Sep 30
Should women reduce pelvic floor exercise in pregnancy?
Is it true that women should reduce their pelvic floor exercise towards the end of pregnancy?
I was asked this question about pelvic floor exercise recently and I decided to reply with a blog response. Because, not only is the answer fairly involved, but I also think it’s important to share the many different ways you can take care of your pelvic floor health.
First, let’s talk about the correct way to ‘kegel’
Focus on your breath:
Pelvic floor exercises, also known as kegels, can be an important tool when done correctly. When I teach pelvic floor contraction in the pre and postnatal period, I focus very much on your breathing. During a kegel exercise, you should have equal focus on the release and the contraction of your pelvic floor, and the way you breathe whilst doing this exercise can make both movements more effective.
When you inhale, your pelvic floor should move down and ‘bloom’.
When you exhale, your pelvic floor should lift back up and naturally contract.
Exhale as you contract the muscles. Inhale as you release them.
If done incorrectly, these exercises could cause your pelvic floor to tighten and draw your tailbone towards your pubic bone, something which definitely won’t help while you are trying to get a baby through there! So, please remember to breathe, focus and take your time.
Use your torso:
You should also work on ensuring that, as you inhale, you are using your entire torso. Your breath should move between your sit bones, hip bones and the bottom of your ribcage. Then, as you exhale, you should first allow the natural recoil to happen and then, towards the end of the exhale, gently contract your pelvic floor.
This feeling is not a ‘lift and squeeze’ motion, it’s a gentle connection between the sit bones as you switch on the muscle without over-tightening or tensing it.
More ways to work these muscles
It is important to understand that kegel exercises aren’t the only way to look after your pelvic floor. The following factors can also play a big part in the aiding the smooth contraction and release of these important birthing muscles.
Mobility
Your pelvic floor needs to have a good amount of mobility to function effectively and allow your baby to move through more easily. A well-functioning pelvic floor is able to release as effectively as it contracts.
When it comes to looking at how your pelvic floor is functioning, you also need to consider your posture. Ensure that your pelvis stacks over your ankles, your ribcage stacks over your pelvis and your head stacks over your ribcage. This alignment will impact how well your pelvic floor supports you day to day.
Movement matters!
A well-functioning pelvic floor also needs to be moved! And there are many ways to work these muscles. In fact, going for a walk can be just as good for your pelvic floor as doing typical pelvic floor exercise like kegels.
To strengthen any muscle, you need to add weight and movement, which you can do with exercises such as squats, with coordinated breathing, and inner thigh strengthening, with coordinated breathing. But remember, you can’t strengthen a tight muscle, with these exercises you should, once again, focus as much on releasing the muscle as contracting it.
Encourage pelvic floor release
There are several exercises that can help you to smoothly release your pelvic floor:
Open like a flower:
As you inhale, visualise your pelvic floor opening like a flower.
Rotate:
On all fours, rock forwards and backwards, rotating the femur internally as you inhale
Cat:
On all fours, exhale to draw your tailbone to your pubic bone and your pubic bone to your chest. Then, inhale to release back to a flat back and feel the space between the sit bones.
Glut release:
You can roll on a tennis ball, or similar, to massage your glut muscles. The gluts – your bum muscles! – are connected to the pelvic floor via connective tissue called the fascial lines, and when we release the gluts, the pelvic floor releases too.
Stay active for labour and beyond.
When preparing for birth, your awareness of how to release your pelvic floor can certainly help during labour. But, not only that, it is also super important to prepare for the postnatal period and keep a level of strength in your pelvic floor, to do that, you need to stay as active as possible.
Jul 27
3 tips to improve pelvic floor health
3 tips to improve pelvic floor health
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 health as part of as a bigger picture. You can improve pelvic floor function by addressing the following issues:
1. your breathing patterns
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!
2. your posture
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.
A Note on Sitting!
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!
3. your toilet habits
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!
