The pelvic floor muscles are perhaps the most important muscles ever exercised in a physical training routine.
Like a springboard at the bottom of your pelvis, these muscles contribute to the overall strengthening of the abdomen and hold various organs in place—including the bladder, bowel, and, for some people, the vagina and uterus. as well as making sure they work properly.
Standing kegel demonstration, in a Portland, Oregon studio on February 12, 2023. All women can benefit from pelvic floor exercises, but very few are aware of them.
(Gritchelle Fallesgon/The New York Times)
Yet many people don't even know these muscles exist, said Amy Park, director of Women's Pelvic Medicine at the Cleveland Clinic, at least not until they stop working the way they're supposed to.
“There is a general lack of knowledge about the pelvic area,” Park said.
"I
educate
women several times a day on the fact that they have pelvic floor muscles."
They may not be visible like the triceps or quadriceps, Park added, but
they are vital
for everything from
basic
toileting functions to sexual health, sitting and standing, plus they can be strengthened with an exercise program.
A demonstration of diaphragmatic breathing, in a studio in Portland, Oregon on February 12, 2023. All women can benefit from pelvic floor exercises, but very few are aware of them.
(Gritchelle Fallesgon/The New York Times)
The pelvic floor is “just as important in your daily life as your Achilles tendon is for running, because we use it for everything,” said Liz Miracle, director of quality and clinical education at Origin, a provider of pelvic floor physical therapy.
Throughout history, talking about this region of the body, even with a doctor, has felt taboo to many.
That modesty has caused years of unnecessary suffering, said Evelyn Hecht, a pelvic floor physical therapist in New York City who began her practice in the 1990s: Many ailments could be treated or avoided entirely if women felt freer to talk about their symptoms, or if the public were
more informed
about the pelvic floor.
Nearly 1 in 3 American women have a pelvic floor disorder, the most common being urinary incontinence, bowel incontinence, pelvic pain, pelvic organ prolapse, or some combination of these problems.
Demonstration of a pelvic floor lengthening exercise in a Portland, Oregon studio on February 12, 2023. All women can benefit from pelvic floor exercises, but few are aware of them.
(Gritchelle Fallesgon/The New York Times)
However, pelvic floor related conditions are not inevitable.
Many pelvic problems can be prevented or mitigated with recurrent
stretching and strengthening
exercises of these muscles.
Most of us could benefit from having "a personal trainer for our pelvic floor," said Lauren Streicher, medical director of Northwestern University's Center for Menopause and Sexual Medicine.
Miracle, who is also a physical therapist and something of a personal pelvic trainer, recommended that all women who do not currently have a pelvic floor disorder or injury incorporate six functional exercises into their physical training routine, and do them at least three times a week.
The pelvic floor muscles, viewed from the side, from above, and from the front.
(Laura Edelbacher/The New York Times)
diaphragmatic breathing
Learning how to move the diaphragm is key to connecting with and conditioning your pelvic floor muscles.
— Sit in a chair with your feet flat on the floor.
Place one hand on your belly and one on your chest.
— Inhale and feel your abdomen expand, then slowly exhale through your mouth.
(Imagine a balloon is inflated inside your belly: when you inhale, the balloon fills with air; when you exhale, the air comes out little by little, as if your thumb covered the opening and gradually let the air out.)
Repeat this 10 times.
Pelvic floor lengthening exercise
Relaxing and lengthening your pelvic floor muscles, so they are capable of a full range of motion, is especially important for basic functions like effortless toileting (think of it as a way to avoid constipation) and penetrative sex. without it hurting
— Lie on your back in a comfortable position with your knees bent and the soles of your feet on the floor.
— Start with diaphragmatic breaths;
Take a deep breath and allow the air to fill your lungs to the bottom.
Feel your belly, lower back, and pelvic floor stretch—or lengthen—outward slightly with each breath.
— Exhale slowly through pursed lips, allowing your belly, back, and pelvic floor to relax in time.
Do not activate any muscles during the exhalation;
make sure your pelvic floor is at complete rest.
Imagine that the balloon we mentioned earlier expands 360 degrees in all directions when you inhale.
One of those directions is down between your legs and toward the perineum (the area between the vagina and the anus).
When the belly inflates, the perineum will also let air pass passively.
Repeat this 10 times.
Kegel exercises
sitting While the previous exercise helps us relax the pelvic floor muscles, Kegel exercises train us to be able to contract them.
This exercise helps us hold urine, stool or gas when we feel the need to go to the bathroom and also works to increase the resistance of the pelvic floor muscles so that they can support our organs and balance the pressure exerted on the abdomen throughout the day.
— Sit upright, with your feet flat on the floor.
— Inhale through your nose and relax your pelvic floor as your belly and ribcage inflate.
— As you exhale, squeeze and lift your pelvic floor muscles and hold the contraction as you exhale.
Try to contract your muscles for 10 seconds.
It may help to imagine that you are squeezing the muscles like when you want to stop the flow of urine in the front and the passage of gas in the back, or imagine that these muscles are picking up a marble and holding it inside.
Activate the muscles inside your body, don't just clench your thighs or buttocks.
— Fully relax for four to ten seconds, or longer if necessary.
Releasing tension is important, as contracting muscles without fully relaxing them can cause them to become overtight and restrict their range of motion.
Do three sets of ten repetitions.
fast contractions
This exercise goes beyond Kegels as it trains the pelvic floor muscles to rapidly contract, a skill that allows them to respond effectively to sudden, automatic functions that create pressure within the abdomen, such as coughing, sneezing, or laughing. .
(It can also help prevent incontinence, or “leaking,” which occurs under this pressure.)
— Sit upright, with your feet flat on the floor.
— Contract and release the muscles that stop the flow of urine several times.
Try to do at least seven repetitions in ten seconds.
Contract and release at least 30 times.
Perineal Knack with 'shhh' Sound
While fast contractions train the pelvic floor muscles to respond quickly to bodily functions that put pressure on the abdomen, this exercise helps build strength and endurance against this kind of pressure.
— Sit upright, with your feet flat on the floor.
— Inhale through your nose, relax your pelvic floor as your ribcage and belly expand.
— As you begin to exhale, squeeze and lift your pelvic floor muscles, then make a loud, rapid “shh” sound through your mouth while holding the contraction.
— Then exhale fully, slowly, through pursed lips, allowing your belly, back, and pelvic floor to relax as desired.
Do three sets of ten repetitions.
belly lifts
In a studio in Portland, Oregon, on February 12, 2023, a sit-up is demonstrated, an exercise that targets the transverse abdominal muscles, which work the pelvic floor muscles to help sit up, Get up and do any exercise that requires balance or stability.
All women can benefit from pelvic floor exercises, but very few know about them.
(Gritchelle Fallesgon/The New York Times)
This exercise activates your transverse abdominis muscle, which is located in the lower abdomen and provides support to the abdomen.
This muscle works with the pelvic floor muscles to help with actions like sitting down, standing up, and any exercise that requires balance or stability.
— Start by getting on your hands and knees, with your hands at shoulder height and knees in line with your hips.
Focus your gaze between your hands.
— Inhale, drawing air into your belly and relaxing it down.
— Exhale and draw your belly button in toward your spine.
This should activate your transverse abdominis muscle.
Keep your back straight during the movement.
(Imagine your belly filling with air again like a balloon, now push the air out of your balloon with your abdominal muscles, contracting them toward your spine.)
Repeat this 10 times.
c.2023 The New York Times Company
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