Whether you’re a new Mumma or planning to have a baby sometime in the near future, learning how to exercise your pelvic floor muscles is one of the biggest weapons you have for a quick recovery, and getting back to exercise safely.
Numerous studies have even suggested that pelvic floor dysfunction is linked closely with chronic lower back pain, due to the pelvic floor’s key role in deep core engagement and close attachment to the tailbone and sacroiliac joint.
In this post, I’ll take you through some of the basics about the pelvic floor.
Note: this post is all specific to the female body; males have a slightly different pelvic floor structure.
We will cover:
- Where your pelvic floor muscles are
- What the pelvic floor muscles do
- Why the pelvic floor gets weak
- How you can exercise your pelvic floor
See a full diagram of the pelvic floor here.
Pre-warning before you read on: if you’re squeamish or easily grossed out by the mention of bodily functions, this post might not be for you.
Where is the pelvic floor located?
Your pelvic floor muscles are located deep inside your lower abdomen, and inside the pelvis. If you’re not sure what your pelvis is, lie down on your back, and place your fingers on the bony protrusions that sit at the top of each thigh, and your pubic bone. These are all part of your pelvis; the back of your pelvis attaches to your spine, near the tailbone.
What does the pelvic floor do?
The “pelvic floor” is actually made up of a group of muscles that support the organs in the lower abdomen. I like to think of them sort of like a “sling”. The organs they support include the rectum, the bladder, and the uterus.
Within this “sling”, we have three little openings for parts of the anus, urethra and the vagina to pass through, allowing us to defecate and pass wind, urinate, and menstruate or give birth. The muscles around these openings stay contracted, until it’s time for things to “come out”, and then they relax.
Why does the pelvic floor get weak?
It’s important to remember that the pelvic floor muscles; are muscles! So if they aren’t exercised properly, or if there is a lot of pressure on them for long periods (pregnant belly), or an extraordinary amount of sudden pressure (labour and delivery), some parts can become weak and overstretched or damaged, just like any other muscle.
Picture your back muscles when you sit constantly in a slumped position; they become weak and over stretched. Meanwhile the opposite side- your chest and shoulders- become weak and tight.
When something puts pressure on your abdominal cavity (like a cough or sneeze, or exercise) the pelvic floor’s job is to tighten just a little more, to stop “leaks”.
Like those back and chest muscles, a pelvic floor that is weak, overstretched or too tight, is going to start having an effect on the other muscles and ligaments around them.
It can lead to overcompensation by other muscles around the lower back and pelvis, or an inability to regulate excretions and urination correctly during exertion.
But like other muscles, over-training of the pelvic floor can also cause issues
This is called a hypertonic pelvic floor, where it no longer relaxes enough to allow for normal function. Though not usually as uncomfortable as a weak pelvic floor, it can worsen if you don’t learn to properly exercise the muscles.
If you need help with your pelvic floor, I’d love to hear from you, get in touch!
Signs of a weak pelvic floor
Some symptoms of a dysfunctional pelvic floor include:
- Passing wind while coughing or sneezing
- Leaking urine while running, jumping, coughing or sneezing
- Trouble completely emptying bladder
- Urgency in needing to use the bathroom
- Prolapse- which feels like a “heaviness” or dragging sensation in the vagina
How to exercise pelvic floor muscles
First, you need to know exactly what it feels like to engage your pelvic floor. It’s important to remember that the pelvic floor is a deep internal muscle, and you can’t actually see anything from the outside when it’s engaged, so when practicing this you should aim to keep all other muscles around your thighs, hips and tummy relaxed. It should feel like a big upward and inward pull from deep in your pelvis.
I explain pelvic floor engagement to my clients in two ways, depending what resonates with them.
- Imagine trying to hold in a tampon which is slipping out
- Imagine trying to stop yourself urinating mid stream
If you try this and still aren’t sure if you’re feeling it, next time you’re on the toilet, simply try and stop yourself mid-way through urination (just don’t do this more than once or twice).
I teach my clients that a pelvic floor “lift” should always be performed on an exhale (breathing out) because that’s when the pelvic floor should be working hardest.
This “breath and lift” coordination can be the trickiest part to get right- especially once other muscle groups are introduced, but is, in my opinion, the most important.
- inhale and relax pelvic floor
- exhale and lift pelvic floor
Beginner pelvic floor routine
Inhale relax, exhale lift and hold for 3-5 seconds
Repeat 10 x per day
Perform while lying down or seated
Intermediate pelvic floor routine
Inhale relax, exhale, contract tummy muscles, lift and hold pelvic floor. Hold for 3-5 seconds.
Repeat 10 x per day
Perform while lying down or seated.
Advanced pelvic floor routine
Inhale relax, exhale, contract tummy muscles, lift and hold pelvic floor.
Hold while taking another breath in and out.
Relax on the third inhale before beginning again.
Repeat 10 x per day.
Perform while lying down or seated.
Once you’e able to hold your pelvic floor while breathing several breaths, you will be ready to introduce some more muscle groups (like glutes or thighs).
For more information pre and post natal exercise and health, check out some of my other posts or send me an email.
It can be lonely and scary having a baby, so don’t forget there are many great free educational resources available to women at local community health centres, a full list of centres around Sydney can be found here.
Other places you can get support include your pelvic physiotherapists, obstetrician or gynaecologist.