Our previous blog ‘Pelvic floor problems explained‘ hopefully gave you the basics of understanding your own body and when you may need help / support for your pelvic health.  You’ll have realized it’s a little more complex that just doing those little short flicking movements as if you are stopping yourself having a wee!

Pelvic Floor Exercises – So where do I start?

There’s no need to be overwhelmed, we can take you through some simple exercise to look after the ‘A’ team that is your pelvic floor and core and get them working together like a synchronized swim team!

A healthy pelvic floor needs to be strong and flexible.  Knowing when to contract and hold and when to let go and relax.  Its not all about gripping and holding on, as if you are trying not to pass urine.  Much of pelvic floor dysfunction comes from an over active pelvic floor that doesn’t know how to correctly contract and relax.

Pelvic Floor Exercises Step 1 – finding your pelvic floor

To find your pelvic floor muscles follow these steps:

Imagine you are picking up a cherry stone/ sucking spaghetti through your back passage and lifting it up as far as you can.  As you do this imagine your pubic bone and tail bone drawing towards each other. (Refer to the diagrams in Blog part 1: ‘Pelvic Floor problems Explained’ 

This will help you to find the muscles and get comfortable with how that feels so you can start some exercises.

 

Pelvic Floor Exercises Step 2 : Slow & controlled pelvic floor exercises

Basic:

• Inhale deep into your tummy (your tummy will stick out) and let your lower ribs expand
• As you breathe out draw that ‘spaghetti / cherry stone’ through your back passage (as above) – hold for 10-15 secs as you slowly exhale. (this make take a while to build up to this time)

Next steps:

Pelvic lift/elevator exercise

Imagine you have an internal lift shaft.  Using the same technique, as before draw your pelvic floor up to the first floor of the lift.  Breathe normally and hold for 10 secs. Then release.

Repeat – taking it up to the second floor, hold 10 secs and relax.

Repeat -taking it up to the third floor, hold 10 secs and relax.

Once you feel comfortable with this:

• Draw your pelvic floor up to the third floor hold 10 secs
• Then drop it to the 2^nd floor, with control and hold for 10 secs
• Drop it to the first floor, with control and hold for 10 secs
• Finally let the lift/pelvic floor drop all the way into the basement (exhale as if steaming up a window and let go relaxing your pelvic floor, buttocks, thighs etc)

Pelvic Floor Exercises Step 3: Fast twitch pelvic floor exercises  

Quickly lift up your pelvic floor muscles, as previously explained. Slowly release and then quickly lift again. Repeat 10 times. These are the traditional ‘as if you are stopping yourself form weeing’ flicks, that you may have been aware of.  Now you can be confident you know how to do them.

Aim to do 10 slow and 10 fast exercise 3 times a day.

No one will ever know you are doing them – so you can do it when you’re stuck in traffic, on the phone, even in an office meeting!

And remember pelvic floor exercises are for life.  Like any muscle in your body, you need to keep working it to keep it healthy.

Other exercises good for pelvic floor health: 

Pilates and Barre (blend of ballet and Pilates), walking and swimming are great ways of keeping on top of your core and pelvic floor health (in addition to these specific exercises listed above) . But essentially any exercise that keeps keeps you fit, healthy and active is an essential part of your lifelong pelvic floor health.

 

 

 

Watch points:

If you are:

• Sucking in your abdominal
• Clenching with your bum, thighs, jaw!
• Bearing down
• Holding your breath

Chances are you haven’t quite got it.  Keep practicing and try to relax as you do them.  You don’t need to grip with all your strength just as long as you feel the muscles working. Less is more as you are starting to get to grips with them.

If you are still struggling contact us for more specific help / a women’s health osteopath / physiotherapist.

The next part of having a healthy pelvic floor is getting it working with your core.  Here’s how you get started.

Core exercises – Part  1: Finding your core: 

Your pelvic floor and core work together so now you know how to engage your pelvic floor you can now work on your core strength too. (see info and diagrams in ‘Pelvic Floor Problems Explained’

• Breathe in through your nose and into your tummy and lower ribs
• Breathe out through your mouth, lift your pelvic floor (but don’t grip) and draw your belly button down towards your spine.

Repeat x10

This can be sitting down, standing, lying down on your back or on all fours – which ever feels most natural to you.

This takes some practice, so get to grips with this before trying any of the exercises.

Core exercises – Part 2: Getting moving

• Table top with leg/arm extension – look at the different video examples and start at a level right for you and progress when you’re ready.

Pilates Table top in four point stance – YouTube

(if this is too much to start just extend the leg and build up to adding the arm as well).

Horse stance opposite lift – YouTube

• Scissor arms:

Pilates: Arm scissors – YouTube

(if pregnant avoid being laid on you back, instead do this exercise sat on a gym ball / dining room chair)

There are so many core exercises you can work on this is just a basic introduction.  Joining a reputable Pilates class is a perfect way to progress these exercises.  See Body Control Pilates or APPI for excellent well trained teachers.  We are happy to help you find a good class, please just get in touch. 

 

 

A note on constipation:

As well as exercising your pelvic floor and core it’s important not to strain it too. Avoiding constipation or straining too hard when going to the toilet is important.

 

• Try to keep generally fit and active, go for a walk, do some gardening but keep moving
• Eat a good balanced diet with a variety of fruit, veg and plenty of fluids.  Avoid skipping meals as eating is often a stimulant for the bowels too .
• Avoid putting off going to the toilet.  If you need to go, go!
• Raise your knees. Opening your bowels in a semi squat position is much easier and therefore less stressful for your core and pelvic floor.  Either use a small step or stack up some toilet rolls under your feet. Try to have your knees higher than your hips.
• Try not to strain. Breathe in and as you breath out through your mouth, as if blowing out candles. Push that breath out and down through your pelvic floor.
• Speak to your GP if you need are still constipated. Laxatives / stool softeners can help.

Useful resources

NHS – Pelvic Health

@gusset_grippers

@physiolaura

@physiomum

‘Why did no one tell me?’ – Emma Brockwell