How NOT to do your Pelvic Floor Exercises
Over the years many women have become more aware of their pelvic floor muscles and of the need to do pelvic floor exercises to keep these muscles strong and working correctly. But also over the years there has been a lot of incorrect information on what is a pelvic floor exercise, and some women still are confused, or unsure if they are doing their exercises correctly.
To find out more on how to know your pelvic floor during pregnancy read our e-booklet
The Pregnancy and Postnatal Pelvic Floor Connection
Some of the ways NOT to do your exercises include:
• Stopping and starting your flow of urine every time you go to the toilet.
This used to be promoted as an exercise, but is not recommended. This is a good check to see that you can do it, and to feel the muscles working. If you are just learning how to do the exercises it can help you to contract the right muscles. Doing this as a check before your baby is born, and also sometime after can help you to make sure that this action of the muscle is working well. But it does not mean that your muscles are completely back to normal if you can do this, as the muscles work in other ways too (like holding on if you need to go to the toilet, supporting our pelvic organs and tightening when we cough, sneeze, laugh, run or jump).
• Tightening your muscles quickly and relaxing and doing 100's of these per day.
A quick contraction is OK to do as an exercise, but it is not the only way that the muscles should be worked. Some people mistakenly think that they are doing a great job of exercising their muscles this way, but it is important to also think quality, not quantity. The pelvic floor muscles should also be exercised by lifting and then holding them up inside, not just pulling them up quickly and relaxing them straight away. So it is important to do a combination of both quick contractions (and you don't have to do 100 per day - although you can if you want to), and slower holding contractions. To find out how to work out your hold time, use the booklet As Your Shape Changes. You can then also record your hold time, using the charts included in the booklet.
• Lying on the floor and lifting your pelvis and hips up and down, while flattening your back against the floor.
This exercise is called the pelvic tilting exercise, and does NOT exercise the pelvic floor muscles (unless of course you deliberately tighten your muscles at the same time, which can be quite tricky to do). In the past this exercise was mistakenly taken to be pelvic floor exercises. Some women still think that this is what pelvic floor exercises involve and that they need to get on the floor to do them. Pelvic floor exercises can be done in sitting, when lying down or in standing positions if you are able to do them well, but do not involve the moving of your pelvis at all, except for when you are trying to get yourself in the right position to start with. Your pelvic floor muscles will work better when your pelvis is in a ‘neutral’ position, that is, when the curve of your back is normal and not flattened or arched. When you exercise your pelvic floor muscles, your pelvis should not move, and your pelvic floor muscles, which are on the inside of your pelvis, lift up and tighten.
Pelvic tilting exercises are good for back mobility, but after you are 16 weeks pregnant it is not recommended that you continue to exercise while lying on your back. They can then be done in a hands and knees position as a back stretch (also called the cat curl). A pelvic tilt can also be a good exercise to help start your tummy muscles to work again after your baby has been born, in addition to your post natal abdominal bracing exercises. But again remember, it is NOT an exercise for your pelvic floor.
• Sitting to do the exercises and your body moves up and down.
If you are tightening your bottom muscles as well as or instead of your pelvic floor muscles, you will notice that your body moves quite a bit when you try to do the exercise, especially if you are sitting. This is incorrect, and does not work the pelvic floor muscles effectively. If you are tightening your bottom instead of your pelvic floor muscles, you will often feel more, but it means that your pelvic floor muscles are not working, so you won't get the desired results from doing the exercises this way. If you are tightening your bottom as well as your pelvic floor muscles, again you will probably feel like you are doing more, but all your extra effort is going into your bottom, not into improving or maintaining the strength of your pelvic floor muscles.
Focus more on the pelvic floor muscles on the inside, lifting them up inside, and try to keep your bottom relaxed as you do the exercise.
• Squeezing your legs together.
Although this may help in an emergency, if you do need to do this, it is a sign that your pelvic floor muscles are not working as well as they should. Again if you do this when you exercise, it is the same effect (or lack of effect) as if you are tightening your bottom muscles instead of, or as well as your pelvic floor muscles.
Often when the pelvic floor muscles are weak or getting tired, the leg and bottom muscles will work. If you cannot stop this from happening it is a good idea to seek some extra advice and a check from a Physiotherapist working in the area of women's health, or your Midwife.
• Holding your breath when you tighten your muscles.
Often when you are first learning how to do the exercises and you need to concentrate very hard, you will hold your breath. As you get better at doing the exercises, then you should learn to be able to tighten them, and to breathe at the same time. This may take several weeks or even a month or two to be able to master this.
• Tightening your tummy really hard.
Although it is OK for your lower abdominal muscles to tighten (the area below your belly button), you should not feel your whole abdominal wall tighten and pull in. If you feel the area under your rib cage really pulling in then you are probably trying too hard, or tightening your tummy instead of your pelvic floor muscles. Focus lower down in your vaginal area as you work to contract your pelvic floor muscles.
You will still read in some books, magazines and brochures that you shouldn't tighten your tummy muscles at all when you do your pelvic floor muscle exercises. The latest research by Physiotherapists in Australia shows that it is OK for the lower tummy muscles to work when you tighten your pelvic floor muscles, and in fact this should happen. It is normal that your pelvic floor and lower tummy muscles actually do work together. To start with this may not happen, but as you get better at both your pelvic floor and pregnancy or postnatal abdominal bracing exercises, this should get easier. Check in As Your Shape Changes, in the section called "Putting it all together", for further information on progressing to this, once you have mastered each exercise individually.
For more HOT tips and practices for your pelvic floor get our e-booklet The Pregnancy and Postnatal Pelvic Floor Connection.
You can also visit our Pregnancy Pelvic Floor Exercises section.
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Click here to download a free factsheet called "About pelvic floor muscles"