Women's health: How to strengthen your pelvic floor

Ever wondered how you can strengthen your pelvic floor after giving birth? Here are some tips on how to do it.

Having complete function and control over your pelvic floor is important to a lot of people, especially after giving birth. In this article you’ll be introduced to the pelvic floor muscles, their purpose, and different ways you can strengthen your pelvic floor. We can help you figure out the best pelvic floor exercises and how often to do them.

What is the pelvic floor?  

The pelvic floor is a group of muscles attached to the pubic bone at the front of the pelvis. They run underneath your body to attach at the tailbone under the base of the spine, creating a sort of hammock. They get their name because of their location at the ‘floor’ of the pelvis, surrounding the neck of the bladder, vagina, and back passage. Their function is to tighten and close around these areas, as well as support your internal organs. 

When contracted, the organs are lifted and tightened, which prevents involuntary movements (such as gas). The pelvic floor also has an important role in maintaining continence (controlling your bladder).

Factors that may cause weakness in your pelvic floor include pregnancy, childbirth, obesity, age, surgery, constipation, and chronic coughing. All of these factors have the potential to slow down having better control of your pelvic floor, so sticking to a regular, daily practice is highly recommended.

How do I strengthen my pelvic floor muscles? 

You can do exercises in a variety of positions to strengthen your pelvic floor muscles. You may wish to start your routine lying down on your back, propped up, or seated. Have your legs bent, comfortably apart with your hands on your lap. With time, you may even progress to laying on your side or standing. 

Establishing the correct technique is important – however, it’s also okay to have a little play with it. A number of visual cues are often used to help you squeeze or lift up the muscles around the vagina and back passage. You can visualise an elevator lift, or a zipper closing from your tailbone towards your pubic bone. Most importantly, try not to hold your breath and avoid bringing in too many other muscle groups, such as your glutes or legs. 

Strengthening your pelvic floor takes time and dedication. For most, it’s an area that is hard to feel, and if you’ve already been through childbirth it can be even more difficult. 

You may wonder how you’ll be able to strengthen something you can’t feel, but one thing you can do is improve your posture. Everything around your spine is connected, so the better your posture is, the easier your pelvic floor awareness journey will be. 

What exercises can I do to strengthen my pelvic floor?

Start by sitting in a chair. Take your weight side to side, trying to feel the chair. This is simply to feel this part of the body, which you may not be familiar with or usually aware of. Feel the weight change as you move left to right, and be sure to try it forward and back, feeling for the bones of your pelvis (such as the tailbone and two sit bones).

You may soon find yourself moving in a circle (or, if moving forward and backward, a rocking or a pelvic tilt as your tailbone draws under). Start now with breathing. Find the space between the bones in your pelvic floor and add visual tools, such as the air coming up through your body. As you exhale, imagine the sit bones coming together. This is where we begin with pelvic floor exercises. 

Become aware of the bones you feel in this movement pattern, with the muscles all working together as you move. Visualise a lift rising as you exhale and tighten. For the next ten exhalations, imagine the lift rising higher. This helps with slow twitch muscle fibres

With practice, you’ll want to include a 2-second quick squeeze for those emergency situations like a sneeze or a cough, where you’re more at risk of leaking.

How can I do pelvic floor exercises after giving birth?

During the first few weeks after giving birth you may not be cleared to exercise, but it’s still safe to begin your pelvic floor exercises (provided you don't have a catheter). Go gently, and make sure to include breathing and mindfulness in your exercise. 

Find a vision to help relax your recovering body. Take a deep breath and on the exhale gently engage the pelvic floor muscles. Notice how long you can do this for, and slowly build on this.

You may wish to include neck and shoulder movement stretches to help relieve any tension, especially if you’ve been breastfeeding. This gentle exercise is designed to help with the first couple of days after birth.

1 to 2 weeks postpartum 

The pelvic area can be tender after giving birth, so start gently, seated or lying on your side with a pillow at your head and in between your legs. Think of the front, back, and middle area of your pelvic floor and simply squeeze and relax. You’ll be working these muscles even if you can’t necessarily feel them. 

Visualisations of an elevator lifting to new levels work really well. Squeeze the pillow with your pelvic floor, doing your best to lift upwards for 3 to 10 counts. If you’re not sure if you can feel the movement, start with short holds for up to 3 seconds and gradually work up. Repeat this process.

2 to 3 weeks postpartum 

Take the static positions from before and add heel slides whilst lying on your back. With knees bent, keep the heel of your foot to the floor as you slide one leg away from you on an inhale. This helps to stabilise your pelvis. 

Slowly move the leg back to your starting position, using the floor as support. Repeat each side up to 6 to 8 times, rest for a minute, and repeat up to 3 sets. If your back is tender, prop yourself up at 45 degrees to take some of the pressures off. 

If you’re resting on your hands and knees, you can also move back to sit on your heels in child’s pose. This allows your pelvic floor to relax for a moment, before you continue with your exercises. 

4 to 6 weeks postpartum 

It's helpful to build regular time in the sequences mentioned above. At this point, you can start to focus on 2 main types of pelvic floor exercise: slow, timed contractions (to improve endurance of muscles) and fast contractions (to improve strength). You can try these exercises for up to 6 to 8 seconds, 3 times a day. Aim for around 8 repetitions of each set. 

It’s around this time that you’ll be able to start exercising again, but always keep an eye on how your body feels, and if anything hurts you should immediately stop.

How often should I do pelvic floor exercises? 

First, you should try to figure out how long you can hold a contraction. Have a think about whether you can feel the muscles pulling up or engaging, and most importantly if you can feel when you let go of the musculature. 

For timed contractions, start by imagining your pelvic floor zipping up, and then hold on the muscles tight on each exhale, imagining an elevator going up each time you breathe out. If you can hold this for up to 10 seconds, work out how many you can do in a row, building up to 8 to 10 repetitions. After that, try to do this exercise 3 times a day, as many days as you can.

The aim is to improve the power of the pelvic floor, with the eventual goal being a strong, quick pelvic floor squeeze. Aim to perform a combination of endurance holds and quick contractions 3 or 4 times a day, with 8 to 10 repetitions each time.

Can you feel the release of your pelvic floor? 

Being able to feel the release of your pelvic floor is great for growing stronger and being aware of how your pelvic floor exercises are working on your muscles. 

Embrace your findings. When you notice the feeling of your pelvic floor tensing and releasing, you may find you’re unknowingly holding your breath, or gripping your muscles. Spend time relaxing with your favourite hip opening positions if you find you’re tensing more than you want to be.

Final thoughts from Kami

Establishing a technique that works best for you is the first step to developing your pelvic floor exercises. After this, look deeper towards the pressure and muscular force working in your pelvic floor. Think of a balloon; the skin of the balloon is the muscle, while inside is the pressure. You’re controlling that pressure, letting it in and out as you do your pelvic floor exercises.

You don’t need to squeeze all the time. In fact, simply taking steps to better your posture and your foot and leg position as you walk can help tremendously. However, if you want to work on strengthening your pelvic floor muscles, the above exercises are a great place to start.

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