Categorically, pelvic floor exercises are done by 2 groups of people: Those who have pelvic floor issues and those who are interested in medical spa features, tightening the muscles of the pelvic floor which may not necessarily cause any symptoms. The common symptoms related to the first group may be:
- Urinary incontinence
- Fecal incontinence
- Chronic constipation
- Chronic hemorrhoids
- Pelvic pain
- Pain during sexual intercourse
- Erectile/ Orgasmic Dysfunction
- Pain in the tailbone/coccyx
- Chronic lower back pain
- Hip pain
- Sacroiliac pain
- And/or poor posture
In this blog, we will be exploring the impact of pelvic floor exercises in tightening pelvic floor muscles which will benefit both groups discussed above.
Are Pelvic Floor Exercises Right for Everyone?
Every human being has a pelvis with its lining, the pelvic floor. The mistake that most people make is that they think the pelvic floor is just the muscles that lie between the anus and vagina/penis. Or that it’s an area only treatable and accessible through the vagina and anus.
Unfortunately, when it comes to treating pelvic floor issues, the medical professionals also primarily work on these areas disregarding all other muscles that are involved in pelvic floor-related issues, including the ones that impact what is connected to the pelvis.
The pelvic floor is not a free-standing structure, therefore the spine, and lower extremities (hips, knees, ankles, and feet) directly influence its integrity and stability. That also means that our lifestyle directly impacts how weak and/or tight the muscles of the pelvic floor may become. For instance, prolonged sitting de-conditions muscles in the following groups:
- Glutes
- Hip stabilizers
- Lower extremities
- Lower back
- Abdomen
Weakness in these muscles leads to the weakness and/or tightness of the pelvic floor muscles without you realizing it.
In some people weakness, is the end result while in others, over contracture of certain muscles of the pelvic floor will be created. Sometimes clinical presentations give the clue as to if the individual is experiencing weakness or over contracture. In other cases, the only way to find out is through a comprehensive examination which may or may not include an internal manual exam. Watch this video to understand more about how an internal examination is not always necessary in the treatment of pelvic floor dysfunction.
What Pelvic Floor Exercises Will Make Me Tighter?
There are 4 groups of muscles that we need to look into in order to better answer this question. Three of the groups have to do with the 3 layers of muscles that are accessible through internal manual work and the 4th group directs attention to muscles that deal directly with the pelvis.
Assuming that the muscles of the pelvic floor belonging to the first 3 groups are not spastic, the best strengthening exercise is Kegels, and my go-to method that jump starts this task is the Emsella Chair treatment. The Emsella chair is FDA-approved for incontinence by providing 400 Kegels per minute which is more than what anyone can ever do on their own. Kegel exercise is not for anyone with spastic pelvic floor muscles and frankly is not the be all end all exercise either.
The 4th group of muscles will address the dysfunctional performance of the pelvis and the pelvis ‘influencers’ which again are the:
- Glutes
- Hip stabilizers
- Lower extremity muscles
- Lower back muscles
- And Abdominal muscles
Lack of functional performance of these muscles will mean that what is connected to the pelvis will be pulling, pushing, rotating, and torquing the pelvis, leading to weakness of the muscles of the pelvis.
You have to understand that the 2 main reasons for a muscle to weaken are:
- Overuse
- Underuse
The end result of either of these conditions is dysfunctional movement patterns. To understand what dysfunctional movements are, think about 2 drivers one sober and the other intoxicated. Assuming they both get to the destination, you can look at the quality of their drive to understand what dysfunctional vs functional driving is like.
When we are injured, have a poor lifestyle, or have habits that are against the design of the body, the patterns of movement change to accommodate us. These changes over time lead to changes in the blueprint of movement. Once the blueprint is changed, the downward spiral begins.
The one exercise that is universal to everyone is breathing. To understand how breathing impacts the muscles of the pelvic floor watch this video:
How to Begin Pelvic Floor Tightening Exercises
First, start by correcting your breathing and do know that unless you are doing the biological breathing, you are not breathing correctly.
Next is Kegel exercises on the Emsella Chair to jump-start the strengthening, that is if you are even a good candidate for Kegels. In my practice, I require every Emsella Chair treatment to be followed by postural stabilization exercises based on the concepts of Developmental Kinesiology.
You cannot work on the ‘floor’ when the ‘house’ is unstable so working on the muscles of the pelvic floor without stabilizing the body and its movement is a waste of time. When talking about stabilization of the pelvis and its influencers, we should never isolate an area to work on it. After all, your movement is never in isolation but in concert with the rest of the body.
Developmental Kinesiology exercises such as Dynamic Neuromuscular Stabilization are based on the fact that all babies throughout the world follow the same patterns of movement innately.
If we all do these exercises to go from a helpless infant to a running toddler, without any dumbbells, straps, bands, or coaches, then why not make the corrections to dysfunctional patterns of movement leading to weakness in the same way?
The video below shows a simple exercise that demonstrates this.
The exercise above practices:
- A neutral spine
- Proper breathing
- Allowing the pelvis to be in a neutral position
- Strengthening the extremities against gravity
- Core Stabilization
This is something that we all did at the age of 6 months:
- Allowing the lower abdominal to work with the lower back in keeping the pelvis neutral.
- Our abdominal diaphragm working with the pelvic diaphragm to stabilize the ‘barrel’.
- Stretching and widening the muscles of the mid and lower back to elongate and widen.
- The neck extensors working with the neck flexors to keep the spine in that area neutral.
- The muscles of the shoulder blades stabilize the shoulder blade while the arm muscles get stronger by being held up against gravity.
You can see that there is not a single muscle that tightens the pelvic floor and a holistic approach is necessary for long-term achievement in the stabilization of the pelvic floor muscles. Check out my YouTube Channel which is about pelvic floor dysfunction and contact me to learn the step-by-step pelvic floor exercises that are right for you.
Dr. Shakib
