Protective Habits for the Pelvic Floor

  • Breathing. Sit in front of a mirror and watch what moves in the upper body as you take a deep breath. The internal respiratory diaphragm does most of the work, so the base of your ribs should open out as you breathe in. When the ribs open, this movement allows the diaphragm to move down internally to draw air into the lungs then the diaphragm moves up under the lungs on the out breath to push air out. If your shoulders lifted along with neck muscles tightening, then your diaphragm does not effectively move up and down internally.

Why is this a problem? Your diaphragm and pelvic floor need to move in a coordinated manner to ensure the pelvic floor and core muscles all work together as you go about everyday tasks. If you have an altered breathing pattern, visit a respiratory therapist or experienced yoga teacher to learn basal breathing and stretches for stiff rib/spinal joints. Breathing with rib opening is an important first step to learning pelvic floor muscle exercises.

  • Posture.  How are you sitting right now? Grow tall through the crown of your head and feel the light muscle activity in your floor and core muscles while breathing into the base of your chest. This should be an everyday posture to keep floor and core muscles switched on (in endurance mode) to protect your spinal joints along with supporting internal pelvic ligaments and organs.

Find the sitting bones under your butt and keep your body weight directly down through these bones (instead of slumped back onto the sacrum and coccyx). Feel some light pressure over the front pubic bone and now be aware of sitting on a triangular base of support. Visualize a string attached to the top of your head that keeps you constantly lifted.

Practice this posture regularly to build up endurance in supporting core muscles. If your back tires, support it with a back cushion while staying tall. Notice how your tummy automatically flattens when you sit up tall?

Standing up can be more of a challenge to postural control. Gently lift the inner arches of your feet and grow tall with the string visualization. Practice regularly until you rewire the postural control hard drive centre in your brain.

  • Exercise. If you train at the gym or work on any fitness exercises, pay attention to what happens to your pelvic floor when you are in a Pilates, Fit ball, Core, Balance, Weights or abdominal workout session. If your pelvic floor pushes down during an exercise, it’s time to rest and choose an easier exercise option as your pelvic floor is fatigued (or you may have always used an incorrect action). Learning the correct pelvic floor and core muscle action is a priority before commencing an exercise program.
  • Slim waists. To achieve a slimmer waist, many women draw in and hold tension at their waist and chest wall. Through repetition of this action, the brain learns to switch these muscles on instead of using the floor and core muscles to flatten the abdomen. Research shows continent women automatically switch on their pelvic floor muscles with activity. In one study, women with stress incontinence switched on their waist and chest wall muscles first which created too much internal pressure for their floor to control, resulting in leaking.

This is a tough habit for the habitual waist narrower to break. Start by sitting tall, then letting go of your waist, keep it soft and breathe in by opening the base of your ribs. As you breathe out, slowly close and lift the pelvic floor muscles from underneath the body. Hold this light lift while breathing for 5 to 10 seconds. Relax, then repeat 5 to 10 times, 2 or 3 times a day. This is the first exercise to learn the correct action before starting pelvic floor strength exercises.

The revised edition of Hold It Sister (for Australian release May 2010) contains the new ‘Find It, Control It, Train It’ exercise program along with a gallery of exercise photos to add to a home or gym program.

  • Lifting. When you lift a weight, the floor and core muscles should automatically tighten to protect the spine, maintain continence and pelvic organ support. Many women push their pelvic floor muscles down instead of drawing them up, so adding more weight to a faulty muscle pattern will strain internal pelvic supports and muscles.

Check how your pelvic floor is reacting to internal pressure with this easy test. Place your hands on the side of your waist and push in firmly. Now cough strongly and feel what happens under your hands. The waist widened out into your hands, right?

Repeat the cough again and be aware of what happens to your pelvic floor. If it tightened and held, give yourself a tick. If your floor descended (this is the case in 50% of women when we do this check in a workshop), this indicates your pelvic floor does not lift and coordinate with the rest of your core and abdominal muscles. This is a warning sign to go back and learn pelvic floor and core coordination instead of repeating exercises which push the floor down.

  • Toileting. Soft, easy poos are the way to go to prevent pelvic floor strain. Pop you feet up on a stool in front of the toilet, lean forwards and let your tummy go soft. Ideally your bowel will empty in a minute or two of sitting. Emptying will be difficult if you habitually round your spine, tighten your tummy and push down into your bottom. (Start children out with a high foot stool to learn easy emptying habits - some naturally squat on the seat).

Notice the difference in your ease of emptying when you eat significantly more vegetables, fruit, beans or lentils, drink 6 glasses of water and enjoy daily exercise. Some women benefit from daily Psyllium Husks in water or juice or from adding ground linseed, sunflower and almond mix (LSA) to their breakfast.

Consider adopting these habits into your daily health routine for improved pelvic health just as you automatically brush and floss your teeth to avoid cavities and gum disease.