Taking Care of Your Pelvic Floor During Exercise

You may not have known anything about pelvic floor muscles until pregnancy or after having a baby. Most likely, you’ve heard two things 1) you should do kegels to strengthen them, and 2) problems with these muscles can cause incontinence. 

Those two things are a good start, but I’d love to provide you with a bit more education so that you feel empowered to care for these muscles and/or continue to exercise if you’re dealing with pelvic floor muscle dysfunction. In this post, we’ll talk about where the pelvic floor muscles are located and their function, common problems that can occur, and four ways to engage and protect them during your workout routine.

What are pelvic floor muscles?

Your pelvic floor muscles form a hammock-like layer across the base of your pelvis. They stretch from your pubic bone in the front to your tailbone in the back. I’ve also heard them referred to as a trampoline, which should be taught and durable. Here are a few things to know about their function:

• When these muscles contract, they lift up and support your pelvic organs. 

• When you bear down, like when sneezing or lifting something heavy, the pelvic floor stretches and lengthens to accommodate the pressure created in your abdomen.

• Additionally, your pelvic floor muscles play a role in sexual function. When these muscles are too tight you might experience painful intercourse. Strong functioning pelvic floor muscles can help you achieve greater sensation during orgasms.  

• Pelvic floor muscles play a role in continence, allowing you to have control over elimination, including passing gas. 

• Lastly, they play a role in spinal and pelvic stability as a member of the core muscle-stabilizing team. 

Common Pelvic Floor Issues in Moms

Factors like pregnancy, childbirth, and aging can impact the function of these muscles. They may weaken due to the weight of the uterus, or they may become too tight due to the birthing process. Either way, if they’re not functioning as they should, it can lead to incontinence, prolapse, and impact your core strength. 

Most of you are probably aware of the connection between pelvic floor muscle function and incontinence. Did you know that there are two types of incontinence? 

• Stress incontinence causes leaking of urine when you cough, laugh, sneeze, or during exercises that involve impact, breath holding, or bearing down.  

• Urge incontinence is when you have the sudden urge to urinate and may not be able to hold it. An example often given is that you know you have to use the bathroom and right before you get to the toilet the urge gets stronger and you can’t prevent urinating.

The majority of incontinence for moms is stress urinary incontinence, however, some moms will also struggle with fecal incontinence which is the inability to control bowels. This can happen due to trauma during the delivery process.

Another condition that involves the pelvic floor muscles is pelvic organ prolapse. Because the pelvic floor muscles support your organs, if there is a dysfunction this can cause organs like your uterus or bladder to drop into the vaginal wall. Picture a hammock or trampoline that can’t support the weight of the person on it…it begins to sag toward the ground. In some cases, the organs can extend outside of the vagina.

The good news is that pelvic floor physical therapy is more widely available and we’re learning more about lifestyle changes and exercise that can treat, improve, or help you cope with these conditions. Additionally, qualified exercise professionals should be able to prescribe exercises that support your efforts to improve pelvic floor function.

Four Ways to Engage, Strengthen, and Protect Your Pelvic Floor During Exercise

As I mentioned, either while you’re in pelvic floor physical therapy, or after you’ve been discharged, a qualified exercise professional can help you engage, strengthen, and protect your pelvic floor during strength workouts. Here are a few strategies you can implement during your workouts:

1. Coordinate your breath: Your pelvic floor muscles are the basement of your core, where the diaphragm is the ceiling. The cylinder which is your core will function optimally when both of those muscles work in synergy. When you exhale your pelvic floor muscles are lifted and when you let the breath out your pelvic floor relaxes. The diaphragm should move in the same direction, descending on your inhale and rising on your exhale. Coordination of these two muscles isn’t always easy, especially when movement is involved. However, it’s important enough to master so that you’re not putting excessive pressure on the pelvic floor muscles. 

2. “Close the holes” or "Blow before you go”: I can’t take credit for these terms as I’ve heard them from several pelvic floor physical therapists. The strategy is to engage the pelvic floor muscles right before you’re about to lift something heavy. Imagine closing your anus as if you’re trying to not pass gas. This will activate your pelvic floor right before there is increased abdominal pressure. You can also try “blow before you go”, which means that right before you’re going to lift, you begin the exhale. Again this can help manage pressure pushing down on the pelvic floor muscles.

