You Can Work Your Pelvic Floor While Lying on the Couch
Thanks to Goop’s jade egg fiasco and the popularity of tech-enabled Kegel trainers like the Elvie, many women are aware they have a body part called a pelvic floor. (FYI, men have one too, but the anatomy is different, obviously.)
The pelvic floor makes up the bottom of your core unit, explains Sarah Bradford, a pre and postnatal fitness specialist and founder of LUNA Mother Collective. It can help to think of the pelvic floor like a basket that holds all the organs in the area, like your bladder, uterus, ovaries, and so on.
That might not sound very sexy, but the pelvic floor is involved in a ton of different bodily processes that are absolutely essential: core function (or how well your abdominal muscles work during everyday activities and exercise), sexual function and pleasure, and even going to the bathroom.
That’s why women in all life stages should understand how their pelvic floor works.
First: a quick anatomy lesson. Your outer core is made up of the rectus abdominis (also known as the “six-pack muscles”), external obliques, and spinal erectors. But deeper inside, there are inner core muscles, including the diaphragm, which helps you breathe, the transverse abdominis (TVA), a corset-like muscle that wraps around your torso underneath your internal obliques, and the pelvic floor.
It’s super important that your inner core muscles work properly for (most importantly) your overall health, but also if you want flat abs. That's because the TVA and pelvic floor work together to provide a solid base of support for virtually every full-body movement you make, from picking something up off the floor to running to sneezing.
“These muscles are anticipatory in nature, which means they should activate milliseconds before movements to provide stability to your spine, ribcage, and pelvis as well as help to regulate intra-abdominal pressure,” Bradford explains. When these muscles aren't working properly, you’ll experience things like leaking when you cough, sneeze, or exercise intensely, which is most common during pregnancy and after birth, but also happens to women who have never been pregnant.
Worst case, you can experience pelvic organ prolapse, where one or more of your pelvic organs drops from its normal position into the vagina. Again, this happens most commonly after childbirth, but it can also happen because of menopause, aging, or pelvic surgery.
A problem with your pelvic floor can actually become a full-body problem, and it doesn’t have to be extreme to show up in other areas of your body. “Slight weakness or slight tightness might not feel like a big deal, but since the pelvic floor is part of the kinetic chain (meaning it interacts with the rest of your body), there is often carryover,” explains Sarah Duvall, PT, DPT, CPT, a physical therapist and personal trainer who specializes in women’s health. “Issues like neck and shoulder tightness from shallow breathing, piriformis pain, or even lower belly bulging can be related to muscle tone in the pelvic floor.”
Women also tend to hold tension in the pelvic floor, which can lead to issues such as pain during sex and with tampon or menstrual cup use, pelvic pain, and low back pain, according to Bradford.
As for how you know whether or not you have pelvic floor dysfunction, most women who are experiencing this know something is wrong, Duvall says. Leaking or feeling like something’s heavy or full inside your vagina — almost like something is falling out of it — are two telltale signs. If you think something up with your pelvic floor, it’s best to seek out a pelvic floor physical therapist for an evaluation. Some PTs even offer this service virtually, including Duvall. (LUNA Mother Collective also offers pelvic floor physical therapy videos on their streaming platform.)
The good news? Targeted exercises can help heal pelvic floor dysfunction and play a role in preventing it in the first place.
It’s not just about Kegels.
“It is commonly believed that one needs a strong pelvic floor in order to prevent and heal from pelvic floor dysfunction such as incontinence and prolapse,” Bradford says. But there’s more to having a healthy pelvic floor than strength. “In some cases, doing pelvic floor strengthening exercises such as Kegels can actually have the opposite effect. A tight or overactive pelvic floor is not the same thing as a strong pelvic floor.”
Muscles need to both lengthen and contract in order to work properly, including your pelvic floor. A common way to think about this is to imagine your arm flexed, with your bicep tensed. If you try to pick up a heavy object in this position, your bicep can’t tense any more to help you pick up the object. Your pelvic floor works the same way. “If it’s already contracted, it can’t contract further to stop the flow of urine or gas when you suddenly cough, sneeze or laugh,” Bradford points out.
That’s why pelvic floor pros recommend focusing on exercises that allow the pelvic floor to lengthen and contract, rather than just Kegels alone.
Luckily, hanging out at home is actually the ideal time to work on your pelvic floor.
