Pelvic Floor Health
How many of you know your pelvic floor? I mean, how many of us actually know what I’m talking about when I say that? Guys included (because you have them too!) What muscles am I referring to? What’s their role?
Most of us have a hard time knowing exactly where these muscles are because we don’t see or touch them the way we do with most other muscles. You can watch your bicep contract when you’re at the gym or picking up around the house, seeing the muscle work helps build a connection with the muscle to deliver feedback to your brain, it’s a little bit more difficult with the Pelvic floor.
In this blog we will delve into the importance of maintaining a strong pelvic floor, how to find and connect with the pelvic floor muscles, and the different techniques we can practice consistently to keep the muscles strong through the trimesters. Pelvic floor exercises are very important, yet often overlooked. It’s important to do them throughout your Pregnancy on a regular basis from as soon as you find out your pregnant.
We will also delve into how Pelvic Floor muscles can become overworked and too tight (I personally have needed to overcome this one and can be common in athletes). Tight pelvic floor muscles can also mean weak pelvic floor muscles as they are constantly in a contracted state, meaning delivery may be harder. Luckily, pelvic floor tension is a problem that we can do something about and in my blog we will talk about ways we can relax and lengthen our pelvic floor muscles to remove the stress and tension that we may be holding so that we can then continue with our strengthening exercises to optimize our Pelvic floor health.
Learning about this part of your body now will encourage you and teach you to practice pelvic floor exercises correctly so that they stay strong not only during pregnancy, birth and postpartum recovery, but also throughout the rest of your life.
Studies show that women who practice pelvic floor exercises correctly during pregnancy have:
1. Decreased labor and birthing times
2. Less likelihood of urine leakage during pregnancy and postpartum
3. Faster postpartum recovery
4. Less chance of tearing or need for episiotomy
The below pictures show the comparison between strong and weak pelvic floor muscles. The pelvic floor muscles run from your pubic bone in the front to your tailbone in the back, with your sit bones side to side. These muscles wrap around all three openings: urethra, vagina, and anus forming more of a bowl than a floor.
The goal of your pelvic floor ‘bowl’ is to keep your pelvic organs (bladder, uterus, and rectum) supported up and inside you and to keep your urine, stool, and gas in until you’re ready to go.
As our uterus gets heavier during Pregnancy it is the pelvic floor muscles that must endure the weight. OUR goal is to increase our awareness and connection with this muscle and improve the ability of it to contract and relax.
Locating your Pelvic Floor muscles.
Next time you have to urinate, try to stop the flow. Can you do it? This gives you some feedback on whether or not you’re activating your pelvic floor. Don’t actually practice these exercises on the toilet, though.
Exercising your Pelvic Floor Exercises
Contraction
The contract-and-lift part of a pelvic floor exercise is called a ‘Kegel’.
In a comfortable position, (a good position is to face/straddle the back of a chair so your legs are wide) feel your sit bones in contact with the surface you are sitting on, relax the muscles of your thighs, buttocks and stomach.
Take a breath in and relax, then on an exhale, imagine the following one by one:
1. You’re going into an elevator, your pelvic floor is the door closing, do this without using your butt, as the elevator moves up a floor, you lift your pelvic floor muscles upwards floor by floor.
Inhale to release the elevator back to the ground floor.
2. Visualize where your pubic bone and tailbone are. Try to bring them up and in together.
3. Squeeze in the muscles around the front passage as if trying to stop the flow of urine.
4. Imagine a red kidney bean at your vaginal opening. On your exhale, close and lift the kidney bean into your body (note – your butt cheeks won’t help that kidney bean lift in), don’t forget on the inhale to relax and let that kidney bean go.
Which cue worked best for you? What visual felt like it helped engage your pelvic floor without overusing other areas or wanting to hold your breath?
Relaxation
Relaxing the muscles between exercises is as important as the exercises themselves. The relaxation phase takes 2-3 times longer so every pelvic floor contraction should be followed by a full relaxation. Your muscles won’t function with optimal strength unless you learn how to relax them and so delivery of your baby may be made harder if your pelvic floor is too tight.
The majority of the time, your pelvic floor muscles should be resting, take a few seconds and take note of the tension throughout your body right now, including your pelvic floor, and work to let that tension go. Relax.
*Try this cue. As you inhale, feel the pressure inside your core increase, let it lengthen your pelvic floor back to a relaxed position. (Imagine your vagina as a flower opening)
Lengthen
Our Pelvic Floor muscles can also become overworked and too tight, the delivery of your baby may be made harder if your pelvic floor is too tight. Luckily, pelvic floor tension is a problem that you can do something about.
There are various reasons the pelvic floor muscles become overworked and tight;
This can be common in athletes, especially runners, due to the high demand on the core muscles and the pelvic floor becoming overworked.
For others the pelvic floor can be a “stress container,” in that we respond to stress by clenching our pelvic floor.
In Post-Partum mums that haven’t reconnected their abdominal muscles or have a weak core, the pelvic floor muscles will work harder to compensate and support the pelvis.
Over time the pelvic floor muscles can become overworked and as a result tighter and eventually weakened and painful. If you are aware of the stress and tension, you can do some work to relax and lengthen the muscle. Part of this is willfully relaxing and unclenching these muscles followed by Kegel exercises to build strength back up.
