On Wednesday I wrote about symphysis pubis dysfunction (SPD) as well as my home practice. Now I’d like to address pelvic floor dysfunction.

I’m by no means a specialist, and if it’s a subject you’re interested in, I would definitely recommend the work of biomechanist Katy Bowman who has a wealth of information to share.

The pelvic floor benefits from all types of strengthening and stretching, not just Kegel exercises.

The pelvic floor benefits from all types of strengthening and stretching, not just Kegel exercises.

But I would say is this: Just as with everything else in life, balance is the key. Nothing is inherently bad, but the frequency with which you do it, and what you are complimenting it with (or not), can set you up for trouble. For example, should you Kegel? Are Kegels bad? Maybe and no. But ask yourself this: do you know what’s going on down there? Is your pelvic floor weak? Perhaps it’s too strong? Do you have urinary incontinence when you sneeze, walk, run, jump?

In a nutshell, a healthy pelvic floor (PF) is one that is not only strong, but that is also able to release. Imagine your quadratus lumborum contracted all day long (as in when you sit cross legged all day long) – eventually your lower back may give you some feedback you may not like. It’s the same with the PF; so what can you do? Perhaps consulting a physiotherapist who specializes in pelvic floor health is a good first step. He or she will be able to assess the quality of tone of your PF and help you determine the best course of action.

But for now, here are a few helpful tips:

  1. Recapture your posture – how you stand not only affects which muscles switch on, but also how you breathe. See part one of Yoga Tune Up® for Mamahood to learn how to achieve impeccable posture that will help your PF find the right amount of tone – for example if you live in a permanent state of tucking, you may find that your PF is hypertonic.
  2. Ditch the heels – OK so I did say that nothing is inherently bad – but a few things are silly, like wearing heels! Not that you should forego them forever, but be mindful of how often you wear them. They will affect your posture and will not only ruin your feet but also change the alignment of your pelvis, and thus the tonicity of the pelvic floor over time.
  3. Instead of adopting a local approach by focusing solely on strengthening your PF, act more globally by strengthening the surrounding tissues. For example, include squats, transverse ab exercises and back work into your routine.
  4. In addition to strengthening your glutes, hamstrings, back, etc., it’s also a good idea to release those tissues – again finding balance. If your PF is hypertonic, muscles in the vicinity of your PF may also feel restricted. I cannot recommend the YTU hip sequence enough (on the floor or at the wall), the adductor release (I love to do it with an ALPHA ball), as well as using any YTU ball around the ischial tuberosities. Another fantastic way to strengthen and release the entire area is the leg stretch series. There is wonderful rendition of the series on Jill Miller’s Creative Live webinar for a healthy pregnancy. A lot of bang for your buck!

This concludes my series on Yoga Tune Up® for mamahood! – I’ll see you on the other side!

Enjoyed this article? Read Healthy Pelvic Floor: Moving Beyond Kegels.

 

Emilie Mikulla

Having contracted a major case of wanderlust, Emilie has traveled the world, working as journalist, and now lives Dubai. After a second surgery on her spine, Emilie followed a lengthy Pilates rehabilitation program and, amazed by the results in her own body, became a comprehensively trained Pilates instructor in 2008. Emilie has taught in Thailand, South Africa, Dubai and in San Francisco. Emilie is an E-RYT and has completed her trainings with YogaWorks and Yoga Tree San Francisco, before earning her Yoga Tune Up® certification from Jill Miller. She has also spent hundreds of hours assisting her mentor Harvey Deutch PT at RedHawk Physical Therapy clinic in San Francisco, in teacher trainings, and on retreats at the Esalen Institute in Big Sur. She has also recently participated in a week-long cadaver dissection workshop with Gil Hedley of Integral Anatomy. Emilie is the Lifestyle Editor for Women's Health & Fitness Middle East where she contributes a variety of articles and columns ranging from fitness and wellness, inspirational stories and nutrition. Blending dynamic movement with therapeutic releases, Emilie’s classes will empower you to practice the activities you love with awareness and joy.

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Clarissa Stewart

Thank you for the heels tip! I had to go to rehab to strengthen my pelvic floor after having children and before that I wore heels all the time so I imagine that might of contributed to some of the weakness. All these years later lol my physical therapist never mentioned it!

kathie

Good article! You’re right! balance is the key!

Marie

Thanks for thé tip on PF and héros never thought about that one before parfait 👍🏻

poirsha

Whoa, this has peaked my interest for my Aunt who is an athlete and has had challenges holding in her urine. I wonder now if it was after having children. If so, maybe I can study more about strengthening the PF and be able to help her!

Genie

Thank you for clarifying strengthening the pelvic floor vs. strengthening the abdominals! I think there are a lot of us out there that think one just goes with the other ? Time to get educated!

Kimberly McWilliams

Thank you Eimilie for this informative piece on the possibilities of over strenghting the pelvic floor muscles. The PF is an area that I have great interest in learning about and sharing knowledge with my student.

