If you are a woman “of a certain age,” you may know how important it is to have a strong Pelvic Floor. If you have ever given birth vaginally, you may understand the effects of gravity on our internal organs and our ability to hold liquids there. Sometimes it can feel like we are bottoming out. Literally. In the past you may have been told to “do your Kegels,” but there is so much more to pelvic strength than that. The Pelvic floor is the foundation of strength and stability for our torso, and affects how our body moves, regardless of genitalia. While this subject is usually directed at people assigned female at birth, pelvic floor health affects everyone. A weak pelvic floor can result in organ prolapse, incontinence, lower back pain, and unsatisfactory sex.
What is the Pelvic Floor?
The Pelvic floor relates to a number of muscles and ligaments that act as a sling for the bottom of our pelvis. It holds in our internal organs to keep them from “giving in to gravity.” It also controls bodily processes like urination, defecation, and genital function. The area expands from the pubic bone to the sacrum and between the sit bones, separating the perineum from the internal organs. Kegels typically refer to the lifting of the vaginal walls, but to build true pelvic floor strength, you need to lift the entire floor. Having a vagina is not required.
The main muscle involved is the Levator ani, which you can feel engage when you try to stop the flow of urination. Keeping the Levator ani strong will prevent or lessen urinary incontinence, fecal incontinence, and prolapse of the bladder, rectum, colon, and uterus. It will also improve sexual function and control, and give stability to the lower back.
How to Strengthen
There are many exercises you can do to strengthen the pelvic floor. First you need to find your own pelvic floor and feel the muscles engage. You should feel a “lifting” sensation through the entire base of your pelvis, between the pubic bone and sacrum and between the two sit bones. Make sure you are not also squeezing the buttocks, as that is a separate action. Many activities require that you do both, but when you can isolate your pelvic floor, you know that you are strengthening the right muscle.
My favorite exercise is a simple pelvic tilt. This exercise will also activate and strengthen the Transverse abdominis, or lower abdominal muscle. These two muscles usually work together, functionally. Lie down on your back, with your knees bent, feet flat on the floor. Start with a neutral pelvis, where your sacrum (back of the pelvis) is flat on the floor, keeping a small space under your lower back. This lumbar curve is the same one you have while standing. Inhale. As you exhale, engage the pelvic floor and activate the lower abdominals. Use these muscles to flatten the lower back on the floor. Make sure that you are not using the legs or buttocks to tilt the pelvis. Release back to a neutral pelvis and repeat this 5-10 times. Once you can intentionally activate those muscles, try to engage them without tilting the pelvis. Once you can activate them with a neutral pelvis, you can take this exercise into your day, doing “lifts” while sitting in your car at a stop light, or when you are sitting at your desk at work. You can even do them lying in bed first thing in the morning.
Click here to watch a video on pelvic tilts.
Start slowly, but be consistent. Over the course of weeks and months, you may notice less “leakage” and more confidence when sneezing or coughing. You may notice that your lower back has more stability and feels more comfortable. You may notice better performance in the bedroom. It’s amazing how such a small area can have such a large effect on our life.
To work on your pelvic floor strength every week (or more) join me online every Friday morning, or on demand when it fits your schedule, for Mindful Core, a 30 minute core class to strengthen your pelvic floor, all 4 abdominal muscles, glutes, inner thighs, back, and hip flexors. Click here to sign up!
Take my Stretch & Strengthen 5 Day Challenge, free in my Facebook group from January 9-13, 2023! Click here to join my group!
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