HOW TO KNOW IF I'M DOING MY PELVIC FLOOR EXERCISES RIGHT?
Unsure if you're doing your pelvic floor exercises right? You are not the only one! Often women feel confused if they are activating their pelvic floor muscles correctly. In this post I'll share my top tips to knowing if you are doing your pelvic floor exercises right.
WHAT IS THE PELVIC FLOOR?
The pelvic floor muscles are a group of muscles that form a sling that creates the floor to our pelvic ring and the base of our pelvic bowl. The muscles of the pelvic floor attach from the pubic bone at the front, to the coccyx (tail bone) at the back, and to the ischial tuberosity (sit bones) on the left and right of the pelvis. There are two layers of muscles that make up the pelvic floor muscles; the deep pelvic floor muscular layer that makes up the internal muscles of the pelvic floor and the superficial layer that make up the external layer of the pelvic floor. The deep pelvic floor muscles are responsible for providing ‘lift’ to the pelvic organs and supporting the connective tissue of the pelvis. The superficial muscles help to give added closure to the vagina and the anus.
It's important to know that the pelvic floor in its entirety is more than just muscles. It is also made up of a complex network of sphincters that open and shut to initiate and stop bladder and bowel emptying, nerves, and ligaments and fascia that provide support.
Physically the pelvic floor has a significant role in:
- Maintaining continence – stopping leakage from the bladder and bowel
- Sexual pleasure - orgasm
- Supporting the pelvic organs - bladder, bowel, uterus in place
WHAT DOES IT FEEL LIKE IF I'M DOING MY PELVIC FLOOR EXERCISES RIGHT?
Activation of the pelvic floor muscles should feel like a drawing inward and upward of the pelvic floor muscles. If you feel like you are pushing down or bearing down - similar to the sensation of the pushing phase of labour or forcing a bowel motion, you are not activating the pelvic floor muscles correctly. If you are doing this bearing down action, you could be doing more harm than good. This is why it's important to know if you are activating the pelvic floor muscles effectively.
HOW DO I KNOW IF I AM ACTIVATING MY PELVIC FLOOR MUSCLES CORRECTLY
The best way to know if you are activating the muscles of the pelvic floor correctly is to have an internal vaginal assessment conducted by a Pelvic Floor Physiotherapist. In this assessment the therapist will be able to tell you:
- If you are activating the pelvic floor muscles correctly
- How strong your pelvic floor contraction is
- What your pelvic floor co-ordiation and endurance is like
- How balanced the muscles are on the left and right
- If you are able to effectively relax the muscles of the pelvic floor
- What the supportive pelvic tissue is like, and if there are signs of pelvic organ prolapse
Some therapists will offer a ultrasound scan in replacement of an internal assessment. An ultrasound is far less accurate than a vaginal assessment, and is only preferred when there an internal assessment is not possible.
If you don't have access to this pelvic floor physiotherapy, please don't worry. There are also ways that you can check for yourself - though they are not quite as accurate.
- STOP THE FLOW OF URINE
This is an effective way to see if you are contracting the muscles of the pelvic floor or bearing down. Even though you may not be able to completely stop the flow of urine, an effective pelvic floor contraction will slow the flow of urine. If you notice the flow increases, this is a good indication that you are bearing down rather than squeezing the muscles. Some people say that doing this may cause a urinary tract infection. There is no evidence to suggest this at all. This is to be done as a simple check. It is not recommended that you exercise the pelvic floor in this way for any length of time.
2. VISUALISE THE PERINEUM
The perineum is the tissue between the vagina and the anus. Using a mirror you can look at the perineum as you activate the muscles of the pelvic floor. If the muscles are contracting well, the perineum will 'tighten', become smaller, and you will see the perineum draw inwards towards the body. If you are bearing down, the perineum will bulge, become bigger, and you will see the perineum move 'away' from the body.
3. USE A THUMB OR FINGER TO FEEL
Inserting a finger or a thumb you can feel for the activation of the pelvic floor muscles. As you contract the pelvic floor you will feel the muscles tighten around your thumb/finger and draw upwards.If you are bearing down you will feel the muscles push downwards and will not be able to feel the tightening.
HOW OFTEN DO I NEED TO DO MY PELVIC FLOOR EXERCISES?
How often you need to do your pelvic floor exercises is very personalised. This is why a pelvic floor assessment with a pelvic floor physiotherapist is very helpful. Along with being able to activate the muscles of the pelvic floor, it is important to be able to fully relax them swell. Often women who experience pelvic pain or pain with sex have highly toned pelvic floor muscles and find it more difficult to relax them. I will share more on how to relax the muscles of the pelvic floor in a future post.
If your wanting in depth information about a holistic approach to pelvic health, I would love to share with you my book Body Conscious: A woman's guide to holistic pelvic wellness and feminine embodiment, shares all of this information in depth. You can learn more about the book here.
If you would like to explore a body connection practice that will help you embody a holistic approach to pelvic wellness, I invite you to share in this Deep Core & Pelvic Floor Embodied Understanding practice. You can access the practice by filling in the form below.