Five simple steps to strengthen your pelvic floor

BY CLARE BOURNE, Pelvic Health Physiotherapist

 

Our pelvic floor muscles can often feel like a mystery. Where are they? What do they do? Where do you even start with pelvic floor muscle exercises? So let’s demystify this important and essential muscle group so you feel empowered to take care of your pelvic health today.

 

First of all, we need to understand why these muscles are important, and the truth is that they are responsible for so many things. Let’s explore them together:

• They help to keep you continent of urine, faeces and wind. Important during day-to-day life, and whilst doing high-impact exercise or lifting weights. 
• They help to support your pelvic organs - your bladder, womb and bowels
• They contribute to your sexual pleasure, which I think we can all agree is really important
• They work with other muscles in the core to support your spine
• They help to pump blood and lymph fluid around your pelvis. 

A lot of these we can take for granted and be completely unaware of how much our pelvic floor is responsible for until we start to experience symptoms. 

We can’t ignore the statistics that state 1 in 3 women experience urinary incontinence, 1 in 10 have faecal incontinence and around 50% of women are thought to have some degree of pelvic organ prolapse.

That’s a lot of women with pelvic floor and pelvic health symptoms. Now, these symptoms are not just down to a ‘weak pelvic floor’, which risks oversimplifying much more complex symptoms. However, the first line of treatment for these issues is pelvic floor muscle training, so I’m here to share my five simple steps to help you strengthen them. 

Before we dive in, I want to highlight that we must ensure we don’t just focus on strength and ‘squeezing’ the muscles, but remember that these muscles need to relax and be flexible as well. 

1. Understand the diaphragm and pelvic floor connection 

Like all muscles in the body, the pelvic floor muscles don’t function in isolation, they work as part of a team, which includes your diaphragm. It can be hard sometimes to understand how our breathing and pelvic floor are connected, but if you think about how these muscles sit in the body, it will make more sense.

As you breathe in (inhale), the diaphragm contracts, flattens and moves down, and your pelvic floor relaxes and lengthens. As you breathe out (exhale), the diaphragm relaxes and moves up, and your pelvic floor contracts and lifts. 

2. Learn how to do diaphragmatic breathing 

It’s time to feel this firsthand. Place one hand on your lower ribs and one on your lower tummy. Take a slow breath in, focusing on the air going down to the bottom of your lungs and expanding your lower ribs into your hand. Your tummy should gently rise into your hand and not pull inwards. Then, slowly exhale. To connect this with your pelvic floor more, as you breathe in you can visualise your vagina opening, or the muscles dropping down. This can be helpful to try 5-10 times before starting any contractions.

3. Connect with your pelvic floor muscles correctly

The best way for most of us to connect with our pelvic floor muscles is first to think about holding wind, squeezing around the anus, then bringing this contraction forwards and upwards towards your pubic bone at the front of your pelvis. After contracting, make sure you fully release and let go. Try this 10 times, contracting and fully releasing, building your confidence in contracting the muscle. Be sure your bottom (glutes), leg and tummy muscles are not contracting simultaneously - this is a localised contraction that you should feel, but there should be no external movement of your body. 

4. Build endurance 

Now that you can contract your pelvic floor, it is important to build endurance.

 

The pelvic floor muscles have slow and fast twitch fibres like other skeletal muscles. 66% of them are slow-twitch fibres—the endurance fibres that are key when trying to hold a wee in a traffic jam!

Use the same contraction you learnt in point 3, but now hold the contraction while breathing normally (these don’t need to be deep breaths). Initially, try to hold for five seconds and then build up to 10 seconds. You can also try doing 10 of them in a row.

 

5. Make it functional 

Most symptoms relating to the pelvic floor are not felt when lying down, but actually when upright. For example, when running or lifting heavy shopping or on the way to the toilet. Therefore, we need to train our pelvic floor muscles for these moments. Once you’ve mastered these exercises lying or sitting (wherever is easiest), try them standing. This will increase the challenge and help your muscles stay prepared for day-to-day life.

Investing in your pelvic health and pelvic floor muscles is important at all ages and stages of life, not just for pregnant and postnatal women. So whether you’re in your 20s and loving regular gym and strength training sessions and don’t have any symptoms, or you’re pregnant, recovering from birth, or moving into midlife and navigating menopausal symptoms, these are for you.

The good news is that you are never too young or too old to learn about and improve your pelvic floor muscle function.

If you’re experiencing any persistent urinary or faecal incontinence symptoms, pain with intercourse, a heaviness or pressured feeling within the vagina, then please do reach out to see your GP or seek assessment from a pelvic health physiotherapist privately. It can be so hard to reach out and talk about these symptoms, but having a plan will help you so much, and please know you are not alone. 

Clare Bourne is a Clinical Specialist Pelvic, Digestive and Biofeedback Physiotherapist and Author of Strong Foundations. She is based in London and is a mother to two young children. Her passion is to educate everyone on their pelvic health and ensure no one feels alone when it comes to any symptoms. 

To enjoy more pelvic health content with Clare, catch up on our Instagram Live. You can also follow her on Instagram, Facebook and discover more at www.clare-bourne.com.