The New York Times
The pelvic floor muscles are perhaps the most important muscles not worked during a workout. Like a stepping stone that sits at the base of the pelvis, they contribute to overall core strength and hold various organs in place — including the bladder, bowel, and in some cases the vagina and uterus — and ensure they function properly.
However, many people don’t even know these muscles exist, says Amy Park, director of female pelvic medicine at the Cleveland Clinic at least not until they stop functioning properly. “There’s a general lack of awareness of the pelvic area,” Park points out. “I educate women several times a day that we have pelvic floor muscles.”
They might not be as visible as the triceps or quadriceps, she says, but they’re fundamental to everything from basic functions like going to the bathroom to sexual health to sitting and standing — and they benefit from workouts that do aim for fitness. .
The pelvic floor is “as important in your daily life as the Achilles tendon is in running because we use it for everything,” says Liz Miracle, director of clinical quality and education at pelvic floor physical therapy provider Origin.
Historically speaking, it seems strange to many to discuss this area of the body even with doctors. This shyness has caused needless suffering for years, says Evelyn Hecht, a pelvic floor physical therapist in New York who began practicing in the 1990s. Many diseases could be treated or simply prevented if women were more comfortable talking about their symptoms , or if the public were better informed about these muscles.
Almost 1 in 3 American women suffer from pelvic floor disease, most commonly in the form of urinary incontinence, bowel incontinence, pelvic pain, pelvic floor prolapse, or a combination of these problems.
But pelvic floor problems are not inevitable. Many can be prevented or alleviated by regularly stretching and strengthening these muscles. Most of us can reap the benefits of a “personal pelvic floor exerciser,” says Lauren Streicher, medical director of the Center for Sexual Medicine and Menopause at Northwestern University.
Miracle, who is also a physical therapist and somewhat of a pelvic personal trainer, recommends that all women who don’t currently have a disorder or injury to these muscles incorporate six compound exercises into their routine, aiming for at least three times a week.
1. Diaphragmatic breathing
Learning to move the diaphragm is key to connecting and conditioning the pelvic floor muscles.
- Sit in a chair with your feet flat on the floor. Put one hand on your stomach and the other on your chest.
- Breathe in and feel your stomach expand, and then breathe out slowly through your mouth. (Imagine a balloon in your abdomen: as you inhale, the balloon fills with air; as you exhale, the air is slowly released, as if your thumb is covering the opening and gradually letting it out.) Repeat 10 times.
2. Stretching
Relaxing and stretching the pelvic floor muscles to allow them full range of motion is especially important for basic functions like going to the toilet with ease (avoiding constipation) and painfree penetrative sex.
- Lie comfortably on your back, knees bent and feet flat on the floor.
- Begin diaphragmatic breathing by taking a deep breath and allowing air to fill the lower part of the lungs. Feel your lower abdomen, lower back, and pelvic floor gently stretch outward—or lengthen—with your breath.
- Exhale slowly through pursed lips and allow your abdomen, back, and pelvic floor to relax passively. Do not contract any muscles when exhaling; Keep your pelvic floor fully rested. Imagine the above balloon expanding 360º in all directions on inhalation. One of those directions is down between the legs and toward the perineum (the area between the vagina and anus). As the abdomen rises passively, the perineum also passively inflates and expands. Repeat 10 times.
3. Seat cone
While the previous exercise helps us relax the pelvic floor muscles, Kegels train us to contract them. This exercise helps us hold back urine, stool or gas when we feel the urge to go to the bathroom and also increases the resistance of the pelvic floor muscles so that they can support our organs and balance the pressure exerted on the pelvic floor abdomen throughout Day.
- Sit up straight with your feet flat on the floor.
- Breathe in through your nose and relax your pelvic floor as your abdomen and chest expand.
- As you exhale, contract and lift your pelvic floor muscles, maintaining the contraction as you exhale. Hold the position for 10 seconds. It can be helpful to imagine the muscles that stop the flow of urine at the front and trap gas at the back contracting—or imagining them picking up a marble and holding it there. Use the muscles in your body instead of just squeezing your thighs or buttocks.
- Relax completely for 4 to 10 seconds—or longer if you must. Release is important because contracting muscles without fully releasing them can overtighten them and limit your range of motion. Perform three sets of 10 reps.
4. Fast movements
This exercise builds on kegels and trains the pelvic floor muscles to contract quickly—an ability that allows them to respond effectively to sudden, automatic bodily functions that create pressure in the abdomen, such as coughing, sneezing, or laughing. (It may also help prevent incontinence, or “leakage,” from that pressure.)
- Sit up straight with your feet flat on the floor.
- Repeatedly contract and relax the muscles that stop the flow of urine, performing at least seven contractions in 10 seconds. Complete at least 30 holds and releases.
5. Make the “Shhh” sound
While fast movement trains the pelvic floor muscles to respond quickly to bodily functions that put pressure on the abdomen, this exercise helps build strength and endurance in the face of that pressure.
- Sit up straight with your feet flat on the floor.
- Inhale through your nose and relax your pelvic floor as your chest and abdomen expand.
- As you begin to exhale, contract and lift your pelvic floor muscles. Then, make a quick, forceful “shh” with your mouth while maintaining the pressure.
- From there, exhale fully and slowly with lips pressed together, allowing your abdomen, back, and pelvic floor to passively retract. Perform three sets of 10 reps.
6. Train your abs
This exercise targets the transverse abdominal muscles, which sit in the lower abdomen and support the core. They work with your pelvic floor muscles to help you sit, stand and do any exercise that requires balance or stability.
- Start on all fours, with your hands in line with your shoulders and your knees with your hips. Focus your gaze between your hands.
- Inhale, fill your stomach with air and relax it towards the floor.
- Exhale and draw your navel towards your spine. This should activate the transverse abdominal muscles. Keep your back straight throughout the movement. (Imagine that your stomach is filled with air again, like a balloon now push the air out of the balloon with your abdominal muscles and press it against your spine.) Repeat 10 times.
Translated by Luiz Roberto M. Gonçalves