The pelvic floor muscles may be the most important muscles you never target with an exercise. Like a trampoline that sits at the base of your pelvis, these muscles not only contribute to overall core strength, but they also keep several organs — including the bladder, bowels and, for some, the vagina and uterus — in place. making sure they work properly.
And yet, many people don’t even know that pelvic muscles exist, says Dr. Amy Park said – at least, until they stop working properly. “There is a general lack of awareness of the pelvic area,” Dr. Park said. “I educate women several times a day about the fact that we Near pelvic floor muscles.
That said, they may not be as visible as the triceps or quads, but they’re important for everything from basic bathroom functions to sexual health to sitting and standing — and they benefit from a well-rounded fitness program.
“The pelvic floor is as important to your daily life as your Achilles is to running, because we use it for everything,” said Liz Miracle, head of clinical quality and education at pelvic floor physical therapy provider Origin. Are.
Historically, talking about this area of the body, even with your doctor, has felt off-limits to many. Even the name of the pudendal nerve that passes through the pelvic floor comes from a Latin word meaning “to be ashamed.”
This indiscretion has led to years of unnecessary suffering, says Evelyn Hecht, a pelvic floor physical therapist in New York City who began practicing in the 1990s: Many conditions can be treated or avoided altogether. This could happen if women felt freer to discuss their symptoms, or if the public was better informed about the pelvic floor. Instead, millions live with pain or discomfort.
Approximately one in three American women suffer from a pelvic floor disorder, usually in the form of urinary incontinence, bowel incontinence, pelvic pain, pelvic organ prolapse, or some combination of the above. And it doesn’t only affect women who have given birth: Studies show that a significant percentage of women with pelvic floor disorders have never been pregnant.
When our pelvic floor is both strong and flexible, the muscles work together — or “co-contract” — with the core muscles to allow us to live our daily lives with ease and stay active as we age. said Ms. Hecht, who now runs PelvicSense, a digital pelvic health provider. The pelvic floor also helps with balance and mobility during sports and exercise. “If I’m playing pickleball and I want to reach for a shot,” she said, “my pelvic floor is going to co-contract and stabilize my trunk.”
Pelvic floor problems can be caused or worsened over time by anything that puts stress on the muscles, causing them to tear or weaken — including running, dancing, lifting heavy without proper form, Chronic constipation or even regular cough, pregnancy and childbirth are included. Injuries can also arise when muscles become too tight, which can be caused by regularly “holding it in” when you feel the urge to go to the bathroom, by overtraining the core, or by prolonged stress and anxiety. Even from (When stressed, many people reflexively contract these muscles.)
Recently, pelvic floor experts have reported an increase in disorders resulting from tight pelvic muscles—a trend they’ve dubbed “pandemic pelvises” because the most common cause appears to be stress combined with too much sitting.
But pelvic floor problems are not inevitable. Many pelvic issues can be prevented or minimized by regularly stretching and strengthening these muscles — and understanding how they function. Most of us could benefit from “a personal trainer for your pelvic floor,” says Dr. Lauren Streicher, medical director of Northwestern University’s Center for Sexual Medicine and Menopause.
Ms. Miracle — herself a physical therapist and personal trainer of sorts for the pelvis — recommends that all women with good pelvic health (who are not currently suffering from pelvic floor disorders or injuries) incorporate six basic exercises into their fitness routines. Do it. , aim to do them at least three times a week. Ms. Miracle said, workouts can be done at any time and place where you feel comfortable; The only equipment you need is a chair or surface on which you can sit straight with your feet flat on the ground. taking care of your pelvic floor Earlier There is a problem, he said, you can help remove the problems that come in the way.
Learning to move the diaphragm is key to engaging and conditioning your pelvic floor muscles.