3. Avoid impact exercises postpartum until you’ve dedicated time to resistance training: The postpartum running guidelines suggest a minimum of 12 weeks of progressive exercise, including resistance training. However, if you’re having symptoms of pelvic floor muscle dysfunction, this may take longer. When you’re ready to add higher impact activities, start with fewer reps and shorter duration. Take your time to progress and build up. You wouldn’t go from lifting a 5-pound dumbbell straight to 50 pounds, would you? It’s worth mentioning that there aren’t prenatal running guidelines and plenty of moms do run during pregnancy, but if you’re noticing symptoms, that may mean your pelvic floor muscles can’t handle the impact and it’s probably best to move to low impact options. 

4. Remember that pelvic floor muscles are muscles: We all understand the concept of challenging a muscle in order to make it stronger and stretching muscles to relax and lengthen. The same goes for pelvic floor muscles. If you have a weak pelvic floor, you don’t want to avoid core training altogether because it’s going to need the challenge of the exercise to get stronger. If you’re not having symptoms, it’s also important to learn how to contract and relax those muscles. The easiest way to do this is by focusing on breath and core stabilization during strength training. If your core muscles are working together, your pelvic floor muscles will maintain/gain strength. If you prefer isolated exercises, you can throw in kegels of different durations (long contractions and quick contractions). 

Education should be empowering. As you learn more about your body, don’t let it cause fear. Research around core stability exercises benefiting the pelvic floor muscles is increasing, which is an incredibly positive thing. So whether you’re experiencing any of the named conditions, or if you’re concerned about atrophy as you age, or if you just want a well-rounded core program, take the time to become familiar with your pelvic floor muscles. 

If you’re ready to put core training to reduce your risk of incontinence and back pain into practice, consider my free 5-day core course.

Happy training!

Designing a Personalized Fitness Plan

Don’t get me wrong, I love seeing so many apps like Nike and Peloton offer prenatal and postpartum workouts. However, the downside is that most moms will jump around to different workouts and won’t “personalize” their exercise program.

When I talk about a personalized workout plan, I’m referring to developing and following an exercise regimen specifically for you. This doesn’t mean you have to work with a personal trainer or that every exercise session needs to be planned specifically for you, however, that is the ultimate way to make sure you have a customized exercise plan. 

Personalization just means that you’re aware of what you need, and what it will take for you to reach your goals. You can still try different apps or studio workouts, but you should be intentional in the classes you’re choosing, when you’re doing them, and how you’re recovering from them. 

Motherhood is a time to be strategic in your plan and stay away from haphazardly following fitness influencers and trends. Personalizing your fitness routine will help you stay consistent and see the results you’re working toward! Exercise can be your biggest mental and physical health tool if you approach it the right way!

What are the benefits of personalizing your mom fitness program?

Personalization is advantageous for all moms, but particularly when you’re training during and after pregnancy. Your prenatal exercise routine and postpartum fitness plan should most definitely be customized. With a tailored regimen, you can expect:

• Workouts that fit into your daily routine. With a personalized plan, you design the workout schedule around your existing commitments (which often fluctuate as your child goes through different phases, so be ready to adapt often). 

• Personal goal achievement. Generic plans only help you meet general goals. If you have specific goals, then you need a targeted workout plan. For example previous to pregnancy you may have been training for toned abs, but during pregnancy, this is not your aim so your plan needs to change so that it aligns with your prenatal goals. 

• A safe progression in exercise. A personalized plan will have you progress at a pace appropriate for your individual fitness level. Each workout should build on the previous one.

• Faster results. Don’t spend your precious time and energy on exercises that may not be your priority. Instead, customize your plan for effectiveness and efficiency. For example, you may have liked using the elliptical machine during pregnancy, but if your main focus postpartum is alleviating back pain then the majority of your effort should be spent on core stability workouts instead of sweating away at the gym.

So how do you personalize your fitness routine?

The first step is being self-aware of the factors that you should account for. Here are a few examples of things to consider when planning for fitness success:

1. Exercise History

2. Current Energy Levels

3. Physical Injuries or Conditions

4. Lifestyle Factors

By reflecting on your unique situation and needs in areas like these, you can craft a fitness routine with purpose. Try this self-assessment as an initial step toward personalizing your exercise program.

Evaluate Often

As you move through motherhood your needs WILL change so remain flexible and be willing to reassess. Your needs in your second trimester may be different than your first trimester, and your progress postpartum may be slower than expected. Be ready to make adjustments so that your fitness journey is fluid and customized.  

No one-size-fits-all workout plan can give you the same benefits as a thoughtful and personalized plan. I'm on a mission to help moms feel strong and confident by taking control of their fitness journey. I hope I’ve inspired you to determine a clear direction for your unique needs so that you can develop a fitness plan that works for you!