Most women are familiar with exercises that tighten the muscles of your pelvic floor. These exercises are sometimes called kegels and involve squeezing and lifting the hammock of muscles that run from the back of your pelvis to your pubic bones at the front, your pelvic floor.
Exercises like these might have been recommended to you if you tend to leak a bit of urine when you sneeze or when you take part in a high impact activity like running (stress incontinence).
This seems logical because if your pelvic floor is weak and you can’t prevent urine from escaping, then it makes sense to try to tighten up these muscles, right? Not necessarily…actually many women who run already have very tight pelvic floor muscle and this might actually be the problem.
The pelvic floor can be so tight, in fact, that these muscles are effectively weakened because they are permanently overworking in a constricted state. So when the bladder is put under sudden pressure, they are unable to generate enough power quickly to block off the flow of urine.
In these circumstances, working on exercises, like kegels, to tighten the pelvic floor will actually make things worse, not better.
Signs Your Pelvic Floor Muscles Are Too Tight
If you have an overactive pelvic floor it’s highly likely that you will be experiencing some kind of persistent (chronic) pelvic pain. Pain coming from the pelvic floor can be felt around the sacroiliac joints, the pubic symphysis, groin, hamstrings, buttocks, iliotibial band and the abdominal and lower back muscles. You might even have tried some kind of treatment for pain in one of these areas that wasn’t effective and this could be because the pain is actually coming from your pelvic floor.
Other common symptoms include:
- Sudden urges to urinate
- A need to urinate often, even when your bladder isn’t very full
- Difficulty starting the flow of urine
- A sense of not being able to empty your bladder fully
- Coccyx pain (pain in your tailbone)
- Painful intercourse or other sexual dysfunction (dyspanurenia)
Why Does This Happen?
The pelvic floor muscles not only help maintain continence but they also form one part of your ‘core’, a group of muscles that work together to support your pelvis and lower back.
Your core muscles have to respond fluidly and efficiently to meet the complex, high-impact demands of running. If another part of the core is weak or not working properly, your pelvic floor muscles have to work harder to compensate and support your pelvis. Over time, this can cause them to become tighter and eventually painful and weakened.
What You Can Do
First and foremost, if you are experiencing any pelvic symptoms it is important to visit your GP or gynecologist to rule out any potential medical issues. However, if you suspect that overactive pelvic floor muscles are the culprit, the best advice is to begin regular ‘down training’ exercises to help relax your pelvic floor as well as stretches for the muscles around your pelvis and abdomen, to restore balance. Here are four exercises we frequently recommend for this condition:
Abdominal breathing and ‘down training’ your pelvic floor
- Lie down on your back with your knees bent. Place one hand on your chest and the other hand on your abdomen.
- Inhale and imagine your abdomen filling with air like a balloon. Your lower hand should rise while your top hand remains still
- Move the breath down and lower your pelvic floor, letting it relax and open
- Make a smooth transition to the next breath without pausing
- Exhale and allow the air to move out of you without effort starting from the ribs down towards to the pelvic floor
- Count to keep each breath long and even, 3 seconds in and 3 seconds out. Repeat for 5 minutes daily
Pelvic floor muscles stretch and release
- Kneel with your bottom on your heels and your forehead resting comfortably on the ground.
- Focus your attention on your pelvic floor muscles
- Inhale and imagine stretching the back of your T-shirt with your ribs and relaxing the muscles around your tailbone as the air fills your lungs
- Exhale without effort
- Repeat 5 cycles of breathing in this position
- Lie face down on a mat and place your hands by your shoulders.
- Inhale to prepare sending the breath down towards your pelvic floor and towards the back of your rib cage
- Exhale and press the floor away with your hands to gently lift the body until your arms are straight. Keep the front of your pelvis facing the floor and move within a comfort zone so that there is no pressure in the lower back
- Do 3 cycles of breathing in this upward position allowing your abdominal wall to stretch. Lower again and repeat 5 times
- Lie on your back with your knees bent and place one foot on the opposite knee.
- Lift the leg underneath and take hold of it with your hands
- Draw your underneath leg in towards your chest to stretch your outer hip muscles.
- Hold for 30 seconds while practising your abdominal breathing (exercise 1)
- Repeat twice on each leg
Physiotherapists specializing in women’s health offer highly effective, non-surgical treatments to relieve this condition and can prescribe a program of exercises tailored to your own individual needs.
Remember, there’s far more to a healthy pelvic floor then just strengthening exercises. In fact, for some women this is entirely the wrong approach.
For more information, visit PhysioFit Cambridge.