Loving your Pelvic Floor Muscles (PFM): part 2

Exploring breath, touch and movement to engage with your PFM

I hope you enjoyed the first blog on what are you PFM and why they are important. In this second part I give you some ideas of different ways in which you can get to know them better and take care of them.

Who can do these exercises and at what phase in their life?

Hopefully you now understand why they are so important for everyone. I feel it’s important to care for them, like any part of our body and not wait until there is a problem. It is helpful to encourage  pubescent boys and girls to get know this part of their body so they can take care of it and express their sexuality in a loving way. If we include our PFM from an early age, we can feel our PFM changing as our body does. Like any part of our body, it is as we age that they may get weaker, but they can still be strong enough if you care for them. For women, pregnancy offers the first challenges with the increased weight they have to bear and the softening of the tissue. During a vaginal birth they need to stretch to go around a baby’s head, so they will need caring for afterwards. Like our abdominal muscles, which have also stretched, they need to regain their tone. After any kind of birth, it’s important to start with the easiest exercises and gradually build up. With each pregnancy and birth, we will need to care for them more. The menopause offers more challenges with changes in tissue, and perhaps additional weight, and they may need more attention. For men, if they are overweight they will be challenged and if they have prostate surgery, this can affect the PFM. For any of us, as we age, underlying weakness, if uncorrected tend to get worse.

Watch my video on these different exercises.

The most well-known exercises are “Kegels”. These were developed by Professor Kegel, a professor of obstetrics and gynaecology at the University of California in Los Angeles. He realised that a great deal of female surgery on the pelvic floor was unnecessary and could be corrected through exercise. In recent years, they have been given a bit of a bad press, because some therapists find women are presenting with overly tight PFM. This is because people are doing them incorrectly and not focusing enough on the relaxation phase!

Hypopressive exercises are another method which build on Kegels. I was introduced to these by Wellmother teacher and practitioner Justine Sipprell.

Justine Sipprell Core Pelvic Floor

They are a little more complex, and involve breathing out and then holding the breath while lifting diaphragm in specific postures. Justine also teaches another method, Eldoa.

Before trying to do any specific exercises, it’s important to know your pelvic floor.

Remember the connection with the breath I explored in the last blog. As you breathe out, try to contract your pelvic floor without tightening your inner thighs or buttocks.. As you breathe in try relax your pelvic floor. If you can feel your tail bone moving slightly you know you are doing this.

Explore the openings (your orifices) –anus, urethra (bladder), vagina or penis

To get more a sense of what it feels like when our PFM are contracted or relaxed we can explore the organs which open to the outside – our clitoris, urethra, vagina or penis and anus. Feel the contraction on your out breath and the relaxation on your in breath. Notice which feels stronger. It is important to be able to contract as well as relax to engage their strength and their flexibility.

For the urethra, one way is to stop and start your urine flow after you have half emptied your bladder. Don’t do this other than to get a sense of what the muscles feel like, because stopping urine may push it back into the bladder and cause problems. For the anus, put a finger inside and try contracting and relaxing around it. Women can put a finger inside their vagina and contract and relax around it, and men try contracting and see the base of their penis drawing in and their scrotum lifting and relaxing and seeing the relaxation of the penis and scrotum. You will feel different sensations as you focus on contracting and releasing these different areas because you are engaging different parts of your PFM.

You can use a vegetable oil like coconut to massage your perineum, feeling areas which feel tighter or more lax. Massage especially around your central tendon.

Exploring with a jade (yoni) egg – for women

A jade egg is the ancient equivalent of modern weights which are used to strengthen your PFM. Some people find this helpful but if you are muscles are very weak, you may not be able to hold it in. Don’t try this if you have prolapse in your vagina, it is too strong and will be painful.

Use it as another way of connecting deeply with yourself and your sexual nature. Lying down, massage your vulva with the broader end of the egg; moving it along your labia (vaginal lips) and over your clitoris. This warms your egg and prepares her to go into your body. You may become aroused.

If you want to try inserting the egg, do it slowly and don’t push it in. It’s more of a gentle easing. Place the broader end  of the egg at the entrance of your vagina and see if you can squeeze it inside. Be sensitive to the feelings and sensations which may arise. Give yourself time. When your body has had enough it may release the egg, although if your muscles are strong or tight, you may need to gently scoop it out. The best position to release it is to squat if that is comfortable.  

Start by putting it in for a few minutes and build up to longer. Try sleeping with it in. If your muscles are strong, you can keep it in while doing PFM exercises. Explore what feels right to you.

Exploring PFM exercises

It is essential to listen to your body and not force any of the movements or positions.

How often should I do them?

