By Cathy Watson BSc Physiotherapy
With a little bit of intention and practice, it’s easier than you think.
With everyone so busy these days, how can anyone think about adding even one more thing into their life? Especially the thought of more exercise! Well, what if it was super easy to blend pelvic floor muscle exercises into your normal daily activities? I’m here to tell you that it really is, so read on…
Pelvic floor dysfunction, primarily incontinence, is a widespread issue affecting roughly 3.3 million Canadians. This condition adds $3.8 billion yearly to the healthcare system. Canadian employers can lose more than $2 billion yearly from lost productivity when employees suffering with incontinence struggle to be at work. In addition, people with incontinence may spend upwards of $2,000 annually on incontinence products. Those are not fun purchases!
This situation has to change. Implementing early conservative help will alleviate the strain on our healthcare system but, more importantly, it will help each individual who suffers with incontinence.
Changing the message is THE most important first step. People typically believe that it is normal to leak after having babies, as well as when we age. This belief is incorrect.
It is very common—but not normal—to leak after having babies. Incontinence does not have to continue just because you have had a baby.
It is very common—but not normal—to become incontinent as we age. If we increase our awareness and knowledge about our pelvic floor, this need not be our fate.
The more we talk about these issues and the more environments that can help with them, the easier it will be for people to seek out help. Because of my fitness background, my goal is to bring pelvic floor exercise into the fitness and Pilates environments. Gyms and studios already offer therapeutic exercise programs to help people with osteoarthritis, people who have had hip or knee replacements, people with cardiac issues, people with Parkinson’s, and so on. Pelvic floor exercise belongs in these environments as well. Our pelvic floor muscles are part of our core, and gyms and studios offer a multitude of core classes, with one key ingredient that is often missing: the pelvic floor.
If our pelvic floor muscles are part of our core, what else makes up the core?
Our transverse abdominis is a great abdominal stabilizer as it compresses our abdominal contents and gives stability to both our thoracic and pelvic regions.
Our deep multifidus muscles give stiffness and stability to our spines because they connect from one vertebral segment to the other.
Our pelvic floor muscles provide many different functions including giving support to our pelvic organs.
Our diaphragm helps balance the intra-abdominal pressures that happen in our bodies throughout the day when we breathe well.
Why is breathing well so important when we are trying to fix our pelvic floor? When we inhale, our diaphragm flattens and lowers, as does our pelvic floor. If we tend to be a chest breather, our diaphragm will never reach its full excursion. Because this lifting and lowering of the diaphragm helps balance our intra-abdominal pressures, it is necessary to breathe well.
Do we have to worry about posture? Our pelvic floor muscles, according to research, have less activity in them when we are sitting in a slouchy position. Less activity means these muscles will be less able to support us and keep us from leaking when we sneeze, cough, or laugh. Our pelvic floor muscles are like all other muscles in the body, in that they work better when placed in an optimal position where the stresses and forces running through them are more easily dispersed.
So, ideally, before integrating with exercise and activity:
You need to make sure you know how to contract and release your pelvic floor muscles.
You need to properly engage your transverse abdominis muscle.
You need to blend your breathing well so your diaphragm can reach its full excursion.
You need to understand your posture and know how to find your optimal posture when practising your pelvic floor exercises.
It is also important to make sure your incontinence issues are from weak pelvic floor muscles, as it is never a good idea to strengthen muscles that are too tight.
So, how can we integrate our pelvic floor muscles into our everyday exercise and activity?
Brushing your teeth: Brush your upper right side for five seconds while holding your pelvic floor contraction for five seconds, release and repeat three times, move on to the lower right side, and so on.
Walking: Walk for five steps while holding your pelvic floor contraction, release for five steps, repeat 10 times, two sets.
During commercials: Use this time to practise your Kegels. Inhale, then as you exhale pull up and in with your pelvic floor muscles.
Watering your plants: Do your Kegels so you don’t water yourself anymore!
Climbing stairs: Contract and release more quickly with each step you climb up. Just before your foot connects with the step above, contract your pelvic floor muscles, release and repeat for next step.
Before activity: Intentionally contract your pelvic floor muscles before you get up out of a chair, before you get in or out of the car, before you lift your child or carry your groceries, before you open the door. This helps remind your pelvic floor that you actually want these muscles to help support you with all the things you are doing.
Use your pelvic floor muscle contraction when you are doing your exercises:
Inhale to lower down into your squat.
Exhale, pull up and in with your pelvic floor; your lower belly naturally moves in as you are blowing air out to stand back up.
Inhale before you move.
Exhale and pull up and in with your pelvic floor; hold this until your foot has stepped out and connected with the floor in front of you.
Hold your pelvic floor muscle contraction as you jump up onto the box.
This is a great way to practise impact while reducing the effect of gravity on your pelvic floor. Make sure your pelvic floor is contracted before your foot connects with the jump board.
Feet in Straps
As you exhale to press away in the straps, pull up with your pelvic floor.
Hold your pelvic floor contraction for five strokes and release for five strokes; repeat.
Hold your pelvic floor contraction for five pedals and release for five pedals; repeat.
Now you know how easily you can blend your pelvic floor muscle work into your daily routine, why not give it a try? It just takes a bit of intention and practice. Your pelvic floor will thank you! n
Sapsford, R. R., et al. (2006). Sitting posture affects pelvic floor muscle activity in parous women: an observation study. Aust L Physiother. 52(3):219-20.
Canadian Continence Society.
Cathy Watson, BSc Physiotherapy, is a registered physiotherapist and Stott certified Pilates instructor. Cathy has found the blending of pelvic floor physiotherapy with Pilates beneficial for many of her clients. In addition to offering workshops, Cathy is re-establishing her Pilates-based physiotherapy business. In her spare time, she enjoys Silver Star Mountain in the winter and Okanagan and Kalamalka lakes in the summer. Call 250-540-0203 or email email@example.com.
*Reprint from our Fall 2017 Issue.