I encourage my clients to see isolated pelvic floor exercises (sometimes called kegels) as a piece of the puzzle. It is important to look at pelvic floor health as part of as a bigger picture. You can improve pelvic floor function by addressing the following issues:
We take around 20,000 breaths every day. Breathing creates Intra-Abdominal Pressure (IAP), which can cause you to bear down on your pelvic floor. This means the way you breathe is instrumental to your pelvic floor health. Your breathing can be affected by many different things including back pain, scars/adhesions and posture. We need to look at how you are using your whole body as well as the pelvic floor on it’s own.
Your pelvic floor works alongside your diaphragm as the top and bottom of a container that creates your centre. When you inhale your pelvic floor descends and releases. This creates space for all of your organs as they move downwards underneath the diaphragm. The muscles and fascia of both the pelvic floor and abdominals elongate on the inhale. How much depends on your breathing pattern. It is important to use the whole of your ‘breathing apparatus’ so you are not just breathing down into your belly and causing a huge increase in intra-abdominal pressure. The ribcage needs to expand up and outwards too so that the pressure created is evenly spread through the torso. When you exhale the pelvic floor recoils back up again. This can be co-ordinated with movement to create an unconscious pelvic floor contraction. Everything starts with your breath!
Everything in your body is connected by a wonderful web of fascia or connective tissue. You can find out more about fascia here https://www.youtube.com/watch?v=-uzQMn87Hg0
We can’t look at the pelvic floor as an individual structure, we need to look at it as part of the whole body (again!). This will allow us to find a holistic approach towards how it functions. Your pelvic floor is directly impacted by what is above it (your organs, your ribcage, your skull) and what is below (your legs and your feet). When our head stacks over our ribcage, our ribcage stacks over our pelvis and the pelvis stacks over the ankles our pelvic floor is able to function as it should. When everything is out of alignment it makes it much more challenging for the pelvic floor to work at optimum function. The position of your feet, the relationship between your hips and your knees, your ankle mobility and your rib cage position all have a direct impact on optimum function.
Many of us spend a lot of their day sitting and it is important to think about that too. Can you move your laptop so that you sometimes work from a standing position? Can you have a ‘meeting on the move’ where you go for a walk instead of being desk-bound. Sitting, particularly when your are slumped on the back of the sit bones, can draw the tailbone towards the pubic bone. This will shorten and tighten the muscles of the pelvic floor. If you can try to be more active day to day it is beneficial for your body as a whole. Simply sitting on top of your sit bones and stacking the ribs and head above the pelvis rather than slumping will help. While I’ve got you, stand up and get moving for 10 seconds RIGHT NOW!! A sedentary lifestyle is the enemy!
Straining when you go to the toilet creates IAP which is something we want to avoid creating too much of when looking at pelvic health. If you are constipated you are likely to be creating a large increase in IAP when you go to the toilet. You can address this by increasing your water intake, the amount of fibre in your diet, the amount you move and using a squatty potty (or equivalent) https://www.squattypotty.co.uk/.
When humans came up with toilets, we didn’t think through the biomechanics necessary to do a nice easy poo! We were designed to poo while squatting (think about your toddler when they go in their nappy!). This allows the puborectalis to fully relax and the anorectal angle to straighten which immediately improves bowel function. It makes it easier to empty the bowel at this angle. Changing the angle of your legs when you are on the toilet (you can also use a toddler step or even a pile of books under each foot) is a great zero effort step to reducing the IAP created.
I hope you found that useful. Keep following @centredmumspilates on Instagram for updates on my blog posts and lots of videos coming soon!
You may be interested in our Your Core Matters course for exercises and more top tips!