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We’ve probably all got one of those aunties or grandmothers who need to cross their legs every time they sneeze and tell you “once you’ve had kids your pelvic floor won’t be the same!” but is this true? Do women have to endure symptoms of a weak pelvic floor throughout their lives after childbirth?
The answer is no - we do not have to put up with being unable to run, jump, skip, sneeze or cough for fear of leaking, there are things we can do to help.
If you’ve had a baby you will no doubt have been told the importance of doing your pelvic floor exercises but do you know what your pelvic floor is and what it does? Can you spot the signs of a pelvic floor that may not be functioning quite right?
Read on to find out and to get our top 3 exercises to help activate your pelvic floor muscles.
WHAT IS THE PELVIC FLOOR?
The pelvic floor is a sling of muscles that sit inside the pelvis and support the bladder, uterus and rectum.
WHAT DOES IT DO AND WHY IS IT IMPORTANT?
A well functioning pelvic floor has several important functions and performs the following roles:
Helps the bladder and back passage close to prevent leakage of urine, faeces and gas.
It should relax to allow for emptying of the bladder and bowel.
Helps support the internal organs and sub-optimal function can lead to symptoms of prolapse.
A well functioning pelvic floor can result in more enjoyable and pain free sex.
Is part of the deep stabilising system which is important for good posture.
Works with the abdominals and diaphragm in response to changes in breath and intra abdominal pressure.
Pregnancy and childbirth can cause weakness in the pelvic floor muscles due to changes in posture, the weight of the baby, delivery interventions and hormonal changes that cause muscles to become more stretchy.
You might think it’s only pregnancy and childbirth that affects pelvic floor function but there are other factors that can contribute. Persistent coughing, a sedentary lifestyle, ageing and menopause can all have an effect the health of your pelvic floor.
Looking out for signs of pelvic floor weakness and seeing a women’s health physio after birth means you can find out what is happening from the inside and work to address any weaknesses.
It is important to note that pelvic floor muscles can also be overactive which causes other problems, ensuring you relax the pelvic floor is as important as being able to activate it.
WHAT ARE THE SIGNS YOU SHOULD GET YOUR PELVIC FLOOR CHECKED?
The following are signs that your pelvic floor might not be functioning quite right and if you experience any of these it’s a good idea to get checked by your women’s health physio:
Leakage of urine or faces during exercise, coughing, sneezing or laughing
More frequent urination (more than 6-8 times per day)
Not being able to make it to the toilet
Painful sex
Difficulty inserting a tampon
Any feeling of dragging or heaviness in the pelvic area
Lack of sensation or ability to orgasm
WHAT CAN YOU DO TO IMPROVE YOUR PELVIC FLOOR?
There are 3 ways you can help improve your pelvic floor but first and foremost, it’s important to see the physio for an assessment and to help you activate and use the right muscles. It’s estimated that around 50% of women incorrectly activate their pelvic floor so it’s important to get help with this! Doing pelvic floor exercises incorrectly may do more harm than good so seek expert help.
1. Do your Pelvic Floor Exercises
Daily strengthening exercises, particularly in pregnancy, that focus on the pelvic floor in isolation but also in combination with movement, can help to reduce urge incontinence later in pregnancy and after birth.
Here some do’s and don’ts for activating your pelvic floor when you first begin:
DO gently lift your pelvic floor
DO gently draw your lower tummy away from your undies line
DO remember to let go and relax the muscles
DO start to add some longer contractions once you have the correct activation
DO try the exercises in different positions eg standing, sitting, side lying
DON’T tuck your pelvis under
DON’T squeeze your bottom
DON’T contract too strongly (about 5% of what you think is fine)
DON’T hold your breath
DON’T flare your ribcage
2. Breathe
Proper breathing ensures that you activate the pelvic floor and other core muscles correctly.
Natural breathing means that your diaphragm moves down on inhale and up on exhale. If we breathe in too heavily before we activate the pelvic floor, it pushes our internal organs down onto the pelvic floor.
A natural breath in and out ensures the pelvic floor muscles lengthen and shorten and that the exercises will be effective.
3. Work on Posture
Posture and alignment of the joints and bones is important. During natural breathing not flaring out the rib cage or puffing the chest will help keep your ribcage stacked over your pelvis and ensure you breath effectively.
OUR TOP 3 EXERCISES TO ACTIVATE THE PELVIC FLOOR
Here are 3 of UV’s Head Coach Jo’s favourite pelvic floor exercises.
They will help you to activate the pelvic floor in isolation and also to learn how to incorporate it into some basic movements. Try to do them daily and as you get more confident you can increase the number of repetitions.
These exercises are all suitable to do after birth as soon as you feel comfortable doing them.
Breathwork with PF activations while lying:
Lie on your back, feet flat on the floor with your hands on the side of your rib cage.
Make sure your spine is neutral and your rib cage is softening down towards your hips, feet are flat on the floor and hip distance.
Take a natural inhale, breathing into your hands, and as you exhale, draw up through your front passage - like you are stopping going to the bathroom or holding in a tampon.
Then inhale and completely relax your pelvic floor remembering the relaxation phase is as important as the drawing up phase.
Repeat for 4 more breaths remembering to draw your PF up each time.
Try and do the exercise daily, once you are sure you are doing the exercise correctly you can try and hold up the pelvic floor for a bit longer with each breath.
Pelvic Tilts:
Still lying on the floor, hands by your side with spine neutral, ribs softening down towards your hips, feet flat on the floor and hip distance.
Take a natural inhale and as you exhale draw your pubic bone towards your navel so your pelvis tilts and your lower back just touches the floor. Keep your glutes relaxed!
Inhale, send the tailbone back towards the floor and bring the pelvis back to neutral.
Repeat these pelvic tilts whilst bringing awareness to your pelvic floor, activating it on each exhale and relaxing it on your inhale.
Repeat for another 6-8 repetitions but be mindful not to jam your lower back into the floor, it’s just a gentle tilt.
Imagine your pelvis is a bowl of water and you are trying to tip the water out of the bowl and into your belly button with each tilt.
Single leg glides:
Remain in your lying position with a neutral spine, feet flat on the floor, hands by your side.
Inhale as you glide your left heel away from your body so that your leg extends keeping the foot in contact with the floor.
Exhale, activate your pelvic floor and glide the foot back to the start position so your knee is pointing to the ceiling. Repeat on the other side.
Continue for another 6-8 repetitions, alternating legs.
If you need some additional support or aren’t sure if you are activating your pelvic floor correctly you can find a physio in your area here: https://mumsafe.com.au/physios/
Jo Maddison is Owner and Head Coach at Unearthed Vitality Gym & Virtual Studio. She is a specialist Personal Trainer in Pre & Postnatal Exercise, Pilates Instructor, Mum of 2 and helps women to exercise safely and effectively during all stages of motherhood.
Article References:
Girls Gone Strong - Pre & Post Natal Certification Manual, 2018
Pelvic Floor Recovery, 4th ed. Sue Croft, 2018
Safe Return to Exercise, Jen Dugard, 2022