Practices: Pelvic Floor

Introduction

  • To promote healthy pelvic floor functioning, learning proper contraction of pelvic floor muscles is a vital aspect of productive strengthening efforts. As with the TA, learning to identify and properly recruit pelvic floor muscles is a primary component of core activation.
  • Traditional teaching of Kegels can lead to pelvic floor weakness rather than strength. Changing the way they are taught and practiced can lead to proper balance.
  • Some exercises and pose examples that can contribute to pelvic health include Setu Bandhasana (Bridge Pose) (including a dynamic version of Bridge), Opposite Limb Extension, Plank Variations, Forearm Plank Variations and Wall Sit.

Wall Sit

  1. Stand facing away from a wall.
  2. Place your back against the wall and then walk your feet out in front of you so that the wall is supporting you.
  3. Bend your knees until they are at 90-degree angles and engage your pelvic floor. Keep your navel drawing up and in towards your spine so that your lower back is pressing into the wall.
  4. Reach your arms straight out in front of you hold for 60 seconds, then release.

Most Do Not Know How

Unfortunately, 65% of people that think that they know how to contract their pelvic floor muscles are doing it incorrectly. – Diane Lee & Assoc Physiotherapy

Learning the Subtleties Important Before Strengthening

Before trying to strengthen the pelvic floor muscles it’s important to identify the slow, subtle action of correctly tightening and lifting without stronger muscles taking over. – Pelvic Floor & Core Works

Choosing Core Exercises To Avoid Muscular Imbalance

Your abdominal muscle strength may exceed the ability of your pelvic floor.  If you have or are at risk of pelvic floor problems, then it is important you train for the ‘weakest link’ and put your pelvic floor first.  There are a number of ways to modify your core exercises to protect your pelvic floor. Cease [these] strong abdominal exercises:

  • Sit ups, curl ups, crunches
  • Abdominal exercises with medicine ball
  • V-sit
  • Hundreds
  • Double leg lowers
  • Plank position on hands and feet (eg ‘hovers’, full push ups)

Pelvic floor safe core exercises

  • Single leg extension with one leg supported by a hand on stationary knee or moving foot on ball
    • Knees side to side with feet on ball
    • Modified plank on hands or knees with a slight bend at the hips
    • Wall push ups
    • Ball bridge (feet on ball or back on ball, +/- single leg lift)
    • Arm and leg lift on all fours
    • Leg lift sitting on the ball
    • Shoulder rotations with back on the ball
    • Standing balance work on the bosu or balance disc

Lift your pelvic floor first and hold it during the exercise, then relax afterwards. Notice how many repetitions you can do before your pelvic floor muscles tire. You may need to add some rests, or reduce the number of repetitions you do in a row, while your pelvic floor muscle fitness improves.

Please note:  whilst these exercises are pelvic floor safe, you will also need to consider the number of repetitions, abdominal challenge, number of sets, length of rest and your fatigue level – which also affects your pelvic floor function. – Pelvic Floor First