I have been asked several times about the process of building up pelvic floor endurance, so I’ve decided to focus on this question in this blog entry.
Perhaps one of the most frustrating things we experience as our bodies work to gain better control of our pelvic basket is the increased symptoms with simple activities such as a walk around the block or a trip to the grocery store. Our first instinct may be to restrict activity. However, the reality is that doing so will only serve to further our deconditioning and exacerbate muscle weakness, thereby leading to increased symptoms with even easier activities. So, probably not surprisingly, my advice it to get out there and move! And, to help you do that, I want to share some of my favorite exercises that I remember doing.
However, before getting into the actual exercises, I want to briefly discuss the importance of giving our pelvic floor time to recover. Just like our bodies have to recover after a hard workout (e.g., with activities such as stretching, icing, rest, compression garments, and/or cross training), we have to be aware of what will help our pelvic floor recover following a long day on our feet or an exercise session that taxes our pelvic basket.
Some of us may have to give our pelvic floor opportunities to recoever several times a day, depending on our symptoms and how early we are in the process of regaining optimal pelvic floor control. For example, after my second and third deliveries, you could find me on the floor performing my multifidi extensions (described below) at least three times per day. I liked this exercise because it put me in a position of extension and, by lying down, it took gravity out of the equation. There was no pressure on the muscle fibers of my pelvic floor in this position and it allowed me to essentially re-set my pelvic floor support.
Some women note the same benefit from any exercise in the hands and knees position. Whatever your preferred position of recovery, it is important to recognize that your pelvic floor may need to re-set throughout your day. Get in a position that gives it some relief from the job of supporting your pelvic organs. This means that coming home from a long day on your feet and simply sitting on the couch with slouched posture is probably not your best option. Follow the instructions for my multifidi extensions as instructed below for a great approach to re-setting your pelvic floor.
Multifidi extensions (3 sets of 10 repetitions) – Position yourself on your stomach with your forehead on a towel roll to avoid having to turn your head to the side. In this position you will perform 10 contractions of your multifidi muscles (the very small muscles in between each segment of the spine that holds the natural curve or neutral spine). Simply rotate your pelvis, lifting our tail bone up toward the ceiling. The movement is very subtle so you shouldn’t see a big rotation of your pelvis. Remember to SLOW DOWN holding each lift for a count before relaxing and repeating.
I also wanted to include one of my favorite exercises that I often work into my daily strengthening routine that I feel has a similar benefit for me now that my pelvic floor is well past the early recovery phase. I call these standing hamstring extensions.
Standing Hamstring Extensions (3 sets of 10 repetitions) – To begin, stand with your feet approximately 6 inches apart with a slight bend in your knees. From this position, hinge at the hips tilting your upper body forward. Take care to keep the arch or “lordosis” in your lower back as you tilt your upper body forward. It may help to think of sticking your buns out. When you reach a point of hamstring tension, stop your forward lean and begin a set of 10 knee extensions, straightening your knees followed by small knee bends. Three sets of 10 repetitions will produce good passive tension in your pelvic floor as well as a good hamstring stretch.
I also want to refer you to Edgar Caycee’s site http://www.choosing-natural-health.com/hemorrhoids-cure.html which presents exercises aimed at controlling symptoms from hemorrhoids. I do like the exercise he demonstrates, reaching for the sky and then grabbing air as he bend from the waist and allows his arms to fall to the ground. It is due to my hamstring tightness that I altered this exercise and came up with my standing hamstring extensions as described above.
Good luck to everyone “re-setting” your pelvic floor!