If you’ve had a baby someone has likely told you that you need to ‘strengthen your pelvic floor’. Technically they’re not wrong, however, there are some things that are incredibly helpful to become aware of to make, you are making the most of your efforts and not actually damaging it instead – ouch!
Let’s dive into some things you need to be aware of….
You could be pushing out - research suggests that 50-60% of women bare down (push out) on their pelvic floor (PF) instead of drawing it up (the correct movement) when they are simply told how to do their pelvic floor exercises verbally or they read them from a brochure. This means a woman that thinks she is ‘strengthening’ her pelvic floor through regular exercises could be weakening them. Imagine this same woman then goes into the gym and loves to lift a bar bell – she loads up the bar thinks she is drawing up at the hardest point of the exercise and now pushes out underload – not ideal!
Know it is an internal muscle and you cannot tell it is working well from external touch or feel. Sometimes it is mistaken that feeling the abdominals inside the hip bones can offer feedback on pelvic floor. This is incorrect. This is the Transversus Abdominis (TA) you are feeling contract. Yes, the TA is designed to co-contract with the PF but in many people, especially postpartum women, it does not. So, we cannot use this as a reliable test.
You might need to learn to relax it – some people have a hypertonic or overactive pelvic floor. This could be you if you had a hard time pushing your baby out or ended up with an emergency c-section after trying to push. Other symptoms of a hypertonic PF could be re-occurring UTI’s, painful sex, glute or lower back pain.
Not only could better understanding your PF assist in relieving these symptoms but a strong muscle is a functional one and must go through its full range of motion to gain its optimal strength.
Let’s go through some pelvic floor activation cues that you might find helpful….
Start laying down on your back, knees bent with feet hip width apart. Relax your abdominals and glutes and place your hands on your belly to make sure you keep it soft. From here take a few natural breaths in and out to further relax – at this point don’t try to ‘do’ anything.
Once you are ready to try to find or activate your pelvic floor; take a natural breath in and as you breath out keep your tummy nice and relaxed and think about drawing the front passage of your vagina in and up. A great analogy I sometimes use is to imagine you have a tampon inserted and draw it in and up. Hold there for a couple of seconds and then completely relax. It is OK to squeeze your back passage at the same time but try to make sure you are drawing in and up, so you are not just using your back passage and potentially compensating or not activating your pelvic floor well. Be aware of any tensing through your abdominals (we don’t want this) or of any feelings of pushing down through the vagina. The ideal scenario is that you feel your pelvic floor activate but everything else stays relaxed.
If you feel comfortable doing this you can try to bring in your Transversus Abdominis too…..Take a natural breath in, as you breath out draw your front passage in and up and then start to peel your tummy skin away from your low-rise undies and back toward your tailbone – again not tensing your tummy and keeping your obliques (the muscles at the side of your abdominals) nice and relaxed.
Moving through 5-10 pelvic floor/TA breaths at the start of a training session can be a great way to put your ‘mind in the muscle’ before you start to work.
Above all else the most effective way to ensure you are properly strengthening YOUR pelvic floor post birth is to ensure you book an appointment with a Women’s Health Physiotherapist. In ‘fitness land’ we refer to WHP’s or Pelvic Health Physio’s as our ‘eyes on the inside’ and those who are experienced in working with pregnant and postnatal women know that we absolutely cannot do our best possible job in appropriate exercise prescription without their support.
To find a Women’s Health Physiotherapist in your area you can head to the ‘find a physio’ section over at https://mumsafe.com.au/physios/
Jen Dugard is the founder and creator of MumSafe™️ - the go-to website for mums to connect with Personal Trainers that are certified, experienced and partner with Women’s Health Physiotherapists so that you know you are in very safe hands.