those muscles, when working as they should, they have three main functions. The first is to hold all of those pelvic organs up in place, the second is that the strength of the muscle is going to effect bladder and bowel control. The last is that changes in the muscle tension can impact sexual activity,” explains Miller.

As a physical therapist at Core Plus Physical Therapy, Miller and the rest of the staff hear complaints from clients about constipation, bowel issues, pelvic pain, back pain, urinary leakage or they’ve been told they’ll need surgery. The therapists know firsthand many of these complaints can be lessened or cured through therapy.

Lisa Janson, co-owner of Core Plus Physical Therapy, was told she would need surgery for a descending bladder. After six weeks of physical therapy, she had strengthened her pelvic floor and her bladder was back where it belonged. She avoided surgery completely.

Janson says muscle is muscle, and if a patient is motivated, any muscle can be strengthened and restored to proper functioning. There are also cases, like for pregnant women, where working on strengthening the pelvic floor may prevent injury in the future.

Miller explains that pelvic floor strength can compensate for the weakening of the muscles that are stretched as a baby grows. Having a strong pelvic floor can also reduce pregnancy-related back pain and strong muscles can even decrease the risk of injury and increase the ease of delivery.

“It’s really amazing to see people conquer these issues that can have such a negative effect on quality of life,” says Miller.