Exercise Your Pelvic Floor - You owe it to Yourself

Tasha Mulligan MPT Health Pro
  • Is there any down side to exercising your pelvic floor and the muscles that support it?  If there is, I can't think of one.  Ask me about the benefits of exercising your pelvic floor and support muscles and my list will go something like this:  it can help reduce if not resolve symptoms of incontinence, it can improve the muscular support for your pelvic organs, improving prolapse symptoms, it can improve or resolve low back pain, it can improve or resolve hip pain, it can improve your sexual experience, and it will improve your posture.


    Usually with various products, medication, or surgery, the possible side effects far out-weigh the possible benefits.  With exercise, it is just the opposite, listing no side effects, just an extensive list of benefits.  Taking an active role in controlling your continence through exercise will not only provide you with physical benefits but also the emotional lift, knowing that you are not passively letting the symptoms of incontinence take control of your life.

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    I am your biggest cheerleader.  I want to get you started in the right direction so read through the 3 exercises I have described in this blog entry.  Do these exercises daily and when you feel like you would like more guidance you can explore the three websites that I have listed at the end of this entry.   Remember, you have nothing to lose and so much to gain!


    Standing multifidi extension  (3x15) - Standing so that you have a side view of your body in a mirror will give you the best visual feedback for this exercise.  Place your hands on your hips, so that you can feel the subtle movement of this exercise.  As you activate your multifidi muscles of your low back, you will give a lift to your tail bone.  The view that you would see in the mirror would be more of a gymnast posture when you activate your multifidi muscles, but make sure the movement is at the level of your pelvis only and there is no movement of your legs, upper back or shoulders.  Repeat this multifidi extension for 15 reps. 


    Remember that your pelvic floor muscles attach to your tail bone, so with each extension you are increasing the tension in your pelvic floor muscles and then relaxing them repetitively throughout the reps. Hands and Knees transverses abdominus lift (3x10) - Position yourself on your hands and knees and relax your belly.  Again, a side view of your body in a mirror is great visual feedback as you work to draw your belly up and in.  Activating your transverses abdominus (TA) muscle will lift your belly up from its relaxed position to flatter, tighter position as if being cinched up like a corset.  The mirror will allow you to see the movement of your belly, but will also ensure that you see no movement of your hips, back, or upper body.  The only movement should be your belly drawing up and in toward your spine. 


    Hold each TA lift for a 5 count before releasing and watching your belly drop back down before repeating.  This is an important exercise as the TA contracts in coordination with your pelvic floor.  Once you have a good feel for this muscle, work the exercise in sitting and standing as well.  Be sure to feel everything in your pelvis and abdomen lift with contraction of your TA.  If you feel any "bearing down" sensation, you are activating the wrong muscle group.


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    2 Step Kegel Exercise (x8 elevation holds x 32 quick flicks) - To perform this pelvic floor exercise, begin on your back with your knees bent.  The first step is to tighten your pelvic floor as if to stop the flow of urine or the passing of gas.  You are tightening the sphincter muscles surrounding the openings in your pelvic floor. 


    The second step is to draw your pelvic floor up into your pelvic outlet as if there is a string attached from your belly button down to your pelvic floor and you are attempting to pull it up.  Continue to draw that string up for a full 8 count. With this action, you are working the deepest muscle layer of your pelvic floor that attaches to your pubic bone and your tail bone.  It tightens from a bowl shaped position to a higher position as it is pulls on its bony attachments and becomes taught like a trampoline.  Following this 8 count hold, allow your pelvic floor to completely relax, releasing all muscle tension. 


    After achieving this relaxed state, then follow with 4 quick flicks.  These are quick squeezes of your sphincter muscles, again tightening as if to stop the flow of urine or the passing of gas, to the rhythm of contract, relax, contract, relax, and so on.  Repeat this 2 step sequence of a longer hold followed by 4 quick flicks for 8 complete cycles. 


    Further information on the 2 step kegel:
    The best position to begin this 2 step kegel exercise is on your back as described or in a side lying position with your knees bent, as these positions allow your pelvic floor to work free from the pull of gravity.  However, once you feel comfortable with activating these muscles, you want to progress to performing the 2 step kegel sequence in sitting and standing positions. 


    These positions are more functional because most of our daily activities are performed in sitting and standing.  They are more difficult as you now have to work against the pull of gravity and you also have to be aware of the position of your tail bone because your pelvic floor will pull on this as an anchor.  To set a solid anchor for your pelvic floor to pull on in sitting and standing, you can activate your multifidi muscles to extend your tailbone , as described in the first exercise.  Working these three muscle groups (multifidi, TA, and pelvic floor) together in sitting and standing positions is a great start to gaining control of your pelvic floor and your continence.


    When you are ready for a more complete pelvic floor exercise program, you can refer to any one of the sites listed below and explore their blogs and further exercise explanation:

Published On: May 27, 2010