First, a Little Brain Food

Pelvic floor issues affect 25% of women of all ages. The most common causes include carrying excess weight, pregnancy, childbirth, sedentary lifestyle and strenuous exercise. Understanding how these muscles work is key to preventing dysfunction!

What is the pelvic floor?

When relaxed, the pelvic floor is a sling of muscle from the pubic bone to the tailbone. The pelvic floor supports your pelvic organs, such as the bladder and bowel.

What does it do?

When contracted, the pelvic floor pulls up and into the body and “pinches” or “squeezes” the urethra, vagina and rectum. The pelvic floor muscles aid urinary control, continence, and sexual function. Both men and women can experience pelvic floor weakness. As with other muscles, exercises can help the pelvic floor work properly. For women specifically, a healthy pelvic floor can lower your risk of vaginal prolapse, contribute to better bowel and bladder control, and improve recovery after childbirth. Physical therapy can address the following conditions: prenatal/postpartum care, pelvic pain, incontinence, endometriosis, irritable bowel syndrome, osteoporosis, low back pain, and musculoskeletal injuries. If you need to see a physical therapist for any of these conditions, please don’t hesitate!

Note: if you have leakage or poor control of your pelvic floor, please read my post titled Got Leaking?

The Pelvic Floor is a REFLEX

The pelvic floor is a muscle group that automatically fires when we laugh, sneeze, cough, jump, run, etc. Pregnancy naturally interrupts this “reflex”. This makes sense because, during pregnancy, your pelvic floor is strained with the weight of the growing baby, and all three of your pelvic organs are stretched, pushed, and squeezed. Although this is natural and to be expected, there are some very serious implications (ie leaking and constipation) if you do not rehabilitate your pelvic floor back to health.

A Note About Pelvic Floor Exercises

I have something VERY VERY important to say about pelvic floor exercises:

The pelvic floor is a REFLEXIVE muscle group.

This means that the pelvic floor is a muscle group that automatically fires when we laugh, sneeze, cough, jump, run, etc. This means that active contraction of the muscles with Kegels will NOT help the reflex get any better at reflexing. We will not be doing Kegel exercises — ever.

Many people simply need to re-educate their pelvic floor muscles to dramatically improve their symptoms. Gaining greater control by “tuning into the pelvic floor muscles” can help improve pelvic floor muscle function.  Rigid (strong and wrong) contractions of both the abdominal and pelvic floor muscles can actually make the pain worse. This is one reason I do NOT endorse Kegel exercises.

How to “Tune into” your Pelvic Floor

This pelvic floor exercise is designed to help you “tune in” and engage your pelvic floor so that you can do these activities without any issues.

It takes diligence to learn how to “tune into” and feel the reflexive contraction of the pelvic floor muscles. Here are some pointers:

• Find the right muscles. To identify your pelvic floor muscles, imagine stopping urination in midstream. Did you feel that clench? Those are your pelvic floor muscles! Repeat this 5 times so that you feel the muscles contract voluntarily.
• Perfect your technique. Remember, the pelvic floor is a REFLEX. That means we need to be doing something for the muscles to engage involuntarily. I like to couple pelvic floor exercises with spine correction or “lengthening” exercises. Try this: sit up nice and tall in a chair. As you exhale, visualize your spine being lengthened upward. Now “tune into” the pelvic floor muscles by visualizing stopping just a teeny tiny drop of urine.  On each exhale, “lengthen” your spine up and “tune into” your pelvic floor. Repeat four or five times in a row.
• Maintain your focus. For best results, on each exhale “lengthen” your spine and visualize stopping an even tiner drop of urine. Be careful not to tighten the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, maintain proper diaphragmatic breathing during the exercises.
• Practice with Diaphragmatic Breathing. Now practice engaging your pelvic floor while you do diaphragmatic breathing. Take a deep breath from your abdomen for 2 seconds. As you exhale through pursed lips, visualize your spine being lengthened as you “tune in” to you pelvic floor muscles. The exhale is 4 seconds long.
• Some helpful cues: “Visualize zipping a zipper.” “Visualize an elevator starting at your pubic bone and slowly going up your spine.” The key here is “visualize”. DO not intentionally contract or tense or squeeze or tighten your muscles. Instead, tune in.
  
  A note of precaution:
  You pelvic floor muscles will not fire correctly if you have underlying pain, asymmetries in the spine, incorrect/poor breathing pattern or you are recovering from trauma (healing from birth). You really shouldn’t be doing a whole lot of exercising postpartum up to 6 weeks anyway. You need to get a release from your doctor or physical therapist to make sure it is safe for you to start exercising. In general, pelvic floor rehab is safe after birth but you do need a release from your doctor. AND, if you need to see a physical therapist for an underlying problem, I encourage you to do so. This platform is not a replacement for seeing a medical professional, nor am I providing medical advice.