Having a tight or hypertonic pelvic floor is more common than people realize. And keep in mind that pelvic floor dysfunction is not gender-specific. Please take a moment to review my blog on pelvic floor dysfunction to better understand the anatomy of the area and what the symptoms of pelvic floor dysfunction are. When experiencing symptoms from a tight or hypertonic pelvic floor you should avoid Kegel exercises and visit a pelvic floor therapist for evaluation, and perhaps internal pelvic floor therapy is a good idea.
What Areas of the Body Are Involved in Pelvic Floor Dysfunction?
The pelvic floor is the floor of the ‘bowl’ like pelvis and is directly influenced by the:
- Lower back
- Hips
- Sacroiliac joints (sacrum and ileum)
- Posture
- Breathing
This means that exercises that bring in mobility, and balance to these areas need to be a part of a tight pelvic floor exercise protocol which unfortunately is not always encouraged by pelvic floor therapists. Read my blog on how to determine which pelvic floor therapist to seek.
Exercises For A Tight Pelvic Floor
When doing any exercise, related to the pelvic floor or not, your goal should not be to do the exercises so many times and for so long but to make sure you do them with the necessary instructions in place as often as you can repeat them without losing the quality. I suggest committing to the form and not the frequency when it comes to doing daily exercises. You are best to do these exercises throughout the day vs doing them once for so many minutes.
1. Breathing
Don’t look at breathing as the way to sustain life, because without oxygen we die! Breathing is the ‘On’ button to access all of our body functions, just like the power switch is for a computer. Breathing when done right provides a strong axial line that movement is built on; it provides a ‘barrel’ that the pelvic floor is the bottom of. Your back muscles are the back of the barrel while the abdominal oblique sleeves are the sides, abdominals are the front, the bottom is the pelvic diaphragm and the top is the abdominal diaphragm. Imagine with proper breathing, you are conditioning all of these areas!
Watch this video to see how to breathe correctly, accessing the pelvic floor; when done right, every breath becomes reinforcement for the pelvic floor to be relaxed.
2. Butterfly Exercise
Lay down on the floor with an elongated spine; if you need support for your neck, roll up a towel and put it under the curve of your neck. Bend your knees and then slowly open them outward and let the bottoms of your feet touch each other. Allow the knees to continue going outward until they touch the floor. If that is not possible, put a pillow under each knee to prop them up.
If you end up using a pillow under the knees, this is an indication of restricted hip mobility. I like the exercise shown below to start working on bringing back some movement into your hip joint.
3. Bottle/Noodle Exercise
Muscles of the pelvic floor are similar to other muscles outside your body and just like those muscles, the application of pressure relieves some of the pain that is associated with the tightness. That is like grabbing your neck and top of your shoulder muscles and squeezing them to get some relief.
Now when it comes to the pelvic floor area on the outside, I prefer one of those firmer noodles cut to about 5-6 inches instead of a bottle placed over the area between the sit bone and the bony arch where the vagina or penis is located. I do like how this video demonstrates the use of the noodle/bottle to massage the area that is commonly found to be tight.
4. Squatting
Most often, people with a tight pelvic floor have tight adductors and dysfunctional gluteus medius and minimus muscles. Please note that the glut. mini is under the highlighted muscle and as you know, adductors are the inner thigh muscles.
When it comes to squatting, the knees need to be stable meaning not moving inward or outward and your back needs to be straight without curving it or arching your lower back. If you cannot maintain these requirements, I suggest sitting on the toilet with a squatty potty to let the muscles of the pelvic floor relax or sit on a yoga block vertically positioned with the knees bent and legs spread as much as you are comfortable. This allows a stretch in the adductor muscles and the obturator externus which in turn relaxes the pelvic floor.
5. Abdominal Exercise
Abdominals are more than just the front of the ‘barrel’ and include the side of your torso which are crucial in the stabilization of the trunk, for better support of the lower back and pelvis. A bulgy tummy means an unsupported lower back which means heavy weight on the pelvis and pelvic floor.
I am 100% against doing abdominal crunches because this actually restricts the front of the ‘barrel’ which is exactly the opposite of what the breathing exercise does. Instead, I recommend doing this exercise to not only practice your breathing but to stabilize the sacroiliac joints and the lower abdominals. What you see in the video below is what we all did as babies at around 5 months of age. My absolute favorite exercises are the Developmental Kinesiology (baby exercises) for all issues related to movement, coordination of muscles, and posture.
If despite doing all of these exercises you still need help with your pelvic floor dysfunction, contact me. You can also find me on IG and Youtube.
Dr. Shakib
