What is the Pelvic Floor?
The pelvic floor is the “floor of the core”, like an internal “hammock” in your pelvis between your “sitting bones”. It stretches from the pubic bone at the front to the coccyx (tail-bone) at the back.
What do the Pelvic Floor Muscles (PFMs) do?
Why are these muscles important?
- They work with your deep abdominal (tummy), back muscles anddiaphragm (breathing muscle).
- They help control the pressure inside the abdomen to deal with the pushing-down force when we lift or strain, helping to control the bladder and bowel.
- They hold up the bladder and bowel, plus the uterus (womb) in women.
If your PFMs are not working well, you might leak urine when you exercise, cough, sneeze, laugh or lift – and you might pass wind unexpectedly. The PFMs play a role in sexual sensation and function too.
Protect and strengthen your Pelvic Floor.
Strengthening your PFMs (Pelvic Floor Muscles)
Can you make your PFMs stronger? Yes! By training with special PFM exercises and by protecting your PFMs to prevent straining and weakening.
Using overly-heavy weights or gym machines, high impact exercise sand straining with constipation can weaken the PFMs.
Be aware of protecting your pelvic floor with any physical activity. Talk to your fitness professional about this important aspect before you begin any exercise program.
The PFM exercise routine.
- Relax your thigh, bottom and lower tummy muscles
- Draw in (lift and tighten) the muscles around your front and back passages and hold for a second or two (while continuing to breathe normally)
- Relax all the muscles
- 3 quick squeezes to finish, relaxing fully between each one
(lift UP: don’t push out or downwards!).
Repeat this set of movements 3 times. Rest between each set.
- Once you can do this set confidently:
Hold the lift-and-tighten for longer, say, 3-5 seconds.
- Build – up slowly over time – to a 1- second hold: feel the muscles “let go” each time.
Don’t hold your breath; breathe normally throughout.
- Don’t press out OR down – lift UP and tighten.
- Do this exercise routine 2-3 times a day.
- You can build this routine up to 10 times in a row.
Put your Pelvic Floor first with this helpful checklist.
10 tips to make exercise “Pelvic Floor safe”.
1. Keep it “comfortable”: Don’t lift weights that are too heavy or make you hold your breath. Aim to lift from waist height rather than from ground level. If your PFMs are weak, keep your weights to a minimum until your pelvic floor muscle strength improves.
2. Lift your PFMs before and during your strength-training. Relax fully between steps or repetitions. The goal is for your pelvic floor to be working immediately before and then as you lift/lower/push or pull any weight.
3. Keep good posture by maintaining that normal inward curve in your lower back during every exercise you do – whether you’re sitting, standing or lying on your back. That way, your supportive deep abdominal and pelvic floor muscles are more involved (instead of the stronger outer abdominal muscles).
4. Breathe out with a push, pull or lift and never hold your breath or pull your stomach in strongly during exercise. This strategy helps you to avoid unwanted strain and (bad) downward pressure on your pelvic floor.
5. Choose sitting or lying down positions wherever possible to reduce pelvic floor strain. Sitting on an exercise ball while you perform your strength exercises is helpful too. Your deep abdominal muscles support your pelvic floor so involving these more decreases the likelihood of strain. It will also be easier to feel your pelvic floor muscles working.
6. Keep your feet close together: Avoid wide-leg standing positions. It’s easier to activate your pelvic your PFMs when your feet are together and your pelvic floor openings are less exposed. If you’re performing a standing resistance (strength) exercise, try to keep your feet no further apart than your hips (your knees about a fist-width apart).
7. Strengthen gradually and exercise correctly: Start with very light resistance. Be aware of how you are performing each movement. To reduce your risk of injury, gradually increase your load only when you are (a) very confident of your technique and (b) when you have good pelvic floor and abdominal muscle control.
8. Take care when tired, injured, unwell or have lower back pain: Your pelvic floor and deep abdominal muscles may not work as well and you’ll be more prone to symptoms and injury. Take a break and recover before returning to resistance training.
9. Rest between sets for a couple of minutes between each set of exercises. This gives your muscles (including the PFMs) time to recover before your next lift.
10. Be aware of your bodies reactions while exercising. If you experience any pain or strain, or you hold your breath with a specific exercise: (a) modify the exercise – change it to protect your pelvic floor (b) leave it out of your program, or (c) get advice about another exercise to replace it.
Abdominal exercises (e.g. sit-ups, curl-ups, crunches, double-leg lifts, exercises on machines)Medicine ball rotations (swinging a medicine ball around from side to side).Deep lunges or side lunges (bending your knee deeply either front-on or to one side).Wide-legged or deep squats.Jump Squats.Lifting or pressing heavy weights.Lateral pull-down with heavy weights. Legg press machine with heavy weightsDead lifts (weights lifted from a still position on the floor)High bench, step up/step down.Exercises with both feet off the ground (e.g. chin-ups, triceps dips).Full push-ups (i.e. from the toes, rather than from the knees which is less of a strain).Exercises where there is a direct downward pressure on the pelvic floor.
RunningJumpingStar jumpsSkippingBoxingHigh impact exercise classes that involve jumping and running Sports with start-stop running and quick changes of direction (e.g. tennis, netball, basketball, hockey, touch football)
Exercises to avoid.
If you have symptoms of a weak pelvic floor or are in a high-risk group:
Do NOT do any type of exercise that causes a downward push, pain or feeling of pressure on your pelvic floor muscles (PFMs)