Vivi Sørensen

This is so important. I just heard a radio program where they were discussing postnatal incontinance and how important working on your pelvic floor pre and postnatal and I thought that ytu would be really great for that.

Jacqueline Matthews

I hear from many women who are in menopause issues surrounding their pelvic floor, this is not just for new mamas. I agree that adding key activities into our movement such as squats will help strengthen the entire region. I just did the YTU Hip sequence which was amazing –opening and releasing the hips….can’t wait to share it with other women. Thanks

Katelyn K Natalie

Thanks for highlighting this issue Emmilie. Pelvic Floor Disfunction is not often talked about and can be a major hurtle when recovering from pregnancy and birth. After the birth of my second, I saw a PT who specializes in PF recovery. She helped me assess what was going on down there so I could focus my energies on the exercises that would help the most (cause we all know there is not much time or energy to spare when you’re taking care of an infant!). All of your tips are very helpful and exactly what the PT walked me through.… Read more »

Martine Lauzon

As a result of having a rather sedentary lifestyle that included a lot of sitting for the last 3 years, I now experience a lot of pain in my pelvis and lower back. I have already adjusted my posture, I have ditched the heels, and I am working on strengthening and release my PF as well as my lower back, and glutes. Using the Alpha balls on my glutes and the Coregous around my pelvis has provided so much relief. As a single parent I can’t afford massages twice a week to fix this and so I am sincerely grateful… Read more »

Maureen Aitken

Thanks Emilie, I will check out the hip sequence you recommend. I want to help students find strength in the PF and adjacent, synergistic muscles.

Marsela Suteja

The quick takeaways from the article are straightforward and practical. Often times, people are not aware of their pelvic/ PF situation and it eventually lead to a long term problem. I definitely have to rethink and add more of strengthening/ stretches of this area.

Louise LeGouis

Thanks, a great many things to explore. I ditched the high heals a long time ago but still find myself in a semi-permanent state of tucked pelvis. The YTU hip sequence it is then!

Andree

Great post! I am not (yet) a Fitness professional. I’ve recently begun to explore the YTU discipline and love how many topics are covered that are left undiscussed in other contexts. I learned a lot from this post!

Ashley Burger

This topic is so undervalued when it is such an important part of our anatomy. I think it a forgotten area due to the fact we cannot see it, palpate it and it is categorized with our reproductive organs. I often have issues untangling my adductors from my PF, but as a dancer am very good at releasing it. These are all helpful tools in improving the quality of the PF.

Emma

Thank you for writing on such an important, if seriously under reported topic! In the UK 1 in 3 women of post menopausal age will have some problems with their pelvic floor whether that be prolapse, stress incontinence etc. It also has no bearing at that age if you have had children or not. It can take years for a woman to pluck up the courage to see a doctor or specialist physio and as such has a massive effect on confidence etc.

Meaghan

Thank you for bringing up some very solid points about the pelvic floor! Your point on recapturing your posture really resonated with me. I, however, am the opposite of the example used- I live in an anterior tilt and my pelvic floor is hypotonic. I do include a lot of squat variations in my strength training, as you mentioned, but never thought about the connection between transverse ab exercises and building a strong pelvic floor.

Sonia

I love learning about the pelvic floor. So many people experience problems with the pelvic floor but don’t know there are things they can do to help/prevent these problems. Glad the word is getting out there!

Tatjana Brandl

Dear Emilie,
thank you for your blog post. I was so used to wearing high heels. But since I am really into fitness, I wear them so little, that it feels strange and false. Poor little calfs and hamstrings. Well thats the retribution for going with fashion.

Ann

I never thought high heel shoes could change the PF! You hear of wearing good shoes to support your joints and low back but people seem to skip over the pelvis floor area. Thanks for making us aware of it.

Evelyne Linder

Doing all around strengthening such as you mention and doing release work should be prescribed by doctors to all pregnant ladies. How are we supposed to get a baby easily out if all they tell us to do Kegels? Thanks for the article!

Genevieve

Appreciate the tip in regarding proper posture and global muscles that may affect pelvic floor function. Thank you!

bee pallomina

I was diagnosed with pelvic floor dysfunction post-partum and definitely relate to this post. I was in a hypertonic state with a lot of tucking (which was strange for me- totally different posture than before pregnancy. I will definitely try to strengthen and release the surrounding tissues as you recommend.

Mindy Porell

I definitely know now I need to strengthen my pelvic floor! I plan to be mindful of my posture and breath and continue to work transverse abs, squats and back strengthening exercises in my strength-training sessions.

Katy Forline

I never considered how the posterior or anterior tilt of the pelvis triggers a response of relaxation or contraction in the pelvic floor. Thank you for awakening my awareness of that. It was a mental “blindspot” I suppose but is so easily felt when I bring my attention to it.

Andrea

I will completely agree with minding your posture to help with pelvic floor dysfunction. I was suffering, and started to be mindful and it has helped a great deal !

