By Courtney Edgecomb, DPT
Even before gyms and group fitness classes closed for COVID-19, I was a big fan of at-home workouts. Don’t get me wrong, I love the community, atmosphere, and variety of equipment available from gyms and classes, but the price can get high and I run like the wolves to avoid traffic or parking in Los Angeles. Some days it is easier for me to wake up in the morning, get my yoga mat and home equipment out, and start moving. I usually select a focus for my at-home workout: core, hips and legs, arms and back, full-body, or flexibility. I also choose the type of workout that matches my mood or energy: strength training, functional movement, cardio, yoga, or stretching. Lastly, I start with high or low intensity, and adjust as needed depending on how the workout flows.
Okay, so you have your workout categories picked out, but then what? It can feel intimidating to pick the series of exercises that match your ideal workout. Should you run through each exercise one-by-one, in a circuit, try a superset, use a timer or count your reps? What happens if you don’t have any equipment? Are you remembering to breathe this whole time? If you don’t have all of the answers, first of all it’s okay, and second take advantage of the millions of online workouts available these days. Confession: I use online videos weekly. And now, I am making one for you.
This 25 minute at-home circuit workout is developed specifically for many of those who are dealing with pelvic health issues: urinary incontinence, pelvic organ prolapse, diastasis recti, pelvic girdle pain, low back pain, sacroiliac joint dysfunction, prenatal and postpartum women, and those who know they struggle with core weakness. It is focused on core stabilization and pelvic floor activation, with functional movements in mind, to teach your body how to engage the diaphragm, transverse abdominis, multifidus, and pelvic floor muscles throughout daily activities. It is low-intensity, but will give your core and glutes a good burn when focusing on the techniques. You do not need any equipment for this workout, however, resistance bands or weights (or babies) may be incorporated. If you are looking for a higher-intensity or longer duration workout, this routine pairs well before a walk or run, before glute-focused strength-training, after a stretching session, or in combination with upper body and back exercises.
Most importantly, have fun and enjoy a movement break! Comment below if you have tried this workout or need help with some modifications. We love to see our PHRC community get active!
Disclaimer: I highly suggest you consult with a pelvic floor physical therapist to see if these exercises are fit for you, as it can exacerbate pelvic pain (or other symptoms) and pelvic floor muscles that are already too tight. However, I will go through some modifications and considerations that may apply. A couple considerations that I want to point out now:
- Diastasis recti: watch for any coning or doming in your abdomen while performing these exercises. If you see coning or doming, focus on coordinating abdominal engagement with your breath. You may need to use one of the modifications. If you continue to see coning or doming, it is best to seek advice for that particular exercise.
- Pelvic pain: If engaging the pelvic floor causes pain, focus only on abdominal engagement with the breath. You may need to use one of the modifications. If you continue to have pain, it is best to seek advice for that particular exercise.
Perform each exercise for 30 seconds. Additional stretches or activation exercises can be included.
Perform each exercise for 1 minute. Take a 10 second break between each exercise. Complete 3 sets of these exercises.
Exhale, pull your belly button to your spine (to engage transverse abdominis) and gently lift the pelvic floor. Continue exhaling as you squeeze your glutes and lift your hips up to form a straight line. Inhale as you lower down.
Modifications: Do not lift as high if you have lower back pain during the exercise. Perform single leg bridges for a progression. Place a weight (or your baby) over your hips for a progression. Use a resistance band around your knees to increase gluteal activation. Bring your heels closer to your buttocks to decrease hamstring engagement.
Sidelying Hip Abduction
(30 seconds per side, or 1 minute per side)
Exhale, pull your belly button to your spine and gently lift the pelvic floor. Continue exhaling as you lift your top leg up towards the ceiling, using your gluteus medius (where my hand is on the hip. Inhale down. Keep leg in line with your body and do not let hips rotate forward, this prevents the hip flexors from compensating.
Exhale, pull your belly button to your spine and gently lift the pelvic floor. Continue exhaling as you lower opposite arm and leg to the floor. Inhale back to starting position. Repeat on other side.
Modifications: Move only your arm or leg at once if the coordination is too difficult, or you cannot keep abdominals engaged. Start in a table top position for a progression. Hold a weight (or your baby) and only move your legs for a progression/modification.
Exhale, pull your belly button to your spine and gently lift the pelvic floor. Continue exhaling as you extend opposite arm and leg out. Inhale and return to starting position. Repeat on other side. Maintain a neutral spine, and do not let the hips rotate. Keep the shoulders engaged as if punching through the ground. Inhale back to starting position.
Modifications: Move only your arm or leg at once if the coordination is too difficult, or you cannot keep abdominals engaged. Place a broomstick across your back, and keep it there, to watch your form. You may use dumbbells or ankle weights for a progression.
Exhale, pull your belly button to your spine and gently lift the pelvic floor. Continue exhaling as you lean forward, squeeze your glutes, and stand up. Watch your knees stay over your middle toes. Keep a neutral spine or slight arch in your lower back. Inhale as you sit.
Modifications: Use a resistance band around your knees to increase gluteal activation and to keep your knees from moving inward as you stand. Perform a squat without a chair for a progression. You may also hold weights or your baby or household items (laundry detergent, gallon of milk, etc) for a progression.
(30 seconds per side, 1 minute per side, or 1 minute alternating)
Exhale, pull your belly button to your spine and gently lift the pelvic floor. Continue exhaling as you bring one knee out to the side (yes, like a dog going to the bathroom). Inhale and return to starting position. Maintain a neutral spine, and do not let the hips rotate. Keep the shoulders engaged as if punching through the ground. Inhale back to starting position. Repeat on other side.
Modifications: Place a broomstick across your back, and keep it there, to watch your form. To modify, lie on your back with your knees bent and feet flat on the floor, keep feet down and move one knee slowly out to the side with control. You may use a resistance band for a progression.
Perform each exercise for 1 minute. Additional stretches or foam rolling can be included.
If you are having trouble performing these exercises, are noticing increased symptoms, or are noticing an improvement and think you could benefit from additional exercises, reach out to your pelvic floor physical therapist today. At PHRC, we can discuss your situation, check your form, and teach you progressions or modifications at any of our clinic locations, as well as online via virtual appointments. If you are interested in a personalized home exercise program to fit your pelvic health needs, schedule with me today!