So in general you don’t always need to practice the lengthen portion, but it’s good to check in every now and then to make sure you have the ability to do so. Sometimes simply exhaling through your mouth as though you were blowing out through a straw will actually lengthen your pelvic floor automatically.
Once you arrive at 35 weeks of pregnancy, increase daily focus on the lengthening of your pelvic floor during exhale as a way to prep you for labor and childbirth. The goal of this is to decrease chances of tearing by improving your ability to relax and push without breath-holding.
Contracting and Relaxing Your Pelvic Floor as You Breathe
The pelvic floor and diaphragm are agonist and antagonist and work together so we have to link it to the breathing to get the most out of it.
Inhale
Let your lungs fill with air = abdominal pressure increase = relax tummy/pelvic floor (“let the bean go”).
Exhale
Air leaves your lungs = decrease pressure in your abdomen = activate pelvic floor (“gently pick up the bean”).
Begin to feel confident doing this in a variety of positions: lying down, sitting, standing, on your hands and knees, and in a squat. Once you get the hang of breathing and coordinating your pelvic floor it should start to become automatic. You can then start adding Kegels in to habits such as brushing your hair, taking your vitamins, checking your whatsapps, taking phone calls, or adverts during your favorite TV show.
Slow and Fast Kegel intervals to practice each day
Adding slow and fast Kegels will strengthen both fast and slow twitch muscle fibers of the pelvic floor. You can use your daily reminders on your phone to ensure you never forget. I would advise allocating a specific time of day to performing your Kegels, this could be whilst brushing your teeth or driving to work. There are plenty of Apps such as KPFE and PFEI that you can use for reminders/cues and a progressive program to follow as your muscles gradually get stronger.
**Try while having a conversation with a friend to ensure you aren’t holding your breath or breathing too quickly. Remember, no one should be able to tell!
4-5 sets of Daily Pelvic exercises
Slow Kegels; designed to strengthen the muscle
Squeeze/relax your pelvic floor in intervals of five seconds and repeat for 6 repetitions.
5 secs of holding firmly/5 secs relaxation x 6
6 secs of holding firmly/6 secs relaxation x 6
Total time is 2mins 10 secs (Repeat 1 x daily, after 35 weeks increase to 2 x daily)
Increase the repetitions by 1 every week. (You will be able to handle more and intervals in time)
Fast Kegels; improve the reflex of your muscles (so we can react quick enough to a sneeze!)
Squeeze quickly and with max strength in intervals of 1-3 seconds for 10-15 repetitions
2 secs/3 secs x 10 repetitions
1 secs/2 secs x 15 repetitions
1 secs/1 secs x 20 repetitions
Total Time is 1 min 55secs (Repeat 1 x daily, after 35 weeks increase to 2 x daily)
Endurance; hold tightly for a long moments effort
Squeeze with half of your max strength for 12 seconds, repeat as any times as you can (Repeat 1-2 x daily)
Mountain Climber Intervals
3/3, 4/4, 5/5, 6/6, 7/7, 8/8
8/8, 7/7, 6/6, 5/5, 4/4, 3/3 (Total of 12 squeezes , 1 min 56) (Repeat 1 x daily)
Pelvic Floor Contractions During Exercise
We don’t live our whole life in predictable patterns or staying in one place, so don’t stop with only performing pelvic floor exercises in a static position, let’s start adding them to a portion of your current exercise program.
*Make sure the exercise is simple and slow so that the brain gets the message.
Exercise choices to start with
• Plank hold
• Hip thrusts
• Sumo squats
• Adduction machine
• Deadlifts
• Shoulder press
• Chest press
Pelvic floor squeezes during sumo squats are my favorites!
During each exercise movement, recognize where the most exertion or effort is required. Add your pelvic floor contraction to the exhale and your pelvic floor relaxation to the inhale.
Example: If I was doing a lifting motion overhead, exhale as I lift and contract my pelvic floor muscles.
Take a breath in and relax the pelvic floor, then…
Breathe out + “gently pick up the bean” + move/lift.
Adding it in to a few of your exercises intentionally should carry over to the rest of your movements with time. At the end of Pregnancy, they bring even more benefits as the diaphragm which is now usually constricted will be able to stay more alive and avoid amnesia.
I hope this blog has helped bring awareness to the importance of Pelvic Floor strengthening for women of all ages. Strong pelvic floor muscles prevent stress incontinence (not being able to hold it in!) enhance your sexual arousal and prepares you for a quicker labor, an easier birth (with less chance of tearing) and a quicker post-partum recovery.
It’s especially important to do them throughout your Pregnancy on a regular basis from as soon as you find out your pregnant. Learning where and how these muscles work is a healthy habit for your best pregnancy, birth, and recovery.
I hope this blog has helped you understand the different ways to perform the exercises and how to combine it with your regular breathing pattern, each technique serves a different purpose, to strengthen and increase endurance and also to improve the reflex of the muscles so we can react quickly to a cough or sneeze!
I hope my blog encourages you and teaches you to practice pelvic floor exercises correctly (using your free daily plan to follow!) so that they stay strong not only during pregnancy, birth and postpartum recovery, but also throughout the rest of your life.
I would love to hear how it’s going for you, I’m here to help. If your interested in reading more about Pregnancy and Exercise please check out the rest of my blogs on my website www.rhianadamsfitforlife.co.uk