Weak, loose, “totally asleep…or maybe dead.” These are all things I’ve heard women call their pelvic floor. The good news is, kegel-style exercises can help! (I know, who even know that there was more than one kind of kegel exercise anyway? Hint: Anyone who’s been to pelvic floor PT, for sure!)
Yes, most of us know the kegel as a generic tightening or engagement of the pelvic floor muscles, but there are actually many different ways to engage the pelvic floor.
Breathing for a Healthier Pelvic Floor
One of the biggest mistakes I see contributing to women’s issues with weak pelvic floor muscles is constantly engaging the abs or “sucking in.” Notice, are you even doing it right now?
If your pelvic floor muscles are weak and your abs are sucking in all the time, that displaces pressure when you breathe downward on the pelvic floor. The pelvic floor will usually respond in one of two ways: Either the pelvic floor will constantly engage, too, to support that extra pressure, creating the over-tight pelvic floor muscles I mentioned above. Or, the pelvic floor muscles won’t be able to sustain the extra pressure, and they can be injured, as is the case in pelvic organ prolapse.
So, the most important and simplest (though not necessarily easiest!) thing to do would be to practice belly breathing, or diaphragmatic breathing, as much of the time as possible. Any time you’re not actively working or exercising, you can be calmly, deeply breathing.
In addition to relieving intra-abdominal pressure on the pelvic floor, diaphragmatic breathing calms the nervous system, which helps reduce inflammation and aids in healing. It also allows your pelvic floor to move up and down — mirroring the movement of the diaphragm up and down — creating more mobility in the tissue, increasing blood-flow to the pelvic floor, and again, aiding in healing and strengthening.
The kegel 2.0 is the basic model of the pelvic floor engagement. You want to know this one before progressing on to the next two.
As you inhale, you totally relax the abs and pelvic floor. As you exhale, you try to engage and lift the perineum or the space between the anus and the vagina. There are a lot of ways of visualizing this exercise, but the best place to get more detail on it is this post right here.
Once you’ve mastered the kegel 2.0, you’ll start to practice elevators. (You may even have been unconsciously doing this while learning the kegel 2.0.)
While engaging, imagine lifting the pelvic floor up 4 floors in an elevator, and then releasing slowly down 4 floors. It’s totally normal for this to be hard at first! You may be able to go up, but totally drop the pelvic floor on the way down. Keep practicing! Notice if you’re squeezing your face, hips, or shoulders to help you out, and try to keep the work in the pelvic floor.
Just like every muscle in your body, your pelvic floor has both slow and fast-twitch muscles. We want both! And in fact, if you only have one, you can still have some symptoms of pelvic floor weakness.
A blink is just what it sounds like! A quick, controlled engagement of the pelvic floor. Try doing sets of 10! Maybe start with one or two and work your way up. You might need to take breaks for a deep, slow breath and start over.