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In order for you to properly perform a pelvic
floor exercise, you also need to be able to
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fully relax the pelvic floor. A lot of people are
told to do pelvic floor exercises, but how do they
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know whether they're actually using the correct
muscles? So, a pelvic floor contraction should
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feel like a gentle squeeze and lift inside the
pelvis. You should be able to breathe throughout
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and then you should feel a complete release once
you've completed. It might feel like a slight
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movement and it very subtle especially when you're
learning. I know we will move on to practicing a
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pelvic floor contraction shortly but before we
do I have always been very curious around what
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exactly the pelvic floor is and what it does. So
the pelvic floor is a group of skeletal muscles
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same as in your arms and your legs and it lives
underneath the pelvis. So it comes from the pubic
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bone, extends around to the tailbone and comes
side to side beneath your sitting bones there.
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Now the pelvic floor is important for assisting in
bladder and bowel control. It closes the passages
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when you don't want to go to the toilet. It's also
really important in your sexual function. And it's
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always there to activate during day-to-day
activities like coughing, sneezing, laughing,
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lifting, but it's also really important for
walking, going up and down stairs and things like
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that, too. We want it to be able to engage, relax,
and coordinate. So, it's not just about strength,
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it's about variety when it comes to the pelvic
floor. What position would you suggest for
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someone to be in when they are first trying
to feel their pelvic floor? So, when you're
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learning to perform a pelvic floor contraction,
there's a couple of ways that might be right for
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you to begin learning. Sometimes laying on your
back with your knees bent or being on hands and
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knees can be a good way to start. And sitting
in a chair can be great, too. Would you mind
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talking me through a pelvic like a gentle pelvic
floor contraction? So, when we're practicing a
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pelvic floor contraction in sitting, we want to
make sure that our feet are well supported and
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comfortable on the floor. We should be sitting up
nice and tall in a comfortable position. Shoulders
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relaxed. And you want your tummy and your hips and
legs to feel pretty soft and pretty relaxed there,
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too. Now, feel for where your sitting bones are on
the chair beneath you. And then gently perform a
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squeeze and lift just at the pelvic floor between
those sitting bones. You might feel a little bit
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of that pressure um off the chair at your labia as
you hold. Now, you should be able to breathe while
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you're holding that squeeze, but you won't be able
to take a deep breath because the diaphragm is
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helping the pelvic floor. Then, when you let go,
you should feel that pressure release and that
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part of your body come back down onto the chair
and everything should be nice and soft. What is
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something that someone would notice if they have
the right technique? So, if you're performing a
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pelvic floor exercise correctly in sitting, you
should feel that squeeze and that lift and maybe
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that pressure come off the chair. You should
be able to breathe relatively comfortably. So,
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we don't want you to be holding your breath,
but taking a deep breath might be challenging
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with that diaphragm involvement there, too. You
shouldn't feel like you can see any movement
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happening. So, there shouldn't be any movement in
the chair or shrugging in the shoulders or curling
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of the toes. And it's really important that you
equally feel that contraction and that lift in the
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pelvic floor, but that you also feel it fully let
go and relax afterwards. What do people commonly
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do instead of using the pelvic floor correctly?
So, some mistakes that some people might make
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is that they try to use too much muscle effort.
So, a pelvic floor exercise is very subtle. So
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we shouldn't be having a lot of tightening around
the legs, the hips and the stomach. We shouldn't
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have any movement occurring and it shouldn't be
really intense. So we should be able to breathe
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and speak normally and we want to avoid things
like breath holding, really bearing down, really
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tightening up, and there definitely shouldn't
be any pain. People hear a lot about squeezing,
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but why is relaxing the pelvic floor also just as
important? So when it comes to the pelvic floor,
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just like other muscles in your body, it needs to
be ready and important that your muscles can relax
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around that. So we need the muscles to be ready
to go when you need them. And in order for that,
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they need to be rested and recovering in between.
Now, pelvic floor relaxation is important to
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achieve that. It's also important for things
like bladder and bowel function. Your pelvic
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floor needs to be able to relax fully for you
to be entirely successful with your toileting.
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It's also important for things like pelvic pain.
Pelvic floor relaxation is an important tool for
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letting go of some of that tension around the
pelvis and helping with the symptoms that are
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associated with that. In order for you to properly
perform a pelvic floor exercise, you also need to
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be able to fully relax the pelvic floor. Should
someone test their pelvic floor by stopping their
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urine flow? So, squeezing the pelvic floor to stop
the flow of urine is a commonly used way to know
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if the pelvic floor is turning on properly. It's
okay for a once- off test if you're not quite sure
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if you've got the right muscles. However, we do
want the pelvic floor to mostly be relaxed when
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we're on the toilet. So, we want to avoid this
becoming a regular part of your treatment plan.
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We want to make sure that we're practicing the
pelvic floor exercises away from the toilet
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so that we're not impacting our our bladder
function and how our body wants to work. What
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should someone do if they can't feel a lift or
release within their pelvic floor? So, especially
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if you're learning pelvic floor contractions for
the first time, it might be kind of difficult to
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tell if you're doing them properly because it is
such a small movement and it is very subtle. So
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the main thing to start with is making sure that
you're not trying too hard. You're not putting too
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much effort into it. We want to make sure that the
legs, the hips, and the shoulders remain relaxed
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and that you're breathing gently still. Now,
sometimes a different position might be helpful.
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So if you've been practicing in sitting, maybe
try laying on your back with your knees bent or
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in hands and knees to take the effect of gravity
out of the equation. And you might feel a little
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bit more movement then. Sometimes people do need
a little bit more assistance with getting pelvic
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floor exercises started depending on people's
circumstances and that's where it might be worth
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reaching out to your healthcare provider
for assistance on that. This has all been
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really helpful advice. I'm just wondering when
someone should stop trying to work it out for
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themselves and it would be time for them to seek
individual advice from their healthcare provider.
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So making sure that you can feel that pelvic floor
contract and relax either way is important. If
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that is very challenging for you, then absolutely
some individual advice would be very relevant.
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Making sure that you've got good control of your
bladder and bowel is also important and making
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sure that pelvic pain isn't out of control. If
you're noticing that you're having any increase
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in your symptoms, then it's definitely time to
reach out for some individual support. Heaviness,
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dragging, and pressure around the pelvic floor
is another indicator that it might be time.