How to strengthen your pelvic floor for new mums

how to strengthen your pelvic floor, pilates in epping, post natal pilates and fitness in epping essex

How to strengthen your pelvic floor. As a Pilates instructor and women’s health writer it’s an area of the female body and of post natal training that I’ve had more than a passing interest in for the past nine years. 

Every week I get ladies in my classes who have received conflicting information from medical or fitness professionals, who have attempted a version of a Buggy Bootcamp which broke their bits, who have signed up for a half marathon but can’t run or have pelvic floor or back related issues when they run, who have minor prolapses, or who have no idea if their symptoms are ‘normal’. It’s a regular thing, not a 1 in a 100 thing. And always they ask: ‘Karen, how can I strengthen my pelvic floor?’

Breaking down the stigma

It’s also a bit of a taboo subject (until you’ve had a baby and then everyone talks about it) – admitting that you’re having a few issues down below can be a challenge. Even if you make it to your GP, it’s quite possible you’ll be sent home with advice to do your pelvic floor exercises, or continue with life as normal and come back if it hasn’t improved. 

How to get the right advice

The pelvic floor is also an area that brings with it some unconventional training methods, some traditional yet mediocre training methods and – sadly – because pelvic floor dysfunction can be debilitating – some crackpot training methods that appear to solve your desperation to fix your body.

Even amongst the world of fitness and Pilates instructors trying to do their bit to help the female human body there is dissent (yup), or spats over who ‘owns’ the women’s health space (yup – ridiculous but true). There are fitness instructors over stepping the mark when really they should be referring on to a physiotherapist, there are fitness instructors giving bad advice because they don’t know and then there’s a massive lack of women’s health physiotherapists on the NHS. Even in private practice, there sometimes aren’t enough women’s health physiotherapists to cope with demand or match the requirements of gynaecologist and obstetricians. It’s all a bit of a mess.

For the past 15+ years I’ve worked as a fitness and a Pilates instructor and I’ve written about women’s health and fitness. From fertility to fat and everything in between, including the pelvic floor. Since 2010, when I gave birth to my baby boy, I’ve had a particular interest in the pelvic floor. Both from personal experience and from listening to women asking for help that they weren’t getting. So I got curious and started doing my best to work out how to help. I’ve been doing this ever since.

I continue to do my best to wade through the noise and get the right help to the right people, or at least help them to get the help they need.

I am not a pelvic floor FIXER, I am an ASSISTER and a Pilates instructor. 

Pelvic floor theories

So here are some of the theories out there about how to train your pelvic floor effectively:

  • Just do kegels. 
  • Don’t do kegels. 
  • If you’ve had a prolapse you won’t be able to do a kegel.
  • Just breathing is sufficient. 
  • You need to learn to breathe properly or your pelvic floor won’t work.
  • If you hold your breath you’ll create too much intra-abdominal pressure.
  • If your pelvic floor is dysfunctional, breathing alone won’t help. 
  • Some pelvic floors are hyper-tonic (work too hard).
  • Few pelvic floors are too strong.
  • It’s normal to leak when you sneeze after you’ve had a baby.
  • You can only effectively train your pelvic floor by imagining you’re stopping a fart (flatus).
  • Imagine you’re drawing your pelvic floor in and up.
  • Imagine you’re picking up a tissue in your vagina.
  • Ignore your vagina and focus on your perineum and anus. 
  • Learn to squat.
  • Don’t lift heavy weights.
  • Stress the pelvic floor by jumping and running.
  • Don’t stress the pelvic floor by jumping and running.
  • Don’t run. 
  • Do run.
  • Learn to stand properly and your pelvic floor will work better.
  • Do your pelvic floor exercises as part of your regular workout.
  • Buy toning balls.
  • Buy vibrating vaginal toning balls.

Here’s the thing – there is a truth in most if not all of the above advice (not sure about those balls but they might be fun) but some advice works better in some cases than others. It depends on what the problem is and what your starting point is.

How to strengthen your pelvic floor

Here’s my opinion (for what it’s worth) that if you don’t have a specific pelvic floor problem (or don’t know), then a combination of approaches is a good approach. Breath. Leg strengthening. Finding a specific post natal Pilates class, post natal fitness class or personal programme to do at home. Adding some specific, localised muscle activations. Getting more active and gradually adding stress to the pelvic floor in a way that is controlled (rather than causing you further discomfort). 

Get stronger

And I have yet to meet a women with a pelvic floor issue that hasn’t shown some improvement by doing a very basic leg strength and conditioning programme. I’m talking three sessions over six weeks with some homework in between.  

Book in with a women’s health physiotherapist

If it’s a more specific problem, book a Mummy MOT with a women’s health physiotherapist. They may well refer you to a gynaecologist (not always private) or other specialist. But knowing is half the battle. It could be a problem with stitches that can easily be rectified. It could be a specific set of exercises you need to practice at home in addition to a Pilates class. But get advice sooner rather than later.

Getting started with strengthening your pelvic floor

Here’s a basic sequence we do in class, both pre and post natal.

  1. Starting on all-fours focus first on breath. As you breathe in feel the ribs expand. As you exhale feel they come together. Imagine blowing away some dust on the floor in front of you. There’s a natural relationship between a functioning pelvic floor and your diaphragm so exhaling can create a natural ‘lift’.
  2. Add to breathing focus a squeeze. It helps if you have a cushion or soft ball between your thighs. On your out breath, slowly squeeze then ball. Getting your thighs involved in the work adds to the intensity of your pelvic floor activation and begins to teach patterns of movement.
  3. At this point you could add a lift. So whilst exhaling and squeezing feel you lift through the pelvic floor. I find the ‘picking a tissue up in your vagina’ the best visual cue but others may work better for you. Try to feel a sense of drawing in from all sides. It’s a sucking up and not just a lift.
  4. Finally, you could add a little hover, where you hover your knees off the floor. I also like to encourage my participants at this stage to feel their bottom rib floats up to the ceiling, this helps with abdominal activation.

Have a go and let me know if you have any questions. These methods are by no means exhaustive but a good start. Knowing why you’re doing something is often half the battle. 

For more information on post natal exercise and rehabilitation, sign up to our post natal list.

We have pre and post natal Pilates classes in Epping and post natal fitness classes. Babies welcome in all our post natal classes.

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