You know by now that the pelvic floor (PF) is an important piece of puzzle when it comes to a strong body, postpartum recovery, and overall health. It is a key player of our core system, helps regulate the pressure in our body, supports all the organs in our abdomen and pelvis, and much more.
The PF is supposed to work automatically without us thinking about it. However, this often gets disrupted (pregnancy or not) and needs some retraining. For optimal PF and core function, we need to be able to both relax and contract the PF in a coordinated way with our breathing.
Many people struggle with this, whether it’s due to PF weakness, “tightness”/tension, lack of coordination, or all of these. And very often people have no idea how to sense their PF, which makes it hard to work on! Greater awareness and practice can make a huge difference in PF function.
The pelvic floor does not work by itself in isolation, either. It works in conjunction with other muscles throughout the body. This is really helpful for learning to find the PF and then integrate PF awareness into movement!
How do we develop this awareness and find the PF?
Here is a series of three exercises to test whether you can feel your pelvic floor. Do not worry if you can’t right now! It takes practice and attention. These tests can become the exercises to help you connect to your pelvic floor!
Often, PF retraining begins lying down, and that is a great place to start. I also find that sitting on the floor with legs wide and knees bent is a very effective position to feel the PF. The PF is in a more lengthened position, making it easier to get a contraction.
Once we can sense the PF and activate and relax it in a controlled manner here, we need to connect our PF with movement. This will allow our PFs to work effectively in different positions and during daily activities and exercise, not just lying or sitting down. After all that, most of the problems occur when we are moving.
Two drills in sitting and then one in standing:
1) Bilateral (both sides) PF connection
- Sit on floor (if not comfortable, sit on chair or physioball) with both knees bent up and back supported
- Feet stay flat on floor with toes and heels in contact with floor
- Inhale slowly through nose:
- allow PF to let go/relax/lower/lengthen
- Neck and shoulders
- press knees out into hands
- Exhale slowly and completely with a “haaaaaa” sound
- PF lifts/contracts/comes up
- press knees in squeezing hands on inside of knees
- Repeat x 5-10 breaths
- Ask yourself:
- Can you feel your PF lifting and lowering/contracting relaxing?
2) Unilateral (1 side) PF contraction
- now focusing on 1 side at a time – can help tune in if hard to tell doing both sides at once, or can tell you if one side needs more attention either activating or relaxing than the other
- Same as above but with one leg at a time
- Once able to feel here, option to incorporate foot motions:
- Inhale foot shortens (supinates) – keeping ball of foot, toes and heel on floor, make an arch. Big toe mound and heel come closer together
- Exhale foot lengthens (pronates). Big toe mound and heel spread apart
- Incorporating the foot motions with the breath can optimize the coordination of the breath and PF and the contraction.
- Repeat 5-10 breaths each side
- Ask yourself:
- Can you feel your PF contract and/or relax?
- Do you feel one side more than the other?
3) “Squatty” squat PF connection
- Bringing it to function
- Stack the ribcage over the pelvis for optimal alignment of diaphragm (breathing muscle) and PF by tucking pelvis under slightly and bringing lower ribs down and back, while keeping upper chest up.
- Keep stacked vertical torso as squat
- Inhale lower down into squat – PF relaxes/lowers
- Exhale rise up from squat – PF contracts/lifts
- Adding a block/towel roll/ball to squeeze between the knees can help engage the PF and lower abdominals as well.
- Repeat 5-10 breaths
PF cueing
Different people respond to different cues, so here are a few to try.
PF Activation/Contraction/Lift:
- Pretend you are trying to stop the flow of urine
- Pretend your vagina is a straw and you are drinking a thick smoothie through the straw or trying not to let a tampon fall out
- For males: Pretend you are walking into a cold ocean
PF Relaxation/lowering:
- more of a controlled or slow letting go
- a spreading out of the tissue
- unclenching
- letting there be pressure (without bearing down)
If you are interested in a more detailed explanation of the exercises, please see below. Otherwise, give them a shot and reach out with any feedback or questions!
More detailed explanation:
On inhale, the diaphragm concentrically contracts down to allow air to come into the lungs. The pelvic floor lengthens down (eccentrically contracting) to make room for the organs to move while air pushes them down. In movement and gait, this action is often paired with hip abduction and external rotation and foot supination.
On exhale, the diaphragm relaxes or eccentrically contracts moving up, and the pelvic floor concentrically contracts/shortens moving up. This is paired with hip adduction and internal rotation and foot pronation. Adduction helps activate the deep lower abdominals and PF.
In these exercises, we pair the breathing with the pelvic floor contraction, as well as, the hip and foot motions. This will help us carry over PF contraction/relaxation during movement. Trial and error, of which associated action helps connect to the PF, may be needed. Trying them all at once may be too much to coordinate. Start with PF and breathing, then PF and hip actions, then maybe incorporate the foot. Play around and see. There is no right or wrong.