While it can initially be very useful to find and activate/relax your pelvic floor muscles in supine or side lying (have you seen the free download about this on the Resources page?!), it’s really not a good long term or functional strategy – the pelvic floor needs to actively work in a number of different positions and in a number of different activities and in coordination with the breath.
Once you have mastered the art of contracting, relaxing, lengthening and relaxing the pelvic floor muscles in a supine or side lying position, try it in sitting (on a firm chair to start with – you can try sitting close to the edge so that when you contract your pelvic floor you can feel it lift up and in and away from the surface of the chair & then relaxing back down again)
In standing, try and keep even weight on both feet and really bring your attention to the movement of the breath as you close the openings, lift up and in and then relax the pf muscles back down again.
Progressing to Movement:
The Knack: Ashton Miller et al first described this pre-emptive tightening of the pelvic floor before a sudden increase in intra abdominal pressure (such as a cough or a sneeze) back in 1998 and it was reviewed again in 2008
Essentially it involves bracing the pelvic floor for a sudden increase in pressure – as stated above, perhaps a cough or a sneeze, but also applicable for going from sitting to standing. Incorporating ‘The Knack’ into every transfer from sit to stand with emphasis on breathing and pf coordination can really enhance the efficiency of the lumbo-pelvic stability system
Try this: Sit close to the edge of your chair. Fold your arms (this way you won’t be tempted to push down on the arms of the chair!)
Take a deep breath in, as you exhale, relax your pelvic floor
Take another breath in, this time with the exhale, close the opening of your pelvic floor and lift up and in as you stand up (Don’t forget to keep breathing!)
Once you are standing, relax the pelvic floor (and again, don’t forget to breathe!). Many women (especially those who do have some incontinence problems, are concerned they will leak if they fully relax their pelvic floors. This is an important mis-conception to address. By being able to fully relax their pelvic floors, they will actually gain a greater spectrum of movement when they contract their pf muscles, promoting a faster return to continence and control than simply
‘Tighten! Tighten! Tighten!)
We need to be able to have a full spectrum range of motion and control with our pelvic floor muscles – for continence control, for sexual health and for avoiding problems with back pain or even pelvic organ prolapse
In my next blog post we will look at how we can incorporate more dynamic and challenging movements into our pelvic floor training programmes.
See you then!