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.

Author Stephanie Leger and her daughter Willa

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.

Important note:

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 the ball provides too much sensation, instead use the soft Coregeous® sponge ball 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 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).

 

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Vera

Thanks to contributing solid information to my newest fascination: pelvic floor health. What is unseen can also easily become a blind spot for many of us.

Tisha

I really appreciate this article because of the awareness it brings to the community. This is something that I’ve only begun to learn about in the last few years, but the pelvic floor is so important to learn more about. More and more of my clients are asking about help with the pelvic floor. Of course, I am no expert, but I am exploring local Pelvic Floor PTs and other specialist whom I can partner with or at least refer folks to. The first time I ever heard about pelvic floor dysfunction was in the YTU ball rolling trainings. I… Read more »

Nancy Triscuit

Thank you for sharing – You’ve explained this in a very thorough and understandable way. I am attending the Tune up ball training in September and am very excited to bring this information to my Yoga classes!

Sara M

Thank you for the beautiful, thorough explanation. This is an area that most of us need to get to know better but it’s scary and hard to find good instruction on how to approach it. Love the gentle introduction.

Marta Hanrahan

I love the diagrams here! Thanks for sharing!

Katelyn

This is the best article for postpartum until pelvic floor PT becomes standard care (hopefully one day). Pelvic floor issues are a blind spot for many women whether or not they have birthed a child. Thank you for providing clear education on this often misunderstood area of the body.

Melanie Hale

I have just started exploring the possibility of pelvic floor dysfunction in my own body, so I appreciate the detailed explanation of several methods to release and strengthen the pelvic floor. I plan to try these soon. Thanks for sharing…

Stephanie Leger

I am so happy to hear Melanie! You are not alone, it is very common and I am thrilled to hear you are on a path to healing. Keep me posted how it goes – the work I refer to is so potent for getting the body back into a functional place. Should you desire more support, please know there are very talented professionals out there. I couldn’t recommend working with a pelvic floor Physical Therapist enough.