Get to know your pelvic floor muscles

Pelvic floor muscles exercise

The Pelvic Floor is a vital muscle in your body: it underpins your bowel, bladder and the uterus, and supports your back and spine. Refer to the picture which shows the muscles that stretch like a hammock from the front to the back of your pelvis. When these muscles are strong and healthy they give us complete control and support over our bodily functions and help contribute to satisfying sex. The muscles consist of two types: fast and slow twitch. You need to strengthen both fast and slow to support your core.

In the absence of exercise, simply getting older brings muscle deterioration. But childbirth, pushing on the loo, hysterectomy, menopause, lack of oestrogen and muscle tone, obesity, bad breathing habits, excessive coughing, poor posture, weak gluts, stress, and high impact exercise like running, jumping and weight lifting can also contribute to a weak and ineffective Pelvic Floor (stats show high reports of female fitpros with weakness).

Leaking urine is embarrassing, inconvenient and happens to one in three women due to a weak Pelvic Floor. First signs show when you cough, sneeze, laugh, run or exercise, or not reaching the loo in time. At its worst, it leads to a prolapse (suffered by millions of women). Weak Pelvic Floor can also contribute to bad posture, back and neck pain, and can take away our freedom and confidence to enjoy an active life.

Pelvic floor strength test / Isolating / Functional exercises

Pelvic Floor restoration and maintenance exercises are incorporated in many Pilates classes. You start by isolating the Pelvic Floor muscles and then incorporating your core – diaphragm, deep abdominals and deep back muscles. If these are dysfunctional you need to start with the basic exercises to learn to isolate the muscles. If you have no problems, just keep mobile and do the following three functional exercises. The functional and movement based exercises can be 70% more effective than just kegel /pelvic floor exercises (research by Dr. Bruce Crawford Pfilates Urogynecologist) because they incorporate the muscles that work to provide stability to the pelvis and PF, and maintain your posture and alignment: gluteus minimus, the hip adductors, and deep hip rotators. During our Pilates classes we advise you to breathe out on the exertion and when you start to engage the PF muscles. Ideally you’ll do these easy yet effective exercises for the rest of your life.


Get to know your pelvic floor (PF) muscles (checks and exercises)

POSITION – Neutral posture (check in the mirror) either seated (don’t cross legs as you can use your gluts/ buttock muscles) or lie down on your back, bend your knees and keep your feet flat then (if pregnant, lie on your side).

To test the strength:

  1. Stop your wee mid flow on the loo (only do this once or you’ll risk getting a bladder infection).
  2. Tighten the muscles around your vagina and back passage and lift inwards and upwards. Count how long you can hold for, then completely relax the muscles. Aim to hold for 10 secs. The Chartered Society of Physiotherapists recommends you practice this contraction just before you get out of a chair, cough, and sneeze or laugh to increase support and to retrain a weak pelvic floor.

Exercises to isolate the pelvic floor:

Fast Pelvic Floor contractions: Lift quickly like an on/off switch – hold for one second. Repeat 10 times.  

  1. Slow Pelvic floor controlled contractions: Imagine your PF muscles are an elevator at the ground floor of a building. As you contract and breathe out, imagine the elevator rising, slowly, to the second and third floors. Release slowly as the imaginary elevator lowers to each floor and returns to the starting position. Breathe in and relax completely. Repeat 10 times holding for 8-10 seconds. This increases endurance for impact activities (eg trampoline, running and weight lifting).

POSITION – Lie on your back with your hips and knees bent, find a neutral curve in your lower back, engage your Pelvic Floor and lower abdominals on each exercise.

