Not that long ago, I stood on the side of the road, 4 months pregnant, having peed my pants.
Not that long ago, I stood on the side of the road, 4 months pregnant, having peed my pants. It was not a glorious moment for me. Unfortunately, I had horrible morning sickness and well, the pressure was so strong that, yup, I peed my pants! And at the time, I thought that was normal.
You know, that’s what happens when you’re pregnant, right? I still believed it to be normal, albeit very embarrassing, when I couldn’t manage to do jumps in my postnatal exercise class because when I did, I peed a little bit.
I wanted to share this experience because I know that women are looking for answers, for help. I see it every day! It’s not easy for me, or for any of us, to share these embarrassing moments but it’s time to get all this out in the open so we can get the help we need and lead a vibrant and healthy lifestyle.
‘Lift your pelvic floor’ she said, to which I replied ‘wha??!!’
The number of times I sat in a yoga or pilates class and was instructed in various ways to engage my pelvic floor is pretty impressive considering when I was in those classes, I had NO idea what the hell they were talking about!
I mean, I had many wonderful, knowledgeable teachers but those muscles were completely foreign to me. Even after doing my own yoga and pilates training I was still left a bit mystified. I knew approximately where they were but I wasn’t quite sure what it meant to engage, or lift, or squeeze.
But I did my best…
I clenched my butt and I imagined lifting, I went through the motions, and went through the motions, with absolute urgency during my pregnancy, yet I still wound up with pelvic floor issues. It’s not easy to share with all of you and as well as the rest of the Internet that my pelvic floor muscles were less than stellar but I know there are women out there who are right where I was a few years ago. Completely out of touch with that area of their body and frustrated with the way things are working and feeling ‘down there!’
Don’t worry, we’ve all said ‘whaa?’
Most of us have no real connection to the pelvic floor muscles. We aren’t sure exactly where they are or how they work, we just know we need to work ‘em.
It really has been a taboo subject here in Canada up until recently but in many European countries Pelvic Health Physiotherapy has been part of standard care for postpartum women for decades… amazing! Thankfully this is changing and the information women need to feel better and more confident in their bodies is slowly coming to light!
Pelvic floor meet brain, brain meet pelvic floor!
Let’s take a look at some of the contributing factors to our disconnection of the pelvic floor muscles and what we can do to increase our awareness and function of these muscles.
We assume dysfunction is normal.
I hate to use the word dysfunction… and I just used the word dysfunction. No one likes to think of themselves as broken but if there is pain, or the muscles are not working optimally, there are things that can be done to help. A lot of women figure that experiencing a little bit (or maybe even a lot) of incontinence is normal during pregnancy and postpartum. But there is a difference between NORMAL and COMMON. Many, many women are experiencing incontinence, pelvic pain and discomfort throughout their pregnancy but that doesn’t mean it’s normal. Misalignment, improper breathing techniques, increased tension and trauma of the tissues can contribute to a weakening and/or decreased function of the pelvic floor muscles.
When it comes to incontinence even though we may think it’s normal, most likely we’re dealing with it silently and not really broadcasting it to everyone. I mean how many people want to tell the world they peed their pants on the side of the road?
It can feel quite disheartening, especially after having given birth and not necessarily feeling comfortable in your “new” body. I know for myself I felt like something must be wrong with me and this was just something I’d have to live with.
Incontinence, painful sex, pain when inserting a tampon, even an increased pressure in the pelvic area can be really hard to talk about. If you feel uncomfortable with a certain area of your body it is going to directly affect your relationship with those muscles and most likely, you will shy away from actually working on those areas/muscles because it feels overwhelming and scary to start.
See no evil, hear no evil, speak no evil.
Another big reason we feel disconnected from that area of the body is that unlike many other muscles in our body, we don’t actually see the pelvic floor muscles because they are internal. Generally, we don’t talk about them. We don’t often touch them and we haven’t received a whole lot of education on these muscles. And our muscles can’t speak to us either. Well they can, however, if we aren’t entirely sure how to identify their stress signals, how are we to know that there’s something wrong with them in the first place?
It’s no wonder that the majority of us are walking around without any kind of awareness or relationship with these muscles!
Generally, it’s not until we experience some kind of dysfunction that we become aware of these muscles and begin to look for help. I can remember these wonderful teachers trying to cue how to engage the pelvic floor muscles but it wasn’t until a physiotherapist suggested I actually touch and feel those muscles that I had a better understanding of where they were and how they should work.