Sit on a chair with your feet flat on the ground. place one hand on your stomach and one hand on your chest
Inhale and feel your belly expand, then exhale slowly through your mouth. (It may help to imagine a balloon in your belly: As you inhale, the balloon fills with air; as you exhale, the air is slowly released, as if your thumb were closing the opening.) Was covering and slowly letting it out.) Repeat 10 times. ,
pelvic floor stretching exercises
The next step in doing pelvic floor exercises is learning how to relax and lengthen the muscles so they are capable of a full range of motion. The ability to relax the pelvis is especially important for basic tasks like using the bathroom without straining (think: avoiding constipation) and having penetrative sex without pain.
Lie comfortably on your back with your knees bent and your feet flat on the floor.
Begin with diaphragmatic breathing, inhaling deeply and allowing the air to fill the bottom of your lungs. Feel your lower abdomen, lower back and pelvic floor slowly stretch — or lengthen — outward with your breath.
Exhale slowly through pursed lips, allowing your abdomen, back and pelvic floor to passively relax. Do not engage any muscles while exhaling; Completely relax your pelvic floor. Imagine the balloon above that when inhaled expands 360 degrees in all directions. One of those directions is between your legs and toward the perineum (the area between the vagina and anus). As the abdomen passively rises, the perineum will also passively move down and out. Repeat 10 times.
while past practice helps us relax 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 use the bathroom and also works to build endurance in the pelvic floor muscles, so they can hold our organs and take pressure off the abdomen. able to balance. All day.
Sit straight with your feet flat on the ground.
Inhale through your nose, relaxing your pelvic floor as your abdomen and rib cage expand.
As you exhale, squeeze and lift your pelvic floor muscles, holding the contraction for the duration of your exhalation. Aim to hold for 10 seconds. It may help to imagine squeezing the muscles that stop the flow of urine in the front and gas in the back — or it may help to imagine these muscles picking up a marble and placing it inside. Be sure to include muscles Inside your body, as opposed to just squeezing your thighs or buttocks together.
Relax completely for four to 10 seconds — or longer if you need to. release is just as important as contraction Only Contracting muscles without completely releasing them can make them overly tight and limit their range of motion. Complete 3 sets of 10 reps.
This exercise builds on Kegels by training them to contract the pelvic floor muscles. quickly – a skill that allows them to respond effectively to sudden, automatic bodily actions that create pressure inside the abdomen, such as coughing, sneezing or even laughing. (It can also help prevent incontinence, or “leaking,” in the face of this pressure.)
Sit straight with your feet flat on the ground.
Contract and release the muscles that stop the flow of urine repeatedly, aiming to squeeze at least 7 times in 10 seconds. Complete at least 30 squeeze-and-releases.
“The Knack” with the “Shh” sound
While quick jerks train the pelvic floor muscles to respond quickly to the type of sudden physical action that puts pressure on the abdomen (as discussed above), this exercise builds strength and endurance to withstand this pressure. helps to create.
Sit straight with your feet flat on the ground.
Inhale through your nose, relaxing your pelvic floor as your rib cage and abdomen expand.
As you begin to exhale, squeeze and lift your pelvic floor muscles, then make a loud, loud and audible “sh” sound through your mouth while maintaining the hold.
From there, exhale slowly through pursed lips, allowing your abdomen, back and pelvic floor to passively retract. Complete 3 sets of 10 reps.
This exercise targets your transverse abdominal muscles, which sit in the lower abdomen and support the core. These muscles work together with the pelvic floor muscles to help you do anything from sitting and standing to doing any exercise that requires balance or stability. Learning to actively engage these muscles is a skill most of us have never been taught.
Exhale and pull your belly button in towards your spine. This should activate your transverse abdominal muscles. Be sure to keep your back flat and immovable for the duration of the movement; Your stomach is the only thing that moves. (If you need a visualization, imagine that your belly is again full of air, like a balloon – now use your abdominal muscles to squeeze the air out of your balloon, pulling them tight to your spine.) Take.) Repeat 10 times.
Danielle Friedman is a journalist in New York City and author of “Let’s Get Physical: How Women Discovered Exercise and Reshaped the World.”
Produced by Deanna Donegan and Tiffany Graham.