Any kind of pelvic floor dysfunction (such as leaking, prolapse or pelvic pain), is often met with the advice “just do your pelvic floor exercises”. Whilst this can be a useful starting point, it might not be the complete solution or the most appropriate solution for your body.
This blog will explore a range of ways to improve your pelvic health - such as the importance of breathing, exercise, bowel and bladder habits. And why letting your tummy relax rather than sucking it in can be super beneficial to your pelvic floor.
But first, let’s dive in and talk about Kegels!
Kegels are named after Dr. Arnold Kegel, an American Gynecologist. He was interested in finding a non-surgical way to help women experiencing leaking. These isolated contractions (and relaxations) of the pelvic floor muscles strengthen the muscles, and are the first line of conservative treatment for pelvic floor dysfunction, including leaking and pelvic organ prolapse.
However, around 30% of women perform them incorrectly, often pushing down, rather than lifting up the pelvic floor muscles. In addition, they may not be appropriate for someone with pelvic pain, or tight (hypertonic) pelvic floor muscles.
So, if you’ve found that doing Kegels hasn’t improved your pelvic floor symptoms, or, in fact you feel like they’ve made them worse, here are some alternative solutions.
Let’s look at the importance of breathing
Breathing is a simple exercise that can help improve the strength of the pelvic floor muscles by engaging the diaphragm and abdominal muscles. We breathe around 20,000 times each day which gives us thousands of opportunities to improve the pelvic floor!
However, breathing patterns can be interrupted and influenced by a number of factors; including pregnancy and birth, postural changes, stress, fear and anxiety. A focus on re-establishing this breathing pattern can also help improve the strength, function and range of movement of the pelvic floor muscles.
Try this exercise; Inhale deeply through your nose and allow your ribs to expand widthways (you might find it useful to pop your hands on your lower ribs). Then, exhale slowly through your mouth, whilst gently contracting your pelvic floor and lower tummy muscles.
You may need a little practice but breathing is a simple and useful way to connect to your pelvic floor. Plus, it might highlight how much time you spend breathing in a shallow way (which is often our response to stress).
Let’s look at the importance of exercise
You may have been told to avoid exercise if you are experiencing pelvic floor dysfunction.
However, research shows that exercise, particularly exercises that incorporate the core, glute and hip muscles, can be a great way to strengthen the pelvic floor.
Exercises, such as squats, lunges, plank hovers, clamshells (and more) all have higher pelvic floor muscle recruitment than Kegels alone (Crawford et al, 2016). Plus have the added benefit of strengthening the whole body which helps reduce the load on the pelvic floor. Incorporating the breathing technique above, can also help improve the coordination of the pelvic floor muscles with movement.
Let’s look at bowel and bladder habits
The pelvic floor muscles play an important role in bowel and bladder function, so ensuring a healthy and happy bladder & bowel can positively influence the pelvic floor.
Poor bowel and bladder habits such as straining for a poo, slouching on the toilet or holding in urine can put extra pressure and strain on the pelvic floor muscles. Over time this may contribute to pelvic floor issues such as leaking, pelvic organ prolapse and fecal incontinence.
Here are my top tips for a happy bowel and bladder:
Urinate regularly and avoid holding on for too long, or going too often (usually referred to as “just in case wees”)
Avoid straining during a bowel movement as this places more downward pressure on the pelvic floor
Improve constipation by drinking more water and adding more fibre to your diet - think fruits and veggies, seeds and nuts and whole grain options.
Practice good posture when sitting on the toilet
Elevate the feet (either by a Squatty Potty, a small step or even a toilet roll under each foot)
Take regular exercise to keep your bowels regular
Let go of your tension tendencies.
You may not even realise you are doing these, but constantly gripping your bum muscles, or sucking your tummy in all day can influence your pelvic floor muscles. Both of these habits can add tension or tightness to the pelvic floor. Over time, this can reduce its range of movement and ability to respond to load and pressure (2 of its key roles). The pelvic floor muscles are much like a trampoline, lengthening and yielding, as well as recoiling and responding upwards.
So, if you are feeling frustrated with the lack of progress you are seeing from Kegels, don’t despair, there are other techniques you can try. Improving the coordination of the pelvic floor muscles with breathing and exercise can be incorporated into everyday life, as well as healthy bowel and bladder habits. Plus, noticing tension tendencies and avoiding gripping allows your pelvic floor muscles to work automatically and reflexively.
Disclaimer: If you are experiencing pelvic floor issues, such as leaking with or without exercise, pelvic organ prolapse or pelvic pain, seeing a pelvic health physio is a great place to start. They can assess your pelvic floor muscles and provide a plan of action.
About the author:
Beth Davies is a personal trainer, helping women with pelvic floor issues get back to the exercise they love. She uses a strength based exercise approach as well as educating clients on how their bodies work. She offers online and face to face coaching and programming and works with women of all ages. Beth is passionate that pelvic health shouldn't be the barrier to an active and awesome life. You can find Beth on her website www.bethdaviescoaching.co.uk as well as on Instagram @bethdaviescoaching
Photo credits: Flossandbea