“Learning about the core and pelvic floor and walking through exercises to learn about this part of your body is often very personal,” Duvall points out. “If you’re in a noisy gym with people around, that can make you feel distracted or self-conscious.”
There’s also a psychological benefit of doing something for yourself, Bradford points out. “Being in quarantine also means a lot more time with kids [if you have them], which inevitably means more getting up and down off of the floor, lifting, carrying, baby-wearing and the like. So taking the time to work on your pelvic floor and core can increase spinal and pelvic stability and decrease low back pain.”
Plus, unlike other at-home workouts, these exercises can be done in bed, on the couch watching Netflix, or even while you’re cleaning your kitchen — no equipment needed.
Three pelvic floor exercises to try at home:
If you’re curious about how your pelvic floor is working or know you want to work on your pelvic floor function, these exercises are a great place to start.
“This is the first, most crucial step toward building and maintaining a truly strong and well-functioning inner core and pelvic floor,” Bradford says. Plus, it can be done anywhere, anytime.
Here’s how to do it: Lying down, sitting up, or standing, with a long, tall spine, allow your pelvic floor and stomach to soften and relax. Let your shoulders drop away from your ears, and keep your ribcage stacked over your hips.
Inhale through your nose into the back and sides of your ribcage, feeling your ribs expanding out 360 degrees while keeping your belly and pelvic floor relaxed.
As you exhale through your mouth, begin to draw the four corners of your pelvis (pubic bone, tailbone, and sitz bones) in toward each other as if you are closing your pelvic floor around a marble, and then lift that marble up toward your heart, Bradford instructs. “At the same time, start to cinch the TVA around your torso like a corset. Imagine you are lacing the corset together from the front of your hip bones all the way up to your ribcage.”
Then, as you inhale, allow the corset to release and the pelvic floor to lengthen again. Repeat five or six times and then take a break to prevent dizziness.
Once you get the hang of it, you can also incorporate this breathing exercise into virtually any of your daily movements. “When bending over to pick up your child, a laundry basket, or a grocery bag, hinge from your hips and inhale on the way down,” Bradford explains. “Exhale engaging your pelvic floor and TVA as you lift and stand. The more you practice this, the sooner you will rewire your brain and your body to do this naturally, without even having to think about it.”
Pelvic floor contraction
Most women with pelvic floor issues, including leaking, naturally tend to start their pelvic floor contraction (aka Kegels) in the back, Duvall says. But instead of starting your pelvic floor contraction from your tailbone, she recommends starting from your pubic bone.
To start, Duvall recommends 10 minutes of quiet meditation to deepen your mind-body connection. “Focus on bringing different parts of your body into your awareness and letting the tension go, including your pelvic floor. Then, place your fingers on the front part of your pelvic floor, just above the top of your pubic bone. “Touching any part of the body that you want to contract helps it connect with your brain to improve muscular recruitment and control,” Duvall explains. “Sometimes it works through clothes, and other times you may need to place a finger just inside your vagina and try to close around the finger from the front.”
Lower ab challenge
This exercise is a bit more advanced, so it’s a good idea to try the first two before moving on to this one.
A lot of people overgrip, or tense too much, with their upper abdominals (the soft area in the middle of your ribcage), and this puts a lot of pressure on the pelvic floor, Duvall explains. Over time, that can create a lower belly pooch. When you’re feeling stressed, that upper ab gripping might be even worse.
So one way to work on releasing that upper abdominal pressure while also working on your TVA and pelvic floor is to try engaging your lower abs while leaving your upper abs soft and squishy. To try it, place one hand right underneath your ribs and the other on your lower abdomen. Try to contract your lower abs, feeling your hand pull in, without tensing your upper abs. Most people won’t be able to do it on their first try, Duvall says, but it’s the perfect thing to work on while hanging out on the couch.
Bonus: Tongue positioning
If you’ve ever found yourself clenching your jaw during a tense moment, you might be surprised to know this can carry down to your pelvic floor, causing tension there, according to Duvall. So while you’re exercising or doing an activity where you tend to clench your jaw, focus on your tongue positioning.
“Make sure your tongue rests on the roof of your mouth, slightly pulled back, so it’s not touching your teeth,” Duvall says. “Keep your teeth slightly apart.” Aside from during workouts, the other time to focus on this is when you’re sitting at your computer — particularly if you struggle with neck and shoulder tension.