  1. Pelvic tilt: gently rock your pelvis forward and back (anterior then posterior pelvic tilt). As you rock back breathe out and pull in your PF and abdominal muscles, feel your low back pressing and hold 30-60 seconds. This mobilises and lubricates the joints of the spine and hips, improves and increases
    blood flow, combines deep breathing and PF activation.
  2. Inner thigh squeeze: place a pillow or ball between the knees and squeeze, repeat x 10. To progress, lift and straighten legs towards ceiling, open, exhale then close and squeeze repeat x 10. Aim to strengthen your deep abdominals, hip flexors, and inner thigh muscles.
  3. Curl up: engage pelvic floor, breathe out, pull in your belly button and lift head x 5. Aim to improve core strength. (If Diastasis rectus, hug arms across chest and gently pull hands towards each other.)
  4. Stretch inner thighs: hug knees in to relax the back and rock then open the knees wide, hold 30 secs.

POSITION – Standing

  1. Squats 1: legs wide, push bottom back as if going to sit back on a chair. Repeat x 10-50. Aim to stretch and strengthen core, bottom and legs and lower back.
  2. Squats 2: slowly lower yourself down into a deep squat, bottom near your heels (you may need to hold onto the back of a chair for support). Place a pillow behind your knees (to take some pressure off the knee joints) or remove for a deeper hip and thigh stretch and stand with your heels on a firm cushion. Do not let your back round or your tailbone tuck under. Lengthen your spine and lift your head, maintaining a neutral spine position. Hold 30 secs repeat x 3. (Feet flat is harder).
  3. Squats: repeat above with PF squeezes (PF muscles are slightly lengthened so a good position to really sense the contraction and relaxation against gravity. Repeat x 5-10, fully relax between repetitions.

Hannah Epps is a Pilates teacher based in Surrey and running courses online. She has specialised in post-natal and pelvic floor dysfunction for over 10 years. This article is a combination of her research, courses, workshops and experience. For more information on classes click here and for more info on the Yummy Tummy programme click here



Hannah’s top reasons to do Pilates

Pilates has really worked for me which is why I became a teacher. The first time I needed to do Pilates was after a car accident, and then throughout both of my pregnancies. Today, if I ever feel out of alignment or in pain, Pilates is the only answer – I can do it in five minutes and I know I’ll feel better. I believe it’s about a balanced, happy body and mind.

Joseph Pilates designed this revolutionary system of exercise in the 1950s and he is still very much respected and referred to today.
“Pilates is the complete coordination of body, mind and spirit” Joseph Pilates

Hannahs Top Reasons to do Pilates

1. The most important thing Pilates does is support your core, strengthen abdominals, back and pelvic floor. This is important for spinal stability. We don’t guarantee a flat tummy but you’ll certainly get a smaller waist- however we will focus on that next week and how you can improve your tummy with “Hannah’s 7 steps to a summer yummy tummy and her favourite abdominal exercises

2. Your balance will improve – try and balance on one leg – if you wobble you need to do Pilates!

3. Your body will have a better posture and proper alignment which improves your self esteem. Look in the mirror – You will look and walk better as more straight and confident with 2 inches taller!

4. Pilates keeps you fit and toned as you age. As our body and hormones change through the seasons of our life. So its right for all stages i.e. post-natal recovery; amazing 40s; sensational 50s; and sexy 60s plus# whether an athlete or recovering from an injury, the level can be adapted for you!

5. Pilates breathing will help you focus and relax the mind – it will improve your circulation, stimulate the spine and muscles. You will sleep better and learn to relax when stressed, as we run such busy lives. As you focus on the movement, the body and mind will work together more giving mind body awareness.

6. You may well look slimmer as the muscles lengthen and tone and it encourages better body circulation to aid weight loss.

top reasons to do pilates

Pilates can enhance your life in so many ways

7. You will improve your pelvic floor (which in turn leads to a better sex life!!). We rely on these muscles more than you think – they are our foundation like a tree’s roots. Your Pelvic floor is so important not just during and after pregnancy for women ALL their life. We need it strong to support our organs and prevent incontinence – if you have a slight leak when you cough of laugh you need to address this now – it means something is wrong . Your pelvic floor may be weak or Pilates will help you relax other muscles so it can get stronger.

8. You will improve the tone of your muscles (less wobbly bits!) as Pilates wont over develop some areas more than others and each movement lengthens the muscles, Pilates focuses on long lean muscles using eccentric contractions – lengthening not on the contraction like a bicep curl but the return phase i.e. lowering your leg.

