Before we get started with the exercises, first let’s get to know a little bit more about this hidden and often forgotten part of the body – the pelvic floor.
What is the pelvic floor?
The pelvic floor is made up of muscles, ligaments and connective tissue that form the base or “floor” of the pelvis. These structures play an important role in stability of the pelvis, support for the pelvic organs (bladder, uterus, rectum), maintaining continence and sexual function. It is pretty much the main thing keeping your organs on the inside, so I guess you could say it’s are pretty important!
Why is it particularly important for women to focus on strengthening the pelvic floor?
Exercises that strengthen the pelvic floor aren’t often high on the priority list, but they should be. This is particularly true for women, after all most of us will have a baby sit on our pelvic floor for 9 months at a time during pregnancy, some of us will delivery a baby vaginally stretching the pelvic floor up to 300% of it’s normal length and we will all go through menopause and the hormonal changes that comes with it. All of these events challenge and put stress on the pelvic floor structures so it’s important to make sure our muscles are up to the task as pelvic floor dysfunction can really impact women’s quality of life.
How can you tell if your pelvic floor is weak?
A few signs you might need to focus a little more on your pelvic floor muscles include leaking with coughing, sneezing or exercise, leakage from the back passage, feelings of heaviness and dragging sensations in the pelvis, or not being able to make it to the toilet in time. So if that’s you, read on!
A few key pointers to help get the most out of the exercises below and ensure the pelvic floor and core work efficiently include:
1. Maintaining neutral spine and pelvic alignment – Whether lying or standing you should aim to have a small natural arch (about the size of a blueberry) under your low back. Your rib cage should be stacked over your hips not flared outwards and your chin slightly tucked.
2. Diaphragmatic breathing – Don’t worry, it sounds harder than it actually is! As you breathe in think of your lungs and rib cage opening like an umbrella. You should feel movement in all directions including into the base of the lungs. You may even feel some movement of your pelvic floor downwards as you inhale then up as you exhale, this is completely normal! If you are over bracing your abdominals you will find this hard so it can be a good reminder to make sure the core is working efficiently not just squeezing for no reason.
3. Pelvic floor activation – Most of us know that we have pelvic floor muscles, but a lot of us don’t know how to work them or incorporate them into exercises. Think about what you would do to try to stop the flow of wee and passing wind. Are you doing it? That’s your pelvic floor! You should feel a squeezing and lifting of the front and back passage. You shouldn’t feel bulging of your abdominal outwards just a gentle tensioning between the hip bones. The deep abdominals and pelvic floor have been found to contract simultaneously which is why certain pilates exercises can be a great way to connect with and strengthen this area of the body.
Now let’s get into the exercises!
This is a great starting point to begin connecting with your pelvic floor and deep core muscles while practising diaphragmatic breathing.
How to do it:
Once you have the strength and control to perform a double tabletop position without bulging through the abdominals you can progress to alternating toe taps. This exercises places increased challenge on your deep core and pelvic stabilisers. It’s harder than it looks when performed correctly! Remember to keep the rib cage gently down and try to keep the pelvis and low back still while the legs are moving.
A challenging exercise for the muscles of the posterior chain (or back of the body) and the muscles around the pelvis. This is also a great exercise for those with pelvic floor weakness as it lifts the hips allowing gravity to take some pressure off the pelvic floor, making activation easier.
How to do it:
TIP: You can add a ball between the knees to help keep the inner thigh connection throughout the exercise.
To challenge yourself you can try performing the same exercise on one leg. Be sure to keep the hips level throughout.
Research has shown that working the external rotators of the hip (one of which shares an attachment to the pelvic floor) can also have an positive effect on strengthening your pelvic floor – win win!
How to do it:
To make this one harder and to challenge the core stabilisers even more I love doing this exercise while holding a side plank on the elbow and knees. Burn!
A great functional exercise that incorporates the pelvic floor and can be used in everyday life when lifting or picking heavier objects up.
How to do it:
Perform the same movement as above but with added weight on one side of the body. You can use a dumbell, kettlebell or even a baby capsule! This one really increases the challenge on the core and pelvic floor with the increased load and is also super functional and great practice for real life situations.
These exercises are a great way to get started on incorporating pelvic floor into your exercise regime. But remember every woman’s body and history is different so if you think you have pelvic floor dysfunction or if you aren’t sure you are using your pelvic floor correctly it is best to seek the advice and guidance from your local women’s health physiotherapist.
Words by Danni Gillham
Danni Gillham is a physiotherapist and women’s health expert as well as owner, director and principle Pilates instructor at The Wellness Boutique on the Gold Coast.
Danni loves nothing more than making a positive and lasting impact on women’s lives through physiotherapy and Pilates, which is why she specialises in incontinence and pelvic floor retraining as well as pre- and post-natal physiotherapy.