Decreased function and sensation.
The one thing that most of us think of when we hear about the pelvic floor is kegels. We’ve all heard we should be doing them religiously – morning noon and night, plus every time we hit a red light!
Kegels focus mainly on the engaging aspect of the pelvic floor muscles and many of us are actually dealing with hypertonic pelvic floor muscles, meaning they are too tense. Tight and stiff muscles don’t work to their full potential and have a limited range of motion.
We can imagine that when we think of our hamstring muscles.
When we feel stiff in our hamstrings they don’t have as much yield to them and feel stuck. Well, that tension and lack of pliability can definitely occur in the pelvic floor as well. When tension builds over time these muscles will not move through their full range of motion therefore we don’t have a good sense of what they feel like when they are relaxed because they are living in a constant state of tension.
Deepening our awareness of the pelvic floor muscles (and other muscles as well) has a direct impact on how well our muscles function. Along with increased awareness comes the ability to move more accurately, ensuring that the proper muscles are working and that we’re not just compensating – this includes our glutes too! Having the pelvic floor muscles working optimally means that your internal organs, spine and pelvis are properly supported.
Let’s explore five ways that we can increase our awareness and deepen our relationship with the pelvic floor muscles.
1. Feel the Rhythm.
I have written about the Core Breath (coined by Bellies Inc. but also known as Diaphragmatic Breathing or Pelvic Breathing) before and what this really means is retraining our core muscles to work in synch with each other as they naturally should. Child’s pose can be a really helpful position to practice this breathing in as it naturally lengthens the pelvic floor muscles allowing us to feel the releasing phase more easily.
Come down onto the floor and rest your bum back toward your heels, knees can be apart or together. Place a pillow under your bum if it does not comfortably rest on your heels. As you inhale imagine the SITS bones (the bones in the middle of each bum cheek) widening apart. As you exhale see if you can feel a gentle lift. You are not squeezing on the exhale but allowing the pelvic floor muscles to naturally draw up. If that doesn’t resonate with you try thinking about the pelvic floor muscles softening or relaxing on the inhalation. If you cannot actually feel any movement just visualize the muscles moving with each breath.
2. Let it go.
For some of us the pelvic floor muscles may not actually move that much because of excessive tension. Try placing a tennis ball (or Yoga Tune Up ball) under one bum cheek, just to the inside of the SITS bones. Allow your muscles to soften and release as you stay here and breathe. You can do this sitting on a chair or on the floor.
3. Get some feedback.
It can be really hard to sense the subtle movements of the pelvic floor, so using some kind of prop may allow you to feel the muscles better. A yoga bolster or something that resembles one (such as a few pillows or a rolled up blanket) works well. A stability ball is another great tool. If you are using a blanket or bolster you will sit on it with your legs on either side of the prop so it is directly below your perineum. Practice diaphragmatic breathing here and feel for the release of the pelvic floor muscles into the prop beneath you.
4. Get in touch.
Many of us are tactile learners so actually touching our bodies and palpating our muscles greatly increases our awareness. Oftentimes we hear or read about anatomy but if we don’t have personal experience with these muscles and bones we don’t have the clearest picture possible. External palpation of the bony landmarks around the pelvis is really helpful as is internal palpation of the muscles and tissues. Remember, education is key in helping you to feel more connected and more confident in your body and with your body!
5. See a professional.
It can be overwhelming to book an appointment with someone who’s going to take a look at your lady bits and let you know what’s going on in there. I get that. Sometimes ignorance is bliss! But I guarantee you will not regret getting a clearer idea of how your body is working, especially if you’re experiencing pain, discomfort, incontinence, a sensation of heaviness in the pelvic area, or even a feeling of weakness in the abdominal muscles. A pelvic health physiotherapist will help guide you and work on any specific issues you have but that being said I cannot stress to my prenatal clients what a great resource a physiotherapist is as you prepare your body for childbirth.
I’m not saying this journey is an easy one. It takes time to build a relationship with these muscles. I would love for you to consider the ways that you can learn to connect to your pelvic floor so that the next time you are in a pilates or yoga class (or even some really great cardio/strength classes) you will know exactly what they are talking about. You could also jump into classes that are specifically designed to connect you to your core and pelvic floor. Many of the classes I offer are designed specifically for optimal function and alignment in the body and we get to know our pelvic floor a whole lot. Hopefully, one day we’ll even come to love our pelvic floor.