While working with my clients, especially my pregnant clients, I am constantly reminded of how important the pelvic floor muscles are. Yet it seems that only when a women falls pregnant does she start becoming more aware of their existence and importance. It’s really quite unfortunate that so many women don’t know or realise how important their pelvic floor muscles are. Don’t worry – if you are read this and thinking “the what muscles?”, you are not alone! Many people are in the same boat and are not aware of their existence! I sometimes refer to them as the “forgotten muscles”. Hopefully after reading this post, you’ll understand a bit more about what the pelvic floor muscles are, why they’re so important and how easy it is to strengthen them.
What is the pelvic floor and why is it important?
The pelvic floor sits at the base of the body like a hammock, attaching to the pubic bone and the coccyx as well as to the side walls of your pelvis. Its main function is to support your pelvic organs – bladder, uterus and rectum as well as to help close these organ’s outlets – the urethra, vagina and anus.
This 16 second video provides a great visualisation of the pelvic floor:
It’s probably starting to become clear why the pelvic floor is so important during pregnancy. You can imagine how a growing uterus can place strain and weaken this important set of muscles. But strong pelvic floor muscles aren’t just important when you’re pregnant! Your pelvic floor plays an important role in your sexual health (and pleasure), as well as your urinary and bowel health.
Just as with wrinkles, we don’t tend to worry about our pelvic floor when we’re younger. It’s only later in life that we might start to suffer serious consequences from weakness in this area. Unfortunately, without intervention, weakening in the pelvic floor muscles is inevitable as we get older and particularly after pregnancy and childbirth. Other factors can speed this weakening including a chronic cough (from asthma or smoking), being overweight, heavy lifting and generally not keeping it active.
So how do I know if I have a weak pelvic floor?
I think it’s important that you start thinking about your pelvic floor before it becomes weak to prevent issues arising. Unfortunately, many women don’t do this and then have to work hard to undo the damage . If you are showing any of these signs of a weak pelvic floor, it’s important to start working on those muscles straight away. If the problem is severe, please make sure to contact a medical professional.
Signs of weak pelvic floor muscles:
- Stress incontinence – leaking urine when you cough or sneeze
- Difficulty preventing passing wind
- Needing to run to the loo urgently for fear of an ‘accident’
- Reduced sensation during sexual intercourse
- A prolapsed vagina – this may be felt as a heaviness in the vagina, a bulge, discomfort, dragging or dropping
How can I strengthen my pelvic floor? Kegel exercises!
Pelvic floor exercises are sometimes called Kegel exercises, named after the obstetrician who developed them: Arnold Kegel. Another name for the exercises is pelvic floor muscle training (PFMT). Ironically, I find a lot more people have heard of Kegel exercises than have heard of the pelvic floor muscles themselves!
Before you can strengthen your pelvic floor muscles, you need to be able to feel them. A Kegel exercise is a contraction of muscles that we don’t often think about so it can take some practice. To get a sense of what it feels like to contract your pelvic floor muscles, think of stopping your flow of urine mid stream. The muscles you use to do this are exactly the muscles that we’re discussing!
NB: Don’t actually do this while you’re urinating as it leads to other complications such as bladder infections – this is just a guide as to what the contraction should feel like.
What pelvic floor exercises should I be doing?
You should aim to do pelvic floor (Kegel) exercises daily – 3 times a day. They should become a part of your everyday life! The good news is that you can do them pretty much anytime and anywhere so this isn’t as tall an order as it might sound.
Incorporate these exercises into your daily routine (whether you are pregnant or not) and you’ll be well on your way to a strong and healthy pelvic floor!
Kegel Exercise 1: The elevator
To do this exercise, think of your pelvic floor as an elevator sitting at the base of the body (the ground floor). Now picture there being 3 floors going up with your belly button on the 3rd floor.
- Lift the ‘elevator’ to the 1st floor and then lower it back to ground floor
- Lift the ‘elevator’ to the 2nd floor and lower it back to the ground
- Lift the ‘elevator’ all the way up to the 3rd floor and lower it back to the ground
- Repeat this 6 times
The variation in the strength of the contraction is a great way to train your pelvic floor muscles for the requirements of everyday life.
Kegel Exercise 2: Fast and slow
Adding different speeds at which you exercise the pelvic floor helps train you to be able to either lift and release the muscle quickly or sustain the lift
- Lift the pelvic floor all the way up slowly for 3 counts
- Quickly release the lift in 1 count
- Repeat 6 times
Now reverse the count:
- Lift the pelvic floor up quickly in 1 count
- Slowly release the lift for 3 counts
- Repeat 6 times
Kegel Exercise 3: The quick and easy
I’d recommend that you try to do the Kegel exercises described above as often as possible – the variation does add something to the routine. However, if you’re pressed for time or can’t remember the patterns, just do pelvic floor lifts! Do them in your car, do them while you’re standing in a queue, do them sitting at your desk – do them anywhere you can! Switch up the length of the contractions from time to time but doing any sort of Kegel exercise is much better than doing none at all!
Important things to remember when doing your pelvic floor exercises:
- Always ‘lower’ or release the pelvic floor completely in between ‘lifting’ or contracting. The release is just as important to practice as the lift. If you are pregnant, this is particularly important as being able to relax the pelvic floor will allow the baby to pass through easier.
- Don’t hold your breath!
- Don’t tense the tummy. You should be able to isolate the pelvic floor without involving the tummy.
- Don’t squeeze the bum or legs either – try to keep everything relaxed and only work the pelvic floor (this is where your Pilates concentration comes into play!).
It’s never too early or too late to start with these pelvic floor exercises and there is no excuse like “I don’t have the time” – you can do these ANYWHERE! (just be careful – the combination of concentration and coordination can lead to some peculiar facial expressions). So put up a bright sticker wherever you can to remind yourself to lift and release daily!