Brittany Mahomes, the wife of quarterback Patrick Mahomes, is urging women to take care of their pelvic floor.
"Just a daily reminder: Once you have kids please take care of your pelvic floor. Seriously," the 28-year-old mother of two wrote in an Instagram Story last week, signing the message: "From: A girl with a fractured back."
Though specific details about Mahomes' case are not publicly known, a fracture from a weak pelvic floor is typically rare, Dr. Fatima Naqvi, the medical director at Atlantic Medical Group Outpatient Obstetrics and Gynecology, told CBS News.
"That's a major injury, and thank goodness we don't hear about it often," she says.
But other more common issues can arise from a weak pelvic floor, experts say, making it an important aspect of overall health.
"(Mahomes) does make a good point to talk about preventative care and that weak pelvic floor muscles can contribute to additional core injuries and fractures," says Aleece Fosnight, medical adviser at Aeroflow Urology and a physician assistant specializing in sexual medicine, women's health and urology.
Here's what to know:
What is the pelvic floor?
The pelvic floor in a female body is a "complex interplay of muscles that hold not just the bony part of the pelvis, but also helps give important support to our internal structures — the uterus, the bladder," Naqvi explains.
The pelvic floor is not rigid, which makes it "designed perfectly for childbirth," she adds.
But a range of problems can arise if those muscles and connective tissues are weakened or injured.
"During the labor process, the muscles, everything has to be able to accommodate the birth of the child, so you need the muscles to stretch," Naqvi says. "...It can cause micro-tears (or) it can cause bigger injury."
In addition to pregnancy and childbirth, there are also other reasons someone's pelvic floor might weaken, Fosnight says, including:
- Constipation
- Back and hip injuries
- Weak abdominal and back muscles
- Poor posture
Pelvic floor issues
Almost 1 in 4 women in the U.S. are affected by pelvic floor disorders, according to the National Institutes of Health. It says the three main pelvic floor disorders that women may experience are urinary incontinence, fecal incontinence and pelvic organ prolapse.
Naqvi says it's normal for pregnant or postpartum women to have trouble holding their urine as they experience changes in their pelvic floor. But while this is fairly normalized, the same issue with gas and stool can also occur, which is less discussed.
"The bladder one, they'll bring it up," she says. "The one that they don't talk about is fecal incontinence or flatus (when you're unable to restrain your flatulence)."
Pelvic organ prolapse is when organs located in the pelvis region — such as the uterus, bladder and bowel — aren't sufficiently supported and drop or collapse, pressing onto the vagina. "The resulting pressure may cause a bulge or protrusion through the vaginal canal. This protrusion may be uncomfortable, may make physical activity difficult, and may interfere with sexual functioning," the NIH explains.
Pelvic organ prolapse is less common than urinary or fecal incontinence, but still affects about 3% of U.S. women. It is also treatable, as are the other pelvic floor disorders. In some cases, using a device to support the bladder, medications or surgery may be recommended to treat prolapse, NIH says.
Research also shows the frequency of pelvic floor disorders increases with age, affecting around 40% of women ages 60 to 79, and about half of those 80 or older. The conditions are also more common in women who have had multiple children.
Even those who haven't given birth can benefit from having a strong pelvic floor, Fosnight says, noting that everyone should aim for a "strong, relaxed pelvic floor."
Does pelvic floor therapy work?
Many women benefit from exercises to strengthen these muscles.
"Prevention and optimization after injury are keys to helping your pelvic floor and pelvic organs to function and recover as best as they can," Fosnight says. "One of the best ways to do this is to make an appointment with a pelvic floor specialist." This can be a health care provider or a physical or occupational therapist who specializes in pelvic floor disorders.
Naqvi says she often refers patients to pelvic floor therapists if they are still presenting with issues 8 to 10 weeks after childbirth.
"These are therapists that specifically understand the pelvic floor, the anatomy, how to get the muscles to work and regain strength so that they're able to support the internal structures," she says. "So it doesn't necessarily mean you're going to need medicine or you're going to need surgery that's out there for your incontinence, but just doing these things that we can do at home will help."
For those who may be predisposed to pelvic floor dysfunction, like patients with autoimmune or connective tissue disorders, Naqvi may send them to pelvic floor therapy even prior to issues arising, to try to prevent future problems.
"By sending them there, I know they're going to get educated on their pelvic floor... (and) start doing exercises early to help strengthen that floor muscle," she says, noting that access and education are key.
How to strengthen the pelvic floor
One exercise that many may already be familiar with are kegels, which you can try by stopping your urine midstream.
"Those are the muscles you've got to exercise," Naqvi says.
But pelvic floor muscle exercises and stretches are not "one size fits all," since everyone is unique, Fosnight says.
"Coordination of the core muscles is also key in optimizing your pelvic floor," she says.
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