5 Ways to Relax Your Pelvic Floor!

In Pelvic Floor Physical Therapy by pelv_admin6 Comments

By PHRC Admin

Do you ever wonder why it is important to relax your pelvic floor? Even if you know you should, do you find yourself wondering how to do so?

 

As a pelvic floor physical therapist, I often have patients who wonder what the value is in being able to relax the pelvic floor. In a culture that places most value on exercises that strengthen, it is important to understand why and how relaxation is just as important.

 

If you are someone who is just interested in building strength, I will speak to that first. In order to have muscles that can generate a good amount of power, it is also important that those muscles have what is called a good “length-tension” relationship. This term means that when muscles sit in too short of a resting state, they are not able to produce effective power. In other words, a tight muscle is not a strong muscle. If your pelvic floor is tight throughout the day and you never allow it to relax, you will not be able to build strength.

 

If you are someone who is in pain, relaxation is key to your recovery. When muscles are tight and shortened, it decreases the ability for blood and oxygen to get to those areas. This makes both the muscles and nerves in that area unhappy and painful. Another aspect of the body that is affected with tight muscles is the fascia. You can read more about fascia and its role in pelvic pain here. When fascia is tight, it also decreases blood flow and oxygen, contributing to pain. In order to help your pelvic floor muscles be happy and healthy, you need to be able to relax and release.

 

Now that I have hopefully convinced you that relaxing your pelvic floor is important, the big question is how! Here are five ways you can get started on your journey to relaxation:

 

  • Diaphragmatic Breathing

 

The importance of breathing and its relationship to the pelvic floor cannot be stated enough. Unlike other muscles in the body, the pelvic floor muscles are directly influenced and impacted by how we breathe. You breathe approximately 20,000 times a day, so it’s a good investment to make sure you are doing it right!

 

With diaphragmatic breathing, the goal is to expand the diaphragm by breathing into the rib cage and belly. Try walking through these steps:

 

  1. Lay on your back with your knees bent so your low back can rest in a neutral position.
  2. Place your hands on your rib cage and try to expand the ribs into your hands as you breathe in through your nose.
  3. Breathe out through your nose slowly, making the exhale longer than in the inhale while letting the rib cage and belly softly fall. Repeat 10 times. 

 

This breath is powerful for two reasons. The first is that your diaphragm and pelvic floor like to copy each other. If you are able to successfully expand and drop the diaphragm as you inhale, your pelvic floor will also expand and drop. You may not feel much during this exercise, but if you can visualize the muscles expanding without feelings of tightening or contracting, you are at a good place. 

 

The second reason this breath is powerful is because it helps to regulate your nervous system. You can learn more about the importance of this with muscle pain and tightness here. 

 

  1. Child’s Pose

 

Many yoga-inspired poses can help with relaxation of the pelvic floor. One great pose for this is child’s pose:

 

  1. Start on hands and knees and bring your feet together while widening your knees.
  2. Slowly send your hips down to your heels- if they do not touch, place a bolster or pillows underneath to support your hips.
  3. Walk your arms out long and lower your head onto the floor- place a pillow under your head if you do not make contact with the floor.
  4. Breathe into the back of your ribcage (diaphragmatic breathing) and imagine your sitz bones (boney ends of the pelvis) separating gently on every inhale. 
  5. Hold for a minimum of 30 seconds while continuously performing diaphragmatic breathing. Repeat 1-2x a day.

 

During child’s pose, you have a great opportunity to play with visualization of the pelvic floor. As you imagine the sitz bones separating on every inhale, you may begin to develop a sensation of the anus bulging or expanding. This can be a signal that your pelvic floor muscles are relaxing. If you do not feel this right away, try not to get frustrated. Just like any other exercise, this work takes practice and patience.

 

  1. Happy Baby

 

Another great pose for stretching and releasing the pelvic floor, happy baby can feel nice if child’s pose does not feel accessible to you at this time. 

 

  1. Start on your back and draw your knees into your chest.
  2. Reach along the inner thighs with your arms to grab each ankle or inner arch of your foot, whichever is accessible for your body.
  3. Open your feet to the sky while continuing to bend your knees and drive them into your armpits.
  4. Breath into your rib cage and belly while imagining the pelvic floor expanding and releasing.
  5. Hold for at least 30 seconds. Repeat 1-2x a day.

If happy baby does not feel relaxing, play with propping yourself to provide support. This could mean putting a bolster underneath your hips, or even placing your feet on a wall or couch/chair so you do not have to feel like you are straining to keep your legs up. As with any exercise, if this does not feel good on your body, do not force yourself to stay in this pose.

 

  1. Yogi Squat

 

If you would like a pose that you can just drop into in the middle of the day without having to fully get on the ground, yogi squat may be for you. This pose requires more hip, knee, and ankle mobility so it is not appropriate for everyone. If you have discomfort, please modify or try the other poses in this list.

