Pelvic Floor | It’s Not Just For Mamas
Pelvic Floor Health
How Pilates Can Help and When You Might Need More
As I’ve become more specialized in prenatal and postpartum movement, pelvic floor health has been a major theme. Think it’s just about doing kegels? Think again! Just like any muscle group (hips, shoulders, back) there is a lot more nuance going on and everyone can benefit from healthy pelvic floor function for core strength. Let’s get into why!
What is the pelvic floor?
Think about the pelvic floor as a sling of muscles that “hammock” the base of your pelvis and hold up your sex and excretory organs. I like to think of them as a diamond shape at the base of the pelvis from the pubic bone to tailbone and both sits bones. The muscles also run vertically so you can both contract your pelvic floor medially (toward the midline) and then lift superiorly (upwards toward the head). Your pelvic floor can contract both independently from and in coordination with your tranverse (corseting) abs for deeper core activation.
Why pelvic floor for all: While we discuss pelvic floor health all the time in growing and delivering a baby for obvious reasons (supporting extra weight of baby while pregnant, delivery and recovery of core postpartum), EVERYONE can benefit from pelvic floor TLC.
The basics:
Can you engage your pelvic floor? Try sitting on a squishy ball kneeling with the ball under the diamond of your pelvic floor. Can you “kegel” by lifting your pelvic floor away from the ball? Think about gently holding in your pee. And just as important, can you relax your pelvic floor back down and melt it into the ball?
More than basic:
Can you isolate this same movement to just the front half of the pelvic floor near your pubic bone? Most of us overuse the muscles of the posterior pelvic floor and over-grip the tailbone. Think about both “closing the elevator doors” at the base of your pelvis inward toward the midline, and then “riding the elevator up” toward the belly button. Try it. Are you squeezing your glutes? Relax them as best you can. Then ride the elevator all the way down. Hard!
When exercise isn’t enough:
I’m a big fan of pelvic floor physical therapy at least once for anyone! The more I have worked in this field, the more I see pelvic floor dysfunction not with an inability to kegel, but more so with an inability to RELEASE the pelvic floor muscles. If you have a hard time “relaxing” to pee, feel like you have to pee all the time, have pain with sex, wear tight clothes and keep your core constantly engaged (guilty!), or have hip pain, these may all be signs of a “too-tight” pelvic floor. Try deep belly breaths and hip opening stretches to help release a tight pelvic floor but my suggestion is to go in for a PT appt when you can. Don’t wait til there is a problem.
Other things pelvic floor therapy can help with:
Back pain
Tailbone pain
Incontinence (peeing or loss of bowels when running, sneezing, coughing)
Constipation
Pain with sex
Other resources:
Internet: @the.vagina.whisperer @vaginarehabdoctor @doclizziedpt @pelvic_floor_jake
IRL Pelvic Floor PTs in NYC: flowphysiobk.com, drjessicababich.com