9. Your joints will be more mobile and therefore help you feel better and prevent injury – not so stiff keeping fluid moving to prevent stiff joints and less pain which is relevant for all ages!

10. You will feel more flexible as Pilates stretches works on the stretch and increasing of the muscles and range of motion within joints. Clients say they feel so much better and their body feels lengthened and lighter after stretching the muscles and with more relaxed muscles tension in your neck, shoulders and lower back can relax and you’ll have less tightness and pain.

11. It is amazing pain relief as the exercises will isolate or focus on one or a few muscles at a time i.e. your bottom or one leg this will stop your dominate side taking over -as it may when you walk/ run or work. Your body will learn to isolate a muscle and therefore your body and muscles will be more balanced so no pain down one side if you over use it. Or as we get older people tend to lean, so working the weak side will stop this. So it is relevant for rehab after injury, also athletes and all ages – we adapt the exercise for different levels and give modifications so classes tailored to all.

12. Pilates will increase your energy and help you sleep well –and keep you pain free to do more of the things you enjoy like gardening, golf, running, skiing, cycling.

You will get addicted to Pilates plus any exercise you enjoy with make you happy, you will look forward to your session or class and you will stick to it. Pilates classes are fun and relaxing and you may make some friends that motivate you to want to do more!

Testimonial from a client “We started Hannah’s Pilates classes when we were training for the London to Paris Bike Ride to celebrate our 40th birthday and the classes saved us! They made an amazing difference to my body while training and helped relieve stiff limbs and a bad back as Hannah stretched us out and corrected our bike posture. The exercises and stretches were essential for our tired muscles during the challenge at the end of each day, and I’m sure a strong core contributed to us completing the ride with no injuries. We have continued the classes and I have found it is a huge difference to how my body feels and releases any tension after daily work and home stresses. Thanks Sophie Hardy Farnham.

For more info on our Yummy Tummy Programme click here


How to check if you have a diastasis split

Diastasis Recti/Abdominal Separation Test

Are you a mum? Do you know what a diastasis / abdominal split is? It is when your tummy muscles have not joined back after having a baby and more than 1cm apart can cause you back problems and issues with trying to regain flat and strong abdominals. This does not just apply to new mums you can still have a split years later!
Please try this simple test to check –
1. Lie on your back with your knees bent, and the soles of your feet on the floor.
2. Place one hand behind your head, and the other hand on your abdomen, with your fingertips across your midline-parallel with your waistline- at the level of your belly button.
3. With your abdominal wall relaxed, gently press your fingertips into your abdomen.
4. Roll your upper body off the floor into a “crunch,” making sure that your ribcage moves closer to your pelvis.
5. Move your fingertips back and forth across your midline, feeling for the right and left sides of your rectus abdominis muscle. Test for separation at, above, and below your belly button.

Use Correct Form for an Accurate Assessment
Make sure that you don’t simply pull your head off the mat-a common mistake. To effectively contract your abs, you need to move your ribcage closer to you pelvis. If you don’t adequately activate your abdominal wall, you might assume that you have abdominal separation. But for most, as the rib cage moves closer to the pelvis and the contraction deepens, the width of the gap at your midline will decrease.
Don’t panic if you feel a “hole” in your belly in the first few postpartum weeks. Everyone’s connective tissue at the midline is lax after childbirth. As you recover, your midline will slowly regain its former density and elasticity, and the “hole” will become shallower, and if you do the right exercises, more narrow too.
Signs of Diastasis Recti/Abdominal Separation
• A gap of more than 2 1/2 finger-widths when the rectus abdominis is fully contracted.
• The gap does not shrink as you contract your abdominal wall.
• You can see a small mound protruding along the length of you midline.

If you are concerned Pilates and the New Yummy Tummy Rescue Programme can help you. Please contact me if you are need to join this programme.

Split diasasis recti and abdominal exercises

Did you know that weak split abdominals can contribute to a bad back