If there were ever a body blind spot, it certainly would be the pelvic floor.
In sports, movement classes, private coaching, Physical Therapy, etc., the pelvic floor has historically been left alone. Many of the professionals working with these clients don’t even mention it.
After I suffered a significant spine injury over a decade ago, not one person in a whole host of talented and educated professionals ever mentioned my pelvic floor, let alone addressed it as part of my recovery. My injury was in the cervical spine (neck), so why would they have brought it up?
The missing piece at the time was that I had pelvic floor dysfunction, causing instability. I was also an intense thrill-seeker and pushed my body hard. Add in a few other factors, and I had a recipe for a spine injury–which lead to two years of living with chronic nerve pain.
Discovering Pelvic Floor Dysfunction Therapies
I was missing this piece in my recovery until I had a baby. After giving birth, I wanted to be sure my body was operating the way it should to prevent issues down the road. So I went to a Physical Therapist who specializes in pelvic care.
This is when the effects of restoring health to the pelvis blew my mind.
I discovered I had a chronically tight pelvic floor. But as you might already know, tight doesn’t mean strong.
Being able to turn muscles on and off is integral to the health of the body. My pelvic floor muscles didn’t know how to naturally take a break. Because of this, they were constantly in a state of panic—clenching and fatigued, which blocked their ability to get stronger in order to properly support me.
This led to my professional specialization in breath, massage, and strengthening practices to restore pelvic floor health.
I’m writing this article to empower you to ask questions and seek professionals who will look at how your entire body is functioning, not just the one or two problem areas you walk in with.
I’m also sharing these practices so health and fitness professionals will consider expanding their knowledge base with how the whole body is connected–including the pelvic floor.
Addressing Pelvic Floor Dysfunction with Therapy Balls
For years now, I’ve been guiding students on how to enhance the health of their pelvic floors. I lead transformative techniques with Roll Model® therapy balls, breath, and movement.
After a workshop that included this work, one gentleman in his 30’s, a firefighter, couldn’t believe how tight his pelvic floor was and how impactful the release was.
Most people I work with have a similar reaction. Releasing the pelvic floor, as I will teach below is empowering because you get to take the health of your body into your own hands.
This work paired with strengthening the pelvic floor will be very helpful if you laugh, sneeze or cough and sometimes go to the bathroom. If you jump up and down or lift heavy weights and then urinate, this work can help you overcome that dysfunction.
The pelvic floor is also an area heavily impacted by hours of sitting and sub-optimal posture. When the body is not aligned—whether it’s sitting, standing, or moving—the pelvic floor must hang on for dear life trying to stabilize the structures of the pelvis and the organs above it.
An important piece to keep in mind is that this is an especially vulnerable area for many people. But if you have ever been violated—male, female, or non-binary—this adds even more to the mix. Releasing with the therapy ball and breathing downward might feel extremely empowering, but it also might bring up some big emotions.
I encourage you to take the time to explore your own experience. Also, have trustworthy people available for support, should you want help processing whatever might surface. Go slowly and give yourself space, you deserve it.
How to Use Therapy Balls to Release and Restore Your Pelvic Floor
The first plus of using the therapy balls to release the pelvic floor is that they simply help you have access to it.
If you have been pregnant you might have been told to manually “massage” the area with oil to prevent tearing during the birth of your baby. If you have tried this, you can appreciate that it is not very comfortable (or accessible) positioning.
The ball setup pictured below enables every person, regardless of their flexibility, to ease into releasing the pelvic floor.
This work can be done while sitting in a chair or on the floor using props under you–the ball position is the same. To do the work on the floor, use yoga blocks (books work, too) and stack them to fit your dimensions.
Use an older Yoga Tune Up® therapy ball, or if you only have a brand new one, break it in with your feet prior to doing this work. You can also wrap the ball in a towel or blanket to soften the intensity.
Place the ball on the props and slowly descend your body down toward the ball. You want the ball to nestle into the center of the transverse perineal muscles.
On female anatomy, this is behind (posterior to) the vaginal hole and in front of (anterior to) the anus. On male anatomy, the spot is behind (posterior to) the scrotum and in front of (anterior to) the anus. See the diagram of a female pelvic floor below for reference. Place the therapy ball where the gray circle is.
Follow these steps to get the therapy ball in place.
You are not alone if you get confused placing the ball! I promise. (Many of us have not been encouraged or given permission to anatomically understand this area of the body.)
Once you have settled your weight onto the therapy ball, make sure you are able to breathe easily and aren’t holding your breath. You might be shocked by how much sensation you feel. Take slow, easy exhales and let your inhales naturally respond once you empty yourself of air. If the ball provides too much sensation, use the soft Coregeous® ball instead, pictured at the top of this post.
Next, shift your weight around on the ball with tiny movements. Move a little more to the front of the ball, and then the back. Be mindful of the tailbone—you never want to put any pressure on this area.