Lee-Anne Heron

Love the holistic outlook and consideration of other muscles that influence the pelvic floor! Fyi think the link to Jill’s webinar changed to https://www.creativelive.com/courses/healthy-pregnancy-healthy-baby-jill-miller

Lee-Anne Heron

Love the holistic outlook and consideration of other muscles that influence the pelvic floor!

Mari

Thank you so much – great read!

Dianne

Interesting and informative article. As a mom of six, pelvic floor weakness and utinsry stress I continence was such an issue for me I choose to have urethral sling surgery 10+ years ago as Kagels did not help. I am wondering if you are familiar with the work of Janet Hulme, DPT and the pelvic rotator cuff? Is her work similar to Katy Bowman’s?

Elyse

This is helpful. Thank you.
My daughter in law just had twins. I’m going to share this with her, more for rehab to help her get back some pelvic floor stability. She was on bed rest for several weeks which exasberated her weakness. She’s going to need that, doubly!

Susan kjesbo

Great article. I liked the advice in number 3 regarding acting globally. I tend to get site specific but working more globally is also important because everything is so connected. Thanks.

Deb

I love to do a cat/cow variation lying on the back with knees bent to work the pelvic floor and low back. Small little tilts or flexing and extending of the low back,…yummy…. I love using the coregeous ball for this routine as well. Love that ball.

Maria

Hi Emilie,
My name is Maria. I am 63 yrs old very active and in I would think great shape. Unfortunately, I’ve come to a standstill. My years of wear and tear ( marathon running) have taken a toll on my body. I have a labrum tear on my right hip and arthritis. So painful.. I religiously roll on my therapy balls which alleviates much of my pain.. Are there any exercises you can recommend that I could incorporate into my exercise routine. I too, have become very aware of my pelvis and proper posture.
Blessings,
Maria

Linda Zanocco

The second of 2 articles Emilie discusses Pelvic Floor disfunction and asks the question whether Kegels are the answer. The Pelvic Floor needs to be strong as well as to release. Strengthen the PF by strengthening the muscles around it—glutes, hamstrings, transverse ab and back exercises. Additionally, hip releases will feel wonderful. She recommends focusing on maintaining good posture and not wearing high heeled shoes.

Nikole

Thanks, Emilie! You offer sound advice. This will be helpful as an instructor going forward in helping clients strengthen and releasing the PF. I may add some YTU techniques to other modalities I already use.

Dominique Pelletier

Pas tjr évidemment de bien ressentir notre plancher pelvien. Nous l’avons masser avec Todd, et le soir même j’ai remarqué une bonne différence. Je vais continuer certainement cet technique avec les balles et le ballon coregous

Maureen

I’ve been hearing more and more about the importance of the PF area. Working in an office environment, I wear heels almost daily. It’s hard to give up; however, I’ve been slowly decreasing the the days when I do wear them. Hopefully, I’ll be able to kick the habit for good.

Geraldine

Tout est relié en nous ( et même au delà de nous..), ceci dit pour en revenir au plancher pelvien, il n’est pas toujours évident de ressentir ses connections de par son côté très interne et très intime. D’avoir une Etude faite rappelant le travail connexe comme la série YTU sur les hanches ou sur les jambes ainsi que le relâchement des adducteurs est un réel plus auquel on ne pense pas nécessairement de prime abord. Merci pour votre travail

Desiree N.

The pelvic floor isn’t talked about much, this was some great information on the importance of strengthening this area in our bodies. I wouldn’t have thought my heels would affect that area of my body!

Ariane Fournier

J’ai découvert le rôle qu’avait le plancher pelvien lors de la formation YTU niveau 1. Ça m’a beaucoup surpris à quel point celui-ci a une influence sur beaucoup d’autres parties de notre corps. J’essaie de porter une attention particulière sur ma posture pour qu’il soit bien positionner et que mon corps en ressente les bienfaits! 🙂

Leiloni Shine

This was a very helpful, concise article, I didn’t realize that 50% of the emphasis should also be placed on training your pelvic floor to release, I assumed the pelvic floor released was a more natural state for most people.

Évelyne Paquin

Je n’avais pas réalisé avant aujourd’hui à quel point le plancher pelvien peut avoir une connexion avec la qualité de notre respiration. Sachant ça, on ne peut s’empêcher d’être plus à l’écoute de notre corps pour augmenter la qualité de notre vie au quotidien. Merci pour le partage !

Vickie Chartrand

Merci pour ces conseils. Je travaille présentement à repositionner ma posture de tout les jours afin que mon pelvis soit bien positionner. Un travail qui parait simple, mais qui ne l’ai pas pour autant!

Marie Streich

This was a good article Emilie because a lot of people don’t realize that pelvic floor dysfunction can be caused by the muscles being habitually too tight, and when they try to strengthen them it only makes it worse !!

Heidi

Thank you so much for adding tools/suggestions on to make positive changes in this area. I love to get new ideas to help in my practice and day-to-day-life!