What is the pelvic floor?
A deep layer of muscle which attaches from the pubic bone to the tailbone and forms a sling/hammock that provides support for the bladder and bowel.
Imagine the pelvic floor as a muscular elastic trampoline that moves up and down in a dome-like shape as we contract and relax the muscle.
Why is the pelvic floor important?
- It supports the bowel, bladder and uterus and prevents problems such as incontinence and prolapse.
- It provides lumbo-pelvic stability
What causes the pelvic floor to be weak?
There are many reasons why your pelvic floor may be weak. A few examples include:
- Childbirth
- Persistent heavy lifting with weak abdominal muscles
- Menopausal hormonal changes
- Prostate problems
- Obesity
- Excess coughing
How do I activate the pelvic floor?
There are a number of different visualisation and imagery techniques used to try and help activate the pelvic floor:
- Imagine drawing up a 5 cent coin slowly with a gentle contraction
- Imagine you are gently trying to pause your flow of urine mid flow
- Stop yourself from releasing wind whilst keeping your glut muscles relaxed
** When you are activating your pelvic floor correctly, it should feel like the muscles around your front and back passage are gently lifting up towards your belly button. **
When activating your pelvic floor, try and activate it in a number of different positions including:
- Sitting
- Standing
- 4 point kneeling
- Lying on your back with knees bent
How should I train my pelvic floor?
Step 1:
Once you can activate your pelvic floor effectively it is important to build up some endurance of these muscles. Try the following program:
- Hold the contraction for 3-5 seconds and then release
- Repeat the contraction and hold for 3 sets of 10 repetitions
- 3-4 times per day for 4 weeks
- Alternate this with quick contractions and release for 3 sets of 10 repetitions
Step 2:
- Incorporate these exercises into a more global exercise programme like Pilates classes
- Remember, the pelvic floor is only one-third of an important set of deep core musculature and so needs to work well in combination with both the Transverse Abdominis and Multifidus (these are the other two other important deep core muscles!)
Important points to remember when completing these exercises:
- You should feel your pelvic floor muscles lifting up and inwards rather than downwards
- There should be no movement or contraction of your glut, core or hip muscles
- Keep breathing throughout the exercise and try not to hold your breath
- The contraction should only be a 3/10 – NEVER GRIP your pelvic floor. Instead, it should feel like a gentle sensation of lifting.
How can a physiotherapist help with your pelvic floor?
To be 100% sure that you are effectively activating your deep core, your Physiotherapist can use Real Time Ultrasound (RTUS) to get a detailed image of how your muscles are working. If you would like to book in for a comprehensive Pilates assessment, please contact one of our clinics today.
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