 

  1. Start standing with your feet a little wider than hip distance apart and the feet turned out about 45 degrees.
  2. Slowly bend your knees until you can sit all the way down while keeping your heels down. If your heels cannot stay down, try placing a pillow or half-cut foam roller underneath your heels for support.
  3. Once you are down, bring your hands together at your chest and use your elbows to gently push the thighs wide, feeling a stretch at the inner thighs.
  4. Breath into your rib cage and belly, and visualize the pelvic floor dropping and expanding with every inhale.
  5. You may do this against a wall to support your back, or even sit on a bolster or yoga block to let your body release into the pose without tensing.
  6. Hold for at least 30 seconds. Repeat 1-2x a day.

 

Yogi squat is excellent for overall mobility of the lower extremity joints as well as the back and the pelvic floor. If this pose is available to you, dropping into it a few times through the work day can help keep tightness from building up throughout the day. 

 

  1. Sphinx Pose

 

One area that is important to release when dealing with pelvic floor tightness is the abdominals. The abdomen is directly linked with the pelvic floor and often when one area is tight it influences the other. Trying a gentle abdomen stretch with spinal extension, such as sphinx pose, can be beneficial in finding full release.

 

  1. Lay on your stomach with your elbows bent right underneath your shoulders. 
  2. Feel a gentle lift in the chest with the collarbone wide while keeping your hips grounded to the earth.
  3. Feel the soft stretch at the abdomen and notice if you are gripping your butt muscles.
  4. If there is any tension, wiggle your hips or your torso to shake it off.
  5. Return to your diaphragmatic breathing and notice any sensations of dropping or release the pelvic floor.
  6. Hold for at least 30 seconds and repeat 1-2x a day.

 

Pay attention to how your spine feels in the posture. Some people may not tolerate extension at the spine in which case the recommendation is to skip this pose. If you feel your gluteal muscles tightening and you are unable to get them to relax, just try squeezing and releasing those muscles for a few rounds before connecting it to the pelvic floor.

 

As with any generalized exercise program, some of these exercises may not be appropriate for every individual. We all have unique bodies with their own stories. It is important you listen to your body’s boundaries and respect limitations rather than try to push through them. This is deep, mindful work that requires truly connecting and engaging with your body’s intuition of what feels right.

 

If you are a visual and kinesthetic learner, I have also created a video that goes over each of the exercises so you can follow along! If you are still interested in learning more about what is right for your individual body and want more feedback, please consider booking a virtual appointment with me. I am now offering one-on-one movement sessions to help you create a movement program that is right for you. These sessions can also serve as a guide to help you return to movement classes you might be interested in, such as yoga or pilates.

Lastly, if you are still unsure what you are doing is correct or are not experiencing any form of relief, please consider booking an appointment with one of our therapists at these locations. Nothing can replace the physical exam a professional pelvic floor therapist can perform to provide more answers and solutions for your pain. You are not alone and we are here to help.

 

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Are you unable to come see us in person? We offer virtual physical therapy appointments too!

Due to COVID-19, we understand people may prefer to utilize our services from their homes. We also understand that many people do not have access to pelvic floor physical therapy and we are here to help! The Pelvic Health and Rehabilitation Center is a multi-city company of highly trained and specialized pelvic floor physical therapists committed to helping people optimize their pelvic health and eliminate pelvic pain and dysfunction. We are here for you and ready to help, whether it is in-person or online. 

Virtual sessions are available with PHRC pelvic floor physical therapists via our video platform, Zoom, or via phone. For more information and to schedule, please visit our digital healthcare page.

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page. 

PHRC is also offering individualized movement sessions, hosted by Karah Charette, DPT. Karah is a pelvic floor physical therapist at the Berkeley and San Francisco locations. She is certified in classical mat and reformer Pilates, as well as a registered 200 hour Ashtanga Vinyasa yoga teacher. There are 30 min and 60 min sessions options where you can: (1) Consult on what type of Pilates or yoga class would be appropriate to participate in (2) Review ways to modify poses to fit your individual needs and (3) Create a synthesis of your home exercise program into a movement flow. To schedule a 1-on-1 appointment call us at (510) 922-9836

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FAQ

What are pelvic floor muscles?

The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.

What is pelvic floor physical therapy?

Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.

What happens at pelvic floor therapy?

During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.

What is pudendal neuralgia and how is it treated?

Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.

Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.

What is interstitial cystitis and how is it treated?

Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.

Who is the Pelvic Health and Rehabilitation Team?

The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.

How many years of experience do we have?

Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.

Why PHRC versus anyone else?

PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.

Do we treat men for pelvic floor therapy?

The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.

Do I need pelvic floor therapy forever?

The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.

Comments

  1. Reply

    Great overview of pelvic floor stretches–thanks! Now I just need to balance these stretches and my flare ups and my daily activities–no easy task!

    1. Reply

      Hi John,
      Consistency can be hard when we lead busy lives. We hope these poses have been helpful to you & you find it easier to do as you incorporate these stretches more into your daily life.

    1. Reply

      Hi Linda,
      They should be fine to do, we just encourage you to modify as necessary! A pillow or blanket underneath you for support and cushion can help you in these positions that are lower to the floor. If any pose causes discomfort or is out of your range, modify or stop all together until you can work up to it!

  3. Reply

    Hi,
    The article mentions that there is a video to watch to follow the above exercises, please could you advise me where to find this. I’ve looked on your you tube channel but can’t find it.
    Thank you,
    Lorraine.

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