What is the pelvic floor?

The pelvic floor is a combination of muscles that create the horizontal “floor” of your pelvis. It is responsible for keeping the organs in the pelvic and abdominal cavity. It also contributes to the voluntary control of your bladder and bowel.

.

.

.

What happens to the pelvic floor during pregnancy?

The weight of the baby starts pushing down on the pelvic floor which stretches these muscles out. With time, these muscles become less successful at giving support to the organs and controlling the bladder and bowel.  Unfortunately, this leads to many issues during and after pregnancy, such as:

• Incontinence: involuntary leakage of urine or feces
• Low back pain: secondary to less core support of the lumbar vertebrae
• Prolapse: the collapse of one or more of the pelvic organs downward through the pelvic floor

What can be done to prevent pelvic floor complications?

One of the most important things to prevent pelvic floor issues during and after pregnancy is exercise your pelvic floor and core muscles. This is something all women should do regardless of pregnancy or not, but it becomes much more important when there is added forces pushing down on the pelvic floor.

Pelvic Floor Exercises:

 These exercises can be done sitting on ball or cross legged, or lying on back like in photo (however, if you are 4 months pregnant or more, it is not recommended lying on back).

Ensure that your sit bones are touching the ball/mat. Deep breath to start, relax.

• Visualize your 2 sit bones and “draw” a line between them, take a deep breath in, then on the exhale, pull those 2 sit bones together, hold for 5-10 seconds then release. Repeat 10-20x, complete 2 sets.
• Now visualize your pubis (front pubic bone) and your tail bone, connect them with a line. Breathe in and on the exhale pull those two points closer together. Hold 5-10 seconds, then release. Repeat 10-20x, complete 2 sets.
• Visualize all 4 points mentioned above (2 sit bones, pubis and tail bone) forming a diamond. Now on the exhale draw those 4 points together and up into the body. Hold 5-10seconds, release. Repeat 10-20x, 2 sets.
• Repeat #3 adding in hollowing the belly to activate transverse abdominus. Draw the navel in through the spine as you “pull up” the diamond. 10x, 2sets.
• Hollowing: Place fingers on each side of your lower stomach.  Hollow your stomach until your bellybutton drops straight down towards the floor (make sure the bellybutton doesn’t move towards your head or towards your feet).  You should feel the sides of your stomach slowly tighten and sag in.

activate transverse abdominus

These are the initial exercises for training your pelvic floor and core, but there are many more progressions to help you gain more strength. If you are struggling to find these muscles, or are unsure if you are using the right muscles (it’s tough, I struggled when I first tried too!), book an appointment with a physiotherapist for a full core assessment and progression of exercises. No matter what stage of your pregnancy (or post-partum), it is never too late to start working on these muscles!

– Lesley Cuddington, Registered Physiotherapist