Finding different edges around the perineum, allow the ball to snuggle into different angles and nooks. Spend 30 seconds or a minute starting out. Then remove the ball.
Position your spine in neutral (which means there is a natural curve in your low back, shoulders are neither rounded forward or pulled back, head over your lungs.)
Breath Practice to Sense and Engage the Pelvic Floor
Now try to breathe down into where the ball was previously. Allow the breath to drop lower without forcing it. Seek a balloon-like sensation in the pelvic floor with the tissue softening on inhale. On exhales, sense your soft tissue/perineum/pelvic floor area come back up into the body.
Try this for a few rounds.
If you aren’t getting any feedback, on your next exhale actively LIFT the pelvic floor. Please do not clench or tighten. Picture an elevator rising up.
When you begin this work, sometimes it is easier to activate a few exhales before you will even feel the tissues release on inhale.
If you aren’t feeling anything, that is absolutely okay. I have had hundreds of students over the years unable to do this at first. Consider adding the above release and breathing strategy to your movement diet a few times a week. Consistency and patience is key.
As you continue to practice you will create new brain channels of movement for the body to wake up the musculature. The goal is to retrain this area and teach it both to release and engage, not just engage.
Practicing this style of breathing is strengthening your body. It is the piece I was missing; I never learned the pelvic floor should release on inhale until I attended a yoga therapy conference four years ago. In many yoga circles, we are taught to release or let go on the exhale, so for me, activating my pelvic floor on the exhale was foreign and took time and practice to embody.
Strengthening Exercises for Pelvic Floor Dysfunction
The next step after the self pelvic floor massage and breathing is to add movement.
Set yourself up in bridge pose prep: lay on your back with feet and knees approximately hip-distance apart. Maintain a neutral spine (low back is naturally arched away from the floor).
For the first few breaths, rest on the ground in this position.
As you inhale, encourage the pelvic floor to soften.
As you exhale, first lift through the pelvic floor, then engage your lower abdominals just above your pubic bone as you continue to exhale—visualize your front hip bones coming together.
Your body has not lifted; you are on the ground still laying in bridge pose prep.
If you aren’t feeling the hipbone piece, that’s okay. After I had my daughter this was a Bermuda Triangle of feeling (or lack thereof).
Please keep sending the message to your body and working through this. It might take some time to get it so be patient with your body and yourself.
Continue trying to inhale down to soften, then exhale to lift up through the pelvic floor and bring the frontal hip bones together. (They won’t drastically move together, but we are asking the lower abdominals to engage and this is the sensation you want to be feeling.)
Bridge Pose to Strengthen and Tone the Pelvic Floor
For the next piece: inhale to soften all effort and soft tissue, then on an exhale lift through the pelvic floor, mentally engage the muscles to bring your hip bones closer together, THEN you can pick up your pelvis, low back, middle back, and upper back off the ground to come into bridge posture.
This bridge is not about “rolling” your spine up or down. Keep a neutral spine as you lift the hips.
Hold at the top for an inhale, try to soften through the pelvic floor.
On your exhale, FIRST, lift up through the pelvic floor, try to close the hip bones towards each other, then come down the upper back, middle back, lower back, hips.
Please resist rolling down—catch yourself if you do and keep your spine in neutral as you go up and down. Inhale again at the bottom.
Do this from start to finish for a few rounds, a few times a week. Remember to initiate the movement first on exhale with the pelvic floor and your lower abdominals, then move your body up off the floor.
Taking This Pelvic Floor Work Into Daily Life
You can add this breathing style and pelvic floor initiation prior to moving throughout the day. For me, the first several yoga classes, working out at the gym, and rollerblading with my daughter in a stroller were very challenging/interesting with this style of movement initiation.
Go easy on yourself. Recognize this as a journey with no judgment on yourself or others. It took a lot of time, dedication and patience, but once my pelvic floor started functioning correctly, my neck healed on another level. My deep neck stabilizer muscles finally turned back on—something they have not been able to do in over ten years since my initial spine injury. This was very significant. It was a missing piece I had been working toward for the greater part of the last decade.
My neck and body no longer feel as vulnerable and I am enjoying this newfound freedom of movement, strength, and stability.
Start where you are with what you can grasp, and keep learning and exploring. The more you practice and connect with your pelvic floor, the more your body will start to do it naturally.
I hope you enjoy adding these new ways to create stability, strength, and release in your life as these components are critical to a healthy and happy body.
Shop this post: For pelvic floor massage, get Original Yoga Tune UP Therapy Ball Pair (used in the pelvic floor massage technique), or the Coregeous® ball (seen in the feature image and as a substitute for the Original Therapy Balls).
