Pelvic Floor 101
The pelvic floor is a sling of muscles that sits at the base of your pelvis, helping to support your pelvic organs and control when you empty your bladder and bowel. These muscles are mostly working at a lower intensity but can contract more strongly when we cough, sneeze or jump. The pelvic floor works closely with our deep abdominal muscles to form our ‘core’ and therefore plays an important role in pelvic stability, continence and sexual function.
Pelvic floor weakness is commonly experienced during pregnancy and after giving birth, but is also experienced by women well before pregnancy and many years after giving birth. The good news is that with the correct guidance and exercises, this can be treated very effectively and symptoms can completely resolve. Just like any other muscle in the body, the tissue heals and with the right exercises, the strength and control will return.
The best time to start your pelvic floor exercises is before you notice any symptoms. Particularly in relation to pregnancy and childbirth, because we can’t see the muscle contraction, it’s important to have good awareness of what it feels like before giving birth, especially with a vaginal delivery. Even women who have a caesarean delivery benefit from improving the function of their pelvic floor muscles due to the weight of the baby throughout pregnancy and the role the pelvic floor plays in core stability.
Equally as important as building the strength of your pelvic floor, is learning how to relax these muscles effectively. It is possible to have an overactive pelvic floor, which means that these muscles are slow to relax or do not relax at all. This can cause excessive tightness in the area, which can lead to pain and reduced relaxation of the pelvic floor during labour. You can read more about pelvic floor overactivity in this blog piece by women’s health physio, Fiona Grouber.
Stage One Pelvic Floor Workout
- Lie on your back, with your knees bent and hip width apart.
- Find your neutral spine position by rolling your pelvis back and forth and stop when there is about enough space to fit a blueberry under your lower back.
- Relax your stomach, buttock and thigh muscles.
- Close your eyes and focus on your breathing.
- Inhale, then as you exhale drawer inwards and upwards through your pelvic floor area (try these cues and see what works best for you):
- Imagine you are sitting on the loo using the least amount of effort needed to stop your urine mid flow
- Think of zipping up from your back passage towards your front passage
- Imagine you are trying to stop yourself from passing wind
- Picture yourself squeezing onto a tampon
- As you inhale, let everything go
- Now using this technique and cue, work through these exercises:
- Exhale to contract, Inhale to relax x 10
- Exhale to contract, maintain this contraction as you breathing in and out x 3
- Exhale to contract, maintain this contraction as you breathing in and out x 10
Tips for improving your pelvic floor function:
- Start simple: begin either sitting or lying down in a quiet space with no distractions. Practise switching your pelvic floor muscles on and off and really focus on what you are feeling.
- Make sure you are breathing: try to exhale when you contract and inhale when you relax at first. Then try to hold your contraction as you breathe in and out - it’s harder than it sounds!
- Practise in a variety of positions: lying down, four point kneeling, sitting and standing all place different levels of strain on the pelvic floor, so it’s important to practise your exercises in all three positions.
- Start to add movement: once you are confident in a static position, add some movement to make the exercise functional and relatable to your real life. Contract as you stand up from a chair, do a squat, calf raise or walk. This is challenging, but so important.
- Practise relaxing your pelvic floor as well: take a really big breath out, let your belly go, relax your inner thighs, feel your pelvic floor release completely. Do this at the end of any Pilates class or pelvic floor strengthening sequence.
If you feel unsure or think you need some extra guidance, I highly recommend booking in to see a women’s health physio to assess your pelvic floor specifically. It’s never too early or late to do this and it can make a huge difference to your confidence and experience.