This is part 2 of Fantastic Pelvic Floors & Where to Find Them.

Hello Pilatinis,

Does the cue to lift or relax your pelvic floor leave you confused? If you’ve ever just stood there pretending to exercise your pelvic floor whilst not really understanding what you’re supposed to be doing, you’re not alone my friend!

Many people’s understanding of the pelvic floor stops with kegels, and most people aren’t doing kegels right anyway. So I’ve written this blog to teach you how to exercise your pelvic floor.

This guide uses a combination of anatomical terms and informal language. This is to help you identify and understand your own pelvic floor through the jargon.

In my last blog post, I talked you through how to find your pelvic floor. If you haven’t read it yet, be sure to check it out now as it contains need-to-know tips before you try the exercises in this blog.

Firstly, let’s recap some key points from the previous blog:

• The pelvic floor is a group of muscles that create a hammock shape in the undercarriage area. There are up to 18 pelvic floor muscles (depending on how you count them).
• These muscles help maintain intra-abdominal pressure and continence, support the internal organs, and play roles in sexual function and natural birth.
• It’s normal not to know how to exercise your pelvic floor because it’s out of sight & mind, functions automatically, and can be embarrassing to discuss. These two blogs aim to help you connect with your body from the comfort of your own home!

The astute readers among you may have noticed earlier that I mentioned it functions automatically.

Nonetheless, knowing how to exercise your pelvic floor voluntarily is beneficial.

Here’s 3 reasons why…

1. The pelvic floor is like any other muscle. It can contract/squeeze and relax/lengthen. It also has an optimal tone, or state of balance, where it is neither too tight nor too relaxed. Learning to take the pelvic floor through this range consciously can help the muscles to work more effectively when you’re not thinking about it.

2. Everyday activities and normal life stages can affect pelvic floor tone. For example, long periods of sitting, lifting & carrying, hormone changes (pregnancy and menopause), physical injury, periods of heavy coughing. Training the pelvic floor can reduce negative effects of these factors.

3. Another muscle that works involuntarily is the heart. Training your heart through cardiovascular exercise can help it to function better and for longer. Well, the pelvic floor is just the same!

Certainly, most peoples’ pelvic floors naturally rest at the optimal tone. But what happens when the pelvic floor isn’t at its best?

The Overactive Pelvic Floor

If your pelvic floor is too tight it has poor flexibility and is unable to relax. A tight pelvic floor is usually weak as well, as it’s unable to generate the force to support the body properly. You may experience some or all of the following symptoms.

• Incontinence
• Pelvic heaviness, pressure, tenderness, or prolapse
• Flatulence, especially if it’s difficult to hold in
• Pain in your low back, pelvis, or tailbone
• Changes in sexual function, sexual sensation, and/or delayed or absent orgasms.

The Underactive Pelvic Floor

If your pelvic floor is weak, you may experience some or all of the following symptoms.

• Chronic constipation
• Incontinence or trouble starting or stopping the flow when you go for a wee
• Painful urination, urgency, or frequent need to urinate
• Pain in your low back, pelvis, or tailbone

If you have any symptoms of overactive or underactive pelvic floor you should seek medical care from your women’s health physiotherapist, physiotherapist, or GP.

Easy Squeezy

Now, focussing on your pelvic floor area, do whatever you think a kegel is.

What happened?

Does your hammock lift or pull downwards? Did it move or contract in position? Did the whole hammock move or just a tiny part of it?

Most people will notice that just a tiny part squeezes, usually around the urethra (wee hole), especially if you were taught to kegel only using the cue to stop the flow of wee.

Remember, the pelvic floor covers the area of the wee hole, bum hole, and vagina for women. So, by only squeezing the wee hole, you’re not getting much bang for your buck!

Let’s try again.

This time, try to lift your pelvic floor upwards, away from your underwear.

Use between 3-5/10 effort, to avoid bigger muscles taking over. If you feel your glutes squeezing, activating, or tiring, you’ve not quite got it yet.

Notice all 3 holes squeeze and close, stopping the flow of wee, holding wind, and squeezing a tampon.

Here’s some other cues that may help:

• It may feel like a pincer squeezing and lifting like an amusement claw pick-up game.
• Imagine picking up a Malteaser without using your hands.
• And a lovely one courtesy of one of my Pilates clients; “imagine sitting in a bath of eels and you don’t want any to get in!”

For many people learning how to exercise your pelvic floor doesn’t come straight away.

So, for the next few days, try 3 of these contractions each time you boil the kettle. Eventually you’ll start to feel those muscles engage!

Control The Holes

Now you know how to contract your pelvic floor, you need to be able to relax it too.

Stay seated on your firm chair with your sit bones on the seat. But this time, slump forwards. It’s important to stay slumped throughout this exercise, so if you struggle to feel the cues try slumping deeper and trying again. You can rest your forehead on a table for support, as long as you remain slumped through the torso.

Take a big sigh. Do you notice your pelvic floor lower? How low does it go? Does it go down low?!

Now, relax your jaw, relax your shoulder blades, maybe close your eyes.

We’re going to work with the breath, squeezing on your exhales and relaxing the pelvic floor on your inhales.

Take 3 big breaths, noticing your belly, your ribs, and your low back stretch with each inhale.

Keep going with those deep breaths.

I’m going to bring your attention to different areas with each breath, but feel free to take more than one breath at each stage until you’re sure you can feel the cue.

Inhale

Your belly is soft, though full of air

Exhale

The lower belly, bellow your belly button, pulls away from your t-shirt

Inhale

Relax your bottom. Notice your tail bone lift and push back.

Exhale

Notice your tailbone close like a flap drawing forward.

Inhale

Feel your anus/bumhole soften, widen, open.

Exhale

The anus closes like a gentle kegel

Inhale

Feel your undercarriage stretch soft and wide. The sit bones draw apart and open.

Exhale

Notice the undercarriage close and gently tighten.

Inhale

The vagina lowers and stretches slightly. The labia (vagina lips) open like French doors.

Exhale

The vagina lifts and tightens and the French doors shut.

Notice how pelvic floor relaxation is just a gentle drop and stay, which is why I love the visual of a hammock so much. It’s held in integrity, but not bulging, pushing, or straining.

Try this exercise a few times a day for up to 10 breaths each time until you truly understand how to exercise your pelvic floor and how it feels when it relaxes. Once you’ve felt that connection, try it from different positions e.g. in the shower, whilst watching telly, or on all fours.

I hope this blog has helped you to understand how to exercise your pelvic floor. If you haven’t felt connected to your pelvic floor before it can take a while to get used to, so don’t worry if you didn’t get it first time. Keep trying and over time you will start to feel the engagement!

See you on the mat soon,

Jennie