Related Article: Building Body Confidence Through Pregnancy with Self-Massage
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This was fascinating. I recall doing a version of this in one of Jill’s union fit classes within the past year and learning more about it here is excellent. I have only started to explore the importance of the pelvic floor within the past three or so years, so anything I find where I can apply to my movement practices and share with others is wonderful. I thought the explanations and exercises in this article were extremely accessible and I was grateful to better understand some of the dynamics at play. I’ll definitely bookmark this one– bridge with emphasis on… Read more »
Après 3 enfants, j’ai toujours su que la santé du plancher pelvien était important mais je ne savais pas à l’époque que d’autres structures de notre corps pouvaient être mises à mal s’il était défaillant.
Très intéressant, il est vrai que notre plancher pelvien est méconnue. Dans tous les cas il est essentiel de faire sa connaissance et de rendre notre plancher pelvien compétent pour une meilleure santé.
travailler sur le plancher pelvien n’est pas facile mais apporte beaucoup de bienfaits surtout que je suis en posture assise toute la journée. Merci pour les excercices
I am a pelvic floor physical therapy and often see stories like that! All professionnal should screen for pelvic floor symptoms
Very interesting and useful article. Understanding and being able to manage your pelvic floor is an essential asset for good health. Thank you.
I really appreciate Stephanie’s thoughtful writing of this blog. There is definitely an interesting lack of discussion about the importance of the pelvic floor, although this is seeming to change (yay!). As a mother of 2 I have experienced the need for a focus on getting to know my pelvic floor and the tight doesn’t equal strong equation. As a yoga teacher, I’m learning to accessibly integrate these practices into all levels classes for core and overall stability and strength.
I appreciate this article so much and love how simply it is explained. Just trying the breathwork connected with the lifting and lowering, its amazing to me how foreign this is to my body. There is definitely a disconnect for me in this area and I’m looking forward to putting theses techniques to use.
This article is so important and hit the nail on the head. As a former athlete the pelvic floor was never discussed. Even in a lot
of my movement trainings (YTU aside) the pelvic floor was non existent. It’s so important to treat the body as a WHOLE and that includes the pelvic floor! Loved the mention that tight in the pelvic floor doesn’t equal strong. Such a great read!
I appreciate the gentle tone of this article. acknowledging that it can take a long time of consistent practice to strengthen the pelvic floor. I will try these practices and note if there are other improvements with my postural challenges.
This article was so helpful. I agree that so many of us (myself included) are so disconnected to our pelvic floor muscles. Releasing I find is the hardest part to train but using the breath and visualization can build on our mental map. Having the coregeous ball is a great tool for proprioceptive feedback.
What a wonderful source of information/gentle exercises for understanding the pelvic floor for each individual. I’ve always been told to focus on the strength of my pelvic floor, but rarely for the release. And like you say, having control is being able to activate or relax the muscles of the pelvic floor. such simple yet potent information. Thank you!
Thanks for detailed yet easy to follow instructions for therapy ball and the supine exercise routines. Due to its location, pelvic floor is often a blind spot for many people. We need more articles like this to bring more attention toward this important part of human body.
This looks like a fantastic practice in a body area often overlooked. I wonder if these exercises apply for treating incontinence as well as post partum issues? seems like they would…
Thank you for outlining this gentle way to become more aware of the pelvic floor and the tips for an optimal functioning pelvic floor. I love this therapy ball exercise and the feedback the ball offers especially after you come off of the ball. And I really appreciate the cue to keep your spine in neutral in the bridge lift as well. It’s so easy to go on auto pilot and begin to roll down. I’m looking forward to putting this practice into my “movement diet”. This info is so valuable to realize that being able to relax your pelvic… Read more »
I’m happy that you were able to pick up on some cues to use in your practice. It sounds like you are already on your way…happy rolling and releasing!
I have always been so focused on strengthening my pelvic floor that I have never considered releasing it. Truthfully, that thought feels scary because it is such a loaded area for me. Thank you so much for sharing this information! Now time for som self exploration and release!
You along with so many others feel this way, but as you now know, you can’t strengthen an already contracted muscle as effectively. Just remember the release is going to allow you to get stronger when you do strengthen! Let your breath guide you and never apply pressure to an extent where there is pain or major discomfort. Go slowly….and good luck!
I love the application of Yoga Tune Up balls to help with tight Pelvic Floor release. I am trained in pelvic floor yoga and have been considering ways to help men who can’t perform internal massage. I can’t wait to try this out on a few clients who, I believe, have a tight pelvic floor that is the cause of low urine flow.
Many women are also not able to reach “down there” to effectively massage the internal muscles and help to release things.
Thank you for the inspiration and guidance.
You are very welcome! Yes, to your comment about men being able to use the therapy balls and also it’s not an easy to reach place. The balls make it accessible for all and it is also low barrier so it isn’t as intimidating to someone who may be less comfortable internally releasing. I’d love to hear how it goes in your population. Best of luck to you!