Pelvic Floor Workout

Every Woman Can Benefit From This Pelvic Floor Workout

The pelvic floor muscles, shown here from the side, run from the pubic bone in the front to the tailbone in the back of the pelvis. They help to support the bladder, uterus and rectum (as shown here) and other organs, ensuring they work properly. Credit…Laura Edelbacher

The pelvic floor muscles may be the most important muscles you never target with a workout. Like a trampoline that sits at the base of your pelvis, these muscles not only contribute to overall core strength, they also hold multiple organs in place — including the bladder, bowel and, for some, the vagina and uterus — ensuring they work properly.

The pelvic floor is “just as important in your daily life as your Achilles is for running, because we use it for everything,” said Liz Miracle, the head of clinical quality and education at the pelvic floor physical therapy provider Origin.

Nearly one in three American women suffers from a pelvic floor disorder, most commonly in the form of urinary incontinence, bowel incontinence, pelvic pain, pelvic organ prolapse or some combination of the above.

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 to stay active as we age, said Ms. Hecht, who now runs the digital pelvic health provider PelvicSense. The pelvic floor helps with balance and mobility during sports and exercise, too. “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.”

Many pelvic issues can be prevented or mitigated by regularly stretching and strengthening these muscles — and understanding how they function.  Ms. Miracle, a physical therapist, recommends that all women in good pelvic health (those who aren’t currently suffering from a pelvic floor disorder or injury) incorporate six foundational exercises into their fitness routine, aiming to do them at least three times a week. The workout can be done any time and place you feel comfortable, said Ms. Miracle; the only equipment you need is a chair or surface on which to sit upright with your feet on the ground.

  • Sit in a chair with your feet flat on the ground. Place one hand on your belly and one hand on your chest

  • Inhale and feel your belly expand, then exhale slowly through your mouth. (It might help to imagine a balloon in your belly: As you inhale, the balloon fills with air; as you exhale, the air slowly releases, as if your thumb were covering the opening and gradually letting it seep out.) Repeat 10 times.

  • Pelvic floor lengthening exercise

  • Lie comfortably on your back with your knees bent and your feet flat on the ground.

  • Start with diaphragmatic breathing, inhaling deeply and allowing air to fill the bottom of your lungs. Feel your low belly, lower back and pelvic floor gently stretch — or lengthen — outward with your breath.

  • Exhale slowly through pursed lips, allowing your belly, back and pelvic floor to passively relax. Do not engage any muscles during the exhale,; keep your pelvic floor fully rested. Imagine the above balloon expanding 360 degrees in all directions on the inhale. One of those directions is downward between your legs and toward the perineum (the area between the vagina and anus). As the belly rises passively, the perineum will also balloon down and out passively. Repeat 10 times.

  • Seated Kegels

  • Sit upright with your feet flat on the ground.

  • Inhale through your nose, relaxing your pelvic floor as your belly and rib cage expand.

  • As you exhale, squeeze and lift your pelvic floor muscles, holding the contraction for the duration of your exhale. Aim to hold for 10 seconds. It may help to imagine squeezing the muscles that stop the flow of urine in the front and hold back gas in the back — or to imagine these muscles picking up a marble and holding it inside. Be sure to engage the muscles inside your body, as opposed to simply squeezing your thighs or buttocks together.

  • Fully relax for four to 10 seconds — or longer, if you need it. The release is as important as the contraction, since only contracting the muscles without fully releasing can make them overly tight and restrict their range of motion. Complete 3 sets of 10 reps.

Quick flicks

  • Sit upright with your feet flat on the ground.

  • Repeatedly contract and release the muscles that stop the flow of urine, aiming for a cadence of at least 7 squeezes over 10 seconds. Complete at least 30 squeeze-and-releases.

  • Sit upright with your feet flat on the ground.

  • Inhale through your nose, relaxing your pelvic floor as your rib cage and belly expand.

  • As you begin to exhale, squeeze and lift your pelvic floor muscles, then perform a quick, forceful and audible “shh” sound from your mouth while maintaining the hold.

  • From there, exhale fully slowly through pursed lips, allowing your belly, back and pelvic floor to passively recoil. Complete 3 sets of 10 reps.

Belly lifts

  • Start on your hands and knees, with your hands under shoulders and knees under hips. Focus your gaze between your hands.

  • Inhale, filling your belly with air and relaxing it toward the ground.

  • Exhale and pull your belly button in toward your spine. This should activate your transverse abdominal muscles. Be sure to keep your back flat and unmoving for the duration of the movement; your belly is the only thing that moves. (If you need a visual, imagine your belly is again full of air, like a balloon — now squeeze the air out of your balloon using your ab muscles, tightening them to your spine.) Repeat 10 times.

The author has done regular pelvic floor exercises and relied on them to stay active since becoming pregnant with her first child in 2018.   Published Feb. 17, 2023. Updated Feb. 22, 2023


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