When it comes to strengthening, the pelvic floor probably isn't at the topic of your list when you hit the gym. However, it's an important part of the body that women, especially those who've given birth, need to know more. Unfortunately, it's a topic that's not often discussed.
"I think it's because some people don't realize they have an issue, and also they think they just have to live with it," says Dr. Shilpi Agarwal, M.D.
So what exactly is the pelvic floor? Basically, it consists of a group of strong muscles that start at the front of the pelvis and cover up the back to the tailbone. They act as a harness to support the bladder, uterus, vagina, and rectum.
"Although it is not inevitable to have a weakened pelvic floor, many things like childbirth, surgeries, and even obesity can weaken the pelvic floor by putting significant pressure and or have trauma, like childbirth, in this area," says Dr. Agarwal. "If we do not strengthen these muscles we have problems like urinary leakage, prolapse, or coming out, of certain organs, or pain in the vaginal canal because of lack of support from the muscles."
You realize you might have a weakened pelvic floor. Now what? Recognizing the problem is half the battle. Now, you have to learn how to strengthen those weakened muscles.
Focus on the Glutes
"The best thing for pelvic floor issues is to focus first on the glutes," says Courtney Wyckoff, trainer and founder of MommaStrong. "This is often a bit surprising for women, as we have been taught that if we have a problem in our belly or our pelvis, then the
answer must live in strengthening the core. The truth is that most women these days are actually hypertoned -- too strong -- in the pelvic floor and too weak in the glutes."
Wyckoff first recommends potty squats to the client, which is exactly how it sounds -- squatting over the toilet. To start, complete 50 potty squats every morning and night.
Work Your Way Up the Bod
Once that's mastered, Wyckoff suggests doing some abdominal bracing, which "involves lying on your back and combining a traditional belly-to- spine move with a traditional kegel while exhaling."
She adds, "The trick to this bracing exercise, however, is that on the inhale, you will want to let go of the kegel entirely. Interestingly, that release becomes the hardest part of the move! After some time practicing both potty squats and this bracing method, what will develop is a firmly supported pelvis that has a resilient trampoline like tone."
Wyckoff likes to then focus on working your way up the rest of the bod. Next, she works with you to help strengthen the midback, and then once she feels confident in your progress, she likes to challenge your glutes, abs, and midback, with dynamic, unpredictable moves, like burpees, for example.
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"The truth is that the human body’s engineering is common sense, it’s just that it hasn’t been explained to most of us in a way we can understand. So, I use lots of visuals and props to help that understanding take place," she says. "And, then, the way the body works from there is that instead of working up' with exercises, we usually will peel away more layers of strength much like an onion. I consider myself and those with whom I work to be forever students of the body mechanics."
Lay off the Crunches
We all want abs of steel -- whether you're pre or post-partum -- but Wyckoff believes our obsession with our abs is what's causing pelvic floor issues for some.
"We are going into pregnancy with hypertonicity of the pelvic floor. This means that our
abdominals are actually too strong and too toned, in the wrong way," she says. "Much of this is because of the framework of core exercises that have become popular over the last two decades. Flexion work like crunches are simply not beneficial for our bodies and can lead to lots of issues later in life."
When you're dealing with strengthening your pelvic floor, Wyckoff believes the goal is "to begin to teach how to create and nurture a resilient strength rather than static strength."
If you're suffering from symptoms of a weakened pelvic floor, especially if you've just given birth, don't be afraid to reach out to your physician or a professional fitness trainer to get the help you need.
"Our doctors tell us, rightly so, to avoid exercise for 6 weeks after childbirth. This makes sense, as a woman ought not to be running or flipping tires up a hill while their bodies are in
recovery. However, this doesn’t mean she can’t do anything," says Wyckoff. "The middle road needs to be developed here, wherein women get adequate pelvic floor rehabilitation exercises directly after birth."
The good news is that since more people are talking about the pelvic floor more than ever, according to Wyckoff, testing and diagnoses have improved dramatically.
And the even better news is that recovery time can be as short of two weeks and as long as four to six weeks.
"With anything, consistent training is key," says Wyckoff. "I will say, in conclusion, that it’s
important for every woman to know that we are all different and just because recovery is taking longer in some cases, doesn’t mean anything is wrong. It’s my job as a trainer to refer you to other clinicians should that be needed and/or investigate what might be holding up progress. Your job is just to show up!"
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