Simple exercises that anyone can do to increase pelvic floor awareness and tone the muscles for strength and suppleness.
Do you ever pee a little when you sneeze? If you do, you’re not alone. Pelvic floor dysfunction is incredibly common, affecting a quarter to a third of women the US. Pregnancy and childbirth are common culprits, but so are injuries, trauma, or even too much Pilates. Most people think we should all be tightening our pelvic floors and doing Kegel exercises all day, but an overly tight pelvic floor isn’t much better than an overly loose one. Dysfunction in this area in either direction can cause pelvic pain, low back pain, constipation, painful sex, or—you guessed it—peeing when you sneeze.
The pelvic floor is a net of muscles that sits like a hammock between the tailbone, the pubic bone and the two sit bones. In a healthy person, it moves gently with our breath and responds to our movement, supporting the pelvic organs and the lower back when we want to carry a baby or jump on a trampoline. When we want to go to the bathroom, give birth, or have sex, it relaxes.
This set of muscles is strongly connected to our nervous systems. It will automatically tighten when we enter fight-or-flight, and relax when we feel safe. For some of us, chronic stress keeps the pelvic floor engaged all day, which exhausts and then weakens the muscles. Chronic tightness in this region can slow circulation, which can mess with our sexual responses and/or cause constipation.
The good news is that the pelvic floor is like any other muscle—we can train it to work better. It’s best to consult a professional, especially if you do have dysfunction, but there are simple exercises that anyone can do to increase pelvic floor awareness and tone the muscles for strength and suppleness.
Lie on your back with your knees bent and your feet on the floor. Widen your feet so the knees can rest against each other and the belly and the back can relax. Place your hands as low on your belly as you can.
Think of the belly as a balloon, gently expanding on all sides on the inhale, and gently deflating on the exhale. Relax your belly as much as you can and pay attention to the feeling of your pelvic floor as you breathe. The sensation is a gentle expansion, almost a stretch, as you inhale, and a relaxation inwards as you exhale. Take 10-30 breaths here.
2. Pelvic Tilts
From this same position, bring your feet in front of your hips so your knees are right over your heels. Keep your hands on your low belly. As you inhale, let the belly expand and tilt your pelvis forward, increasing the curve underneath your lower back away from the floor. Keep your bum down. As you exhale, flatten your back to the ground and focus on gently engaging the pelvic floor muscles, drawing them in and up towards your heart. Your belly button should also draw in towards your spine. Move with your breath, relaxing the pelvic floor as you inhale and tilt your pelvis away, then gently contract the pelvic floor and belly muscles as you exhale and tilt your pelvis in. Repeat 5-10 times.
3. Knee falls
Now find a neutral spine: a little bit of space under your back, and keep that. Inhale, and as you exhale, move your right knee down a few inches to the floor on the right. Keep your foot engaged, moving on the blade. Repeat on the left side. The key of this exercise is to keep your hips and pelvis completely still—no rocking from side to side or forward and back. This engages your pelvic floor as a stabilizer for your back. Repeat 5-10 times each side.
Spend some time exploring your pelvic floor with the breath in this guided meditation for stress relief.