Your pelvic floor muscles are vital for bladder, bowel, and sexual function as well as supporting your womb and the growing fetus inside it during pregnancy. When our pelvic floor muscles are weak or overworked, we experience symptoms like incontinence, straining during bowel movements, lower back pain, and more. Pregnancy and childbirth can put additional strain on these muscles, but we’re here to help. 

Weak vs. Overworked Pelvic Floor

Weak pelvic floor muscles are muscles that have not been strengthened and can lead to vaginal prolapse if left untreated. Think of someone with weak arm strength and asking them to hold a heavy bag. They would struggle to hold the bag and likely drop it. When you have a weak pelvic floor, you may have a hard time pushing out a bowel movement or holding in your urine because those muscles just don’t have the strength to push or hold.

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Overworked pelvic floor muscles aren’t necessarily strong but can be very weak due to being under constant straining. This can lead to bladder leakage when sneezing, coughing, laughing, or jumping because the muscles have been contracting so much that when a big force applying pressure on the pelvic floor happens, they cannot sustain the contraction anymore and the muscles release. 

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Think of an overworked pelvic floor as trying to hold a gallon of milk for a long period of time then think what would happen if you were to jump while holding it. You would likely drop the milk due to too much strain on your muscles with no rest period. Women with overworked pelvic floor muscles may also find that they have pain during intercourse and have a difficult time taking in deep breaths.

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So how do you know whether your muscles are underactive or overactive? If you have the time, access, and can afford to see a pelvic floor physical therapist, you should! If that is not an option for you, you can do a little bit of research into your own body to find out. What happens when you try to do a kegel? Do you feel little to no change, or do you find it hard to hold the kegel for a few seconds? If you have an overactive pelvic floor, you may not feel a change when you attempt a kegel because your muscles are already contracting. Underactive pelvic floor muscles may quiver when attempting a kegel or the contraction may release after only a couple seconds. 

To Kegel or Not to Kegel?

Most everyone knows what a kegel is, and many know how to do them, but did you know that not everyone needs to? Kegels are great for women with weak pelvic floor muscles, but if your pelvic floor muscles are overworked, this exercise can do more harm than good. 

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To do a kegel, pretend like you are trying to stop the flow of urine and contract the muscles. Hold this contraction for 4-5 seconds then release with an exhale, making sure to release the tension all the way. Your relaxation time should be at least as long as the contraction. Repeat this exercise nine more times for a total of 10 contractions. While doing kegels, make sure that you are only engaging your pelvic floor and not lifting your pelvis while doing so. 

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As your muscles become stronger, you can gradually increase the time spent contracting to 10 seconds and increase your reps. If you want to switch up the exercise, you can try doing quick flicks of the pelvic floor muscles.

Core Exercises

Our core is closely connected to our pelvic floor so when we are doing core exercises, we are strengthening and lengthening our core and pelvic floor together. If you have an overactive pelvic floor, you’ll want to prioritize releasing tension during your workouts before trying to strengthen it. Yoga is a great way to accomplish this because it is low-impact and you can use diaphragmatic breathing along with the poses. We’ll discuss diaphragmatic breathing more in depth in the next section of this blog post. 

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When you’re doing core exercises, be sure to really engage your core, otherwise you won’t be working those muscles properly. Now let’s take a look at some of the exercises you can do to strengthen your core and pelvic floor.

Glute Bridges  

Lie flat on your back with your knees drawn up so that your feet are flat on the floor. If there is a big gap between your lower back and the floor, adjust your spine so that it is as flat to the floor as possible. Bring your pelvis up so that your body draws a straight line from your knees to your shoulders. Squeeze your glutes and hold this position for a couple seconds before bringing your butt back down to the ground. Repeat for a total of 5-10 reps, depending on your fitness level. When this exercise becomes easier and you want more of a challenge, you can add weights or bring one leg up then repeat with the other leg. 

Pelvic Tilts

Starting from the same position as the glute bridges, take a deep breath in through your nose, exhale, and rock your hips toward your head but do not lift your pelvis off the floor. Hold for a couple seconds, inhale, and return to a neutral spine position. Repeat for 5-10 reps. This movement doesn’t look like you’re doing much, but you are strengthening your lower back muscles, pelvic floor, and your core. You can also do pelvic tilts while sitting on an exercise ball and rocking your pelvis back and forth. 

Bird Dog

Begin this exercise by getting on your hands and knees with your hands directly under your shoulders and knees just under your hips. Direct your gaze between your hands and keep a neutral spine. Exhale, engage your core, and extend one leg back while bringing the arm on the opposite side of your body forward. So, if you bring your left leg back, your right arm will go forward. If your hips have rotated, fix them to be level with the floor, hold for a moment then bring your leg and arm back to the starting position and alternate your arms and legs. Do not rush this movement, take it slow so you don’t lose control and focus on the form. Repeat for 10 reps on each side.

Goblet Squats

You’ll want to have some weight with this exercise, but if you don’t have weights, grab a gallon of milk or a backpack and fill it to add some weight to it. Standing with your feet slightly wider apart than your hips and toes turned out, grab your weight with both hands, engage your core, and push your hips out, bending your knees into a deep squat. Keep a neutral spine and your chest forward for best results. Hold the position and squeeze your glutes to return to standing. Repeat 5-10 times. Once you have the proper form down and you're ready to make it more challenging you can increase your weight. 

Learn to Relax the Pelvic Floor

Women with an overworked pelvic floor should learn how to release their muscles. One thing you can do to help relax those muscles is diaphragmatic breathing. To do this, place one hand on your chest and the other hand on your belly then take in a deep breath, breathing into your belly rather than your chest and exhale through your mouth. If it helps, you can make a “Shh,” sound as you exhale to activate your abdominal muscles. This allows the breathing muscles to work in tandem with the pelvic floor muscles and gives them a chance to rest. 

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If you’re having a hard time finding and releasing all of the tension in your pelvic floor, you can try using a pelvic wand. Pelvic wands can help you release the tension that is deeper into the muscle and harder to reach. 

Takeaway

Try to determine whether you have underactive, just right, or overactive pelvic floor muscles. If you have underactive pelvic floor muscles then kegels and core exercises will help strengthen them. For women with overactive muscles, prioritize relaxing your pelvic floor muscles and deep breathing. 

To learn more about pelvic floor health, contact our midwives today!