How to exercise the pelvic floor

I am often asked what it feels like to contract the pelvic floor, which can feel different for everyone. Elevation is key! You can picture it like an elevator moving up, or a tent being pulled up from the apex. However, a common misconception is breath holding and an abdominal contraction. Being able to isolate the pelvic floor can be quite a challenge. Whilst contracting or activating your pelvic floor, there should not be any abdominal contraction, glute/bum contracting or shaking in your legs and holding of your breath. Try this. Sit or lie on your back in a quiet room – breathe in and as you exhale, picture your pelvic floor; draw up and picture the internal elevator I spoke about earlier; then let go; inhale and repeat. Check in with yourself that your bottom muscles aren’t trying to join in; your tummy isn’t tightening with the effort and that your toes aren’t gripping.

There is a lot to think about with this exercise, which is often why people struggle to feel the elevation, or are unable to elevate their pelvic floor without a bum squeeze or breathing easily.

If you could grasp a pelvic floor contraction pre-pregnancy and now you are struggling to feel it, that is common. The reason for this is the stretching of the pelvic floor that occurs during delivery that decreases the receptiveness of the pelvic floor. This increases the importance of correct pelvic floor contraction postnatally to encourage the pelvic floor in its supportive role and to help facilitate your return to exercise safely.

Whether you are a gym goer, yogi, pilates queen, runner or just dabble in the odd class - a normal functioning pelvic floor should be working alongside your core and other muscles without you even having to think about it. The key to exercising your pelvic floor and making it stronger is through having an increased awareness of what your pelvic floor is and how best to activate it.

If you are unsure that you are exercising your pelvic floor correctly, a Women’s health physiotherapist/ physical therapist can assess and guide you. Women’s health physiotherapy/ physical therapy is a vital part of the rehabilitation during the fourth trimester.

Reference: American College Obstetrics & Gynecology (ACOG) (2018) Optimizing Postpartum Care: Obstetrics and Gynecology VOL. 131, NO. 5, p140-150