So… not many of us therapists are willing to cover this info in a blog post – but I see so much confusion out there – from 95% of the women I work with – and so I simply had to share.
Now – there’s some ‘anatomical’ language ahead. I use it only for the purpose of you knowing exactly where I am referring to so you can train your pelvic floor correctly. Sometimes our fear of using these terms is what can lead to the confusion (and therefore not knowing what we are doing!) – so here we go…
1 – Lie on your back with your knees bent, feet flat on the floor
2 – Start by drawing up through the 3 openings that are at the base of a woman’s pelvis – back passage (anus), middle (vagina), and front (urethra).
3 – As you draw them upward towards your belly you will feel a drawing inward of each one simultaneously
4 – Once that’s done, draw the deep TVA (transverse abdominis) muscle down towards the spine – think low – between the pelvis and the belly button
TACTILE TIP – If you aren’t sure what you should be feeling –
Place your hands on your hip bones – then move them inward an inch, and down an inch. Press in deeply – as you draw the TVA in you should feel the fascia firming underneath your fingers
You shouldn’t be aiming for a ‘sucking in’ of the stomach – it’s a deep and low movement of the low part of the belly – towards the spine – very gradually.
5 – Hold all 4 parts in together (back, middle, front of pelvic floor plus the TVA) for 2 counts
6 – Then let each part relax – this is not a pushing out, but rather a gentle letting go
7 – For a full release – do a deep diaphragmatic breath – where the belly rises on the inhale and falls on the exhale – with the chest and shoulders staying neutral. As you inhale and the belly rises you will feel a full releasing sensation of the pelvic floor
The diaphragm is on the same neurological loop as the pelvic floor so it benefits to use it in between repetitions, to enhance activation.
Eventually as you become more co-ordinated you would aim for a co-contraction – all 4 points at once, rather than 1 at a time.
Stability training for a post natal woman focuses completely on activation and strengthening of the pelvic floor in a variety of sequences and movements – for the entire first 5 weeks of our program. I recommend you do something similar.
We are only as strong as our weakest link in any given movement – so if you have any leaking or pelvic floor weakness during a jump, run, or lifting something heavy – it’s just a sign you may not be ready for that yet.
When we build our bodies so that’s they are more stable than any activity we do in our daily lives – we generally stay pain free.