If you caught up with us in part 1, you may be nodding your head thinking “oh, well that makes sense. I’ve definitely tried kegels here and there but I’m still leaking, my back still sort of hurts, and my vagina still doesn’t feel right.” In part 1, we chatted about what it means to have range of motion, timing, sequencing, and awareness in your pelvic floor muscles. All of this fancy stuff helps you take care of your kiddo(s), engage in pain free intercourse, and even exercise more efficiently with less pelvic/low back pain.
But like anything, being able to train the pelvic muscles to move through their full range of motion and have proper timing and sequencing takes a little practice. Many women begin with different ability levels. This why seeing a pelvic floor PT is important to get individualized care to meet your needs where they are. But let’s go over a few more tid bits that may help connect the pelvic floor dots…
For starters, there are 3 different types of pelvic floor contractions that can be helpful:
- Very quick flicks. So, in other words, a very quick turn on of the muscles followed by a very quick turn off. Like little blinks. Quick on/off, quick on/off, quick on/off. This targets those sprinter muscle fibers; the ones useful when holding in urine during a sneeze.
- Slow/controlled coordinations with the breath. This looks like this>> inhale slowly through your nose to expand the belly/let go/lengthen into the pelvic floor muscles and then exhale through pursed lips to gently squeeze/lift like you’re picking up a marble with your vaginal muscles and drawing that marble gently up and in. Finish with a relaxed inhale, allowing your pelvic muscles to return back to their resting baseline position. With the inhale, picture a jelly fish or a parachute gently opening up and creating space between the sits bones, pubic bone, and tail bone.
- Endurance holds. These types of contractions are the least well known. They can be tricky, but hang in there. Endurance holds can range between 2 seconds up to 10 seconds. These holding type contractions look like this>> inhale through your nose to expand belly/let go & lengthen pelvic floor like a parachute and then exhale through pursed lips to gently squeeze/lift like you’re picking up a marble and hold for count 5, 4, 3, 2, 1 followed by finishing with a relaxed inhale as you drop the marble, allowing your pelvic muscles to return back to their resting baseline position.
You’ll notice that we use the inhale/let go/lengthen concept as sort of book ends to a pelvic floor muscle contraction. This helps us start and end with relaxed muscles. It’s important to release a pelvic contraction and not hold onto any additional tension that could arise in the muscles. Usually once I assess an individual’s pelvic floor muscle abilities, I can better discern how many reps/second holds are appropriate for her. Again, it varies for everyone. Usually the numbers range from anywhere between 2-10 quick flicks, 2-10 breath contractions, and 2-10 second holds. I usually recommend that women touch base with and gain awareness in their pelvic floor muscles but don’t over obsess. One time through this sequence in a variety of positions anywhere from 2-4x/day can be all that is required to gain that magic pelvic floor muscle awareness.
These 3 different levels of pelvic floor muscle work – very quick flicks, breath coodinations, and endurance holds – can and should be done in a variety of positions (thanks to gravity!). Gravity changes how we interact with our pelvic floor muscles. We can do these motor control exercises in lying down (putting kids to bed), on our hands & knees (playing with kids on floor), in sitting (reading this blog or sitting in work meeting), and in standing (doing dishes). Plenty of opportunity to touch base with your pelvic floor muscles during your busy day!
Because the pelvic floor muscles are mostly endurance fibers, they help support posture and dynamic positions during the day as well as support continence (both urinary and fecal). Many times in order to perform all of the mentioned motor control activities noted in parts 1 & 2 of this blog, we need to ensure the muscles have a good, resting baseline. Furthermore, these pelvic floor muscles work directly with the abdominal diaphragm and core muscles to support the spine and whole pelvis region (pelvic girdle).
So, as it turns out, there’s so much more to the pelvic floor than kegels alone. And this is just the tip of the wonderful pelvic floor iceberg! There are other important components that need considering (fascia, nerves, bones, hormones, etc…all of the other fun stuff) when working with the pelvic floor muscles, but we’ll save that for another day. Chew on these concepts for a while and if you need help, simply connect with a pelvic physio. If you’re experiencing pelvic pain, urinary leakage, or bowel issues, YOU have the power to take charge and make slow, steady gains that end up being the gifts that keep on giving. Happy training!