Even if you are used to working your PFM don’t do too many repetitions in one go. The muscles tire easily and if you do too many they may go into spasm. Spread them out during the day doing a few minutes at a time for at least 4 or more sets a day. Have a break of at least 10 minutes between doing sets.

What position is best to be in?

The PFM engage and release slightly differently according to the position you are in. Explore different positions. Some will help you feel the PFM more. If you haven’t done PFM exercises before, or you have very weak muscles, especially if you have a prolapse, or after giving birth,  start with the more gentle positions which reduce pressure on the PFM. These are lying on your back or an inverted position, like resting on the floor and resting your legs up against a wall or a sofa. Another position is being on all fours and then resting your head and arms on the floor. In late pregnancy you will probably not want to be lying on your back, but instead all fours or side lying can be good positions to work them. However, if your muscles are strong you may still be able to do them even in the stronger positions such as the squat.

The PFM work most when you are squatting, either full squat or standing squat, because there is more pressure on them., In between are positions like lying on your back, your side, or sitting.

In each position, explore different movements with your pelvis. Explore how they affect the curve in your lower back, if one hip is higher than the other, the engagement of your abdominal muscles and what is happening in your inner thighs.,

If you have a movement practice try integrating the specific pelvic floor exercises within this. On my video I give some ideas.

A note on hypermobility and pelvic girdle instability

The position which works for you, will also be determined by whether you have issues with the major joints of your pelvis. At the front is the symphysis pubis, at the back, on each side, the sacroiliac joints. It is more likely to be an issue in the maternity period. I have a blog

https://www.wellmother.uk/pelvic-girdle-instability/

 and video on which movements are likely to be helpful if you are experiencing this.

PFM exercises

Holding and releasing – slowly and quickly

Breathing out, tighten your PFM and then hold them tight for as long as feels comfortable before breathing in and relaxing them. This works the slow twitch fibres of the muscles. Don’t hold for longer than 10 seconds and don’t repeat more than 10 times.

Focus some more around your vagina/penis, some around your anus and some focusing on both at the same time. Try to extend your awareness behind your anus to exercise the part of muscle attached to your tail bone.

After resting try some faster pulsing movements. These work the fast twitch fibres. On a slow out breath, tighten and then partly release. Repeat as many times as you can comfortably. On your in breath slowly release as much as you can. Repeat up to 3 times focusing around your vagina/penis, 2/3 around your anus and 2 to 3 with both.

You could do this pulsing using “bellows breath” (Kapalabhati) unless you are heavily pregnant. Breathe in deeply. Breathe out quickly and sharply through your nose drawing in your abdominal muscles and drawing up your pelvic floor muscles as you do. Do this for at least 20 out breaths, but more if you can. Don’t focus on the in breath, just let it happen.

Once you are comfortable with drawing up and releasing you can engage your pelvic floor muscles whenever you think about them, and in any position. For example, every time you boil a kettle or are at a red traffic light. 

Drawing up higher – the lift  

Try drawing up higher inside and controlling the release to work with endurance. Focus either around your vagina/penis or anus or both and gradually tighten your muscles on a long slow out-breath. Imagine they are being tightened in levels like going up one floor at a time in a lift. See how many levels you can go up before you get to the top. Can reach the fifth floor or more? Do you feel the top of your pubic bone and your lower abdomen drawing in ? Keep holding the muscles drawn up as much as possible till the end of your outbreath. If you can hold your breath out for a few seconds do. Then as you breathe in, gradually release back down through the floors to the ground floor. To make sure the muscles are fully relaxed see if you can go down further to the basement. .

Only do this once or twice as it is quite strong.

The energetic layer – Brain and Extraordinary Vessels connection

This continues from the lift. Place your tongue on the roof of your mouth and lift your PFM to the highest floor. Then bring your attention up to your tongue and see if you can feel a connection. This activates the inner pathways of the Vessels. Hold drawn up as long as you can. If you can, hold your out breath out for a few seconds. On the in breath gradually release to down to the basement. 

You can also focus on the energetic connection between your brain and pelvic floor while doing bellows breath (Kapalabhati) with alternate nostril breathing. Put your thumb over your right nostril and your index and middle finger over your third eye. Breathe in through your left nostril with your right closed and sharply out through the right quickly releasing your thumb. Repeat for about a minute or so moving your thumb and ring finger quickly. Then switch sides,  breathing in through your left nostril with your right closed. Breathe normally for at least a minute to end. 

Explore the different PFM exercises in different positions

I hope these exercises will help you feel more connected to your pelvic floor and have ideas of how to include them in your daily activities. Whenever you stand up, sit down, carry something, try thinking about your pelvic floor and either focus on engaging or releasing or both!

I hope you enjoy exploring your PFM and I look forward to hearing how you get on.