Pelvic Floor Health
Our pelvic floor helps to maintain and control continence, sexual function, they play a pivotal role during the birthing process and helps to provide stability to pelvic area.
What is the pelvic floor? Our pelvic floor muscles are located between the tailbone (coccyx) and the pubic bone, along with between the sits bones (ischial tuberosities), within the pelvis. They support the bowel and bladder and the uterus. Muscular bands also known as sphincters, encircle the urethra, vagina and anus as they pass through the pelvic floor. Pelvic floor muscles form the bottom of our ‘core’. They work with the deep abdominal and back muscles as well as the respiratory diaphragm muscle to support the spine and control the pressure inside the abdomen. When working with our pelvic floor, we need to consider how to create both suppleness and strength. This includes working our pelvic floor muscles them in various different positions and with more dynamic movement.
What's a Kegel?
Kegels do have their place and are the most commonly known pelvic floor exercise. Women are generally told to pull the pelvic floor towards the cervix, like a ‘lift up’. However, due to the muscle structure from pubic bone to tail bone and then a second layer, running from sit bone to sit bone (ischial tuberosities), the pelvic floor muscles move more in a sliding forwards and back and side to side motion . Kegel exercises are more than likely only activating the anal and urethra sphincters. Aggressive 'pulling up' may result in an overly tight pelvic diaphragm, which can lead to other issues such as incontinence, low back and SI joint pain. Strengthening outer pelvic muscles to encourage stability of the pelvis as well.
Breath is better
The body has many diaphragms beginning with the arches of the feet, pelvic floor, respiratory diaphragm, the throat, roof of the mouth and base of the skull. When we take a breath in the diaphragm pulls downward, this movement is mirrored by our pelvic floor, allowing it to stretch and release. When we breath out, the diaphragm relaxes/recoils back up, and the pelvic floor returns to its resting position. In order to work on strengthening the pelvic floor with the breath, the connection of movement comes at the end of the breath out. We need to be able to connect the deeper support abdominal and back muscles (part of our respiration) to create a more gentle pull on the pelvic floor, rather than an aggressive contraction.
Breath with Movement
Ideally lay on you back, with your knees bent and feet flat on the floor. You can also sit on a fit ball to do this, or be on hands and knees.
Activation with an exhale breath
Pelvic diaphragm activation = pull your tailbone to your pubic bone
Urogenital triangle activation = pull your sits bones together
Whole pelvic floor activation = pull all points together
Relaxation with an inhale breath
Using the inhale breath while releasing the activation and allowing the tailbone to move down towards the floor.
If you have pelvic floor concerns, consult your GP or pelvic health specialist.
References:
The Centre for Women's Fitness, Support your floor - pelvic health training. https://thecenterforwomensfitness.com
Cser-Pratzky, S. (2023). Women's Health Workshop for Perimenopause,. https://www.pilates44.com/workshops