Core Specialist Cheryl Coppa with the most effective way to do pelvic floor exercises
By Cheryl Coppa
Just so we are all on the same page, what is a Kegel? “Kegel exercises, also called pelvic floor muscle training, are simple exercises you can do to treat bladder problems and improve bowel control. The exercises strengthen the pelvic floor muscles that support the bladder, rectum, and uterus.“ Now this is the general description you will get if you google Kegels and why you should do them. So often we are told to do our Kegels: Have a leaky bladder? Do your kegels. Have prolapse? Do your kegels. Have a weak pelvic floor? Do your kegels. Are you pregnant? Do your kegels. Hitting Menopause? Do your kegels. The basic Kegel is an isolated contraction of the pelvic floor muscles. The only problem is if you are looking to strengthen your pelvic floor and improve conditions for your bladder, rectum, and uterus, it goes way beyond Kegels. If you are doing your kegels, I am going to stop you right here, just stop, and continue reading to understand why, and how you can more effectively and completely restore strength to your pelvic floor. How Do You Strengthen Your Pelvic Floor Muscles Other Than Kegels?
Let’s cover a bit of anatomy just to help get a clearer understanding. The Pelvic floor is a sling of muscles in the pelvis. They are responsible for many functions which include supporting the bladder, rectum, and uterus. They also play a role in our spinal stability and our core strength and function. They also play a huge role in childbirth, of course, sexual function, and what is less known, breathing!
The Pelvic Floor is part of a unit, it is actually the foundation of the core. The core unit starts at the diaphragm and ends with the pelvic floor. Everything in between is part of the unit including the abdominal muscles, the rib cage, your thoracic spine, your hips, and glutes! All the muscles when strong and healthy, beautifully and naturally work together. What happens somewhere along the way is we lose this connection of the core working as a unit, which means there is a disconnect. This can happen from childbearing and childbirth, but this is certainly not limited to this! Every woman is susceptible to this disconnect because of modern life, meaning the way we sit for extended periods of time, the way we stand, and the way we don’t move our bodies, contribute to this disconnect. This disconnect can also happen with over-training in fitness or improper fitness training. The great news is the solution is pretty simple! All we have to do is realign this unit and get it connected again. We were all once there, just have to put it back. This solution is exactly how we will most effectively strengthen our pelvic floor muscles. Continuing isolated pelvic floor contractions without incorporating the whole body is like focusing on tuning one instrument in an orchestra while neglecting the harmony of the entire ensemble. A whole-body approach will ensure holistic strength, just as a symphony requires each instrument to play together for the best performance. - Step 1) Get your body in alignment:
Step 2) Reconnect this unit with proper breathing
Let's do a little practice together. Just take note of how you are breathing right now. What happens when you inhale? Is your chest lifting? Are your shoulders rising up? Is your belly going in? If you are, you have this disconnect in your core unit. If you are breathing this way, this is called a shallow breathing pattern. The air you are breathing in is not going into your ribs (so this means they are not expanding which is restricting your thoracic spinal movement), and therefore not going into your core and then not into the pelvic floor. This results in not only a weak core and pelvic floor but a hypertonic pelvic floor, meaning it is tight! This is exactly why a Kegel would not be the proper recommendation. Contracting an already tight muscle will just contribute to the symptoms and the dysfunction.
Pelvic Floor Exercises For Women
Let me talk you through how to breathe properly and connect this unit to begin working again as one.
Make sure you are in proper alignment as explained in the video above.
➡️ Put your hand on your side rib, any side. Take an inhale through your nose and breathe into that side rib so it expands. Feel your bra strap expand. On the inhale your ribs should expand out to the side.
➡️ Now put one hand on your belly. Inhale through your nose. On the inhale, your belly should expand. Think of inflating a balloon. As you inhale your core canister should expand and fill with air, and on the exhale deflate and narrow.
➡️ Now put a hand on the side rib and one on the belly and feel both expand on the inhale and get smaller, narrower (or that deflating balloon) on the exhale.
Think about letting all the air in, everything expands.
➡️ Now we will focus on the pelvic floor. On the inhale your pelvic floor should be completely relaxed. I’m going to be very graphic with my words so you understand exactly what I mean. Think of the front of your pelvic floor as the vagina and the back side of the pelvic floor as the anus. Now, on the inhale, completely relax those areas, don’t push down, just relax. Now on the exhale lift those areas.
Imagine lifting up a tampon that is falling out or a stool that is falling out. In our Core and Pelvic Floor Restore Program we offer different visuals to help you find what works best for your brain, but for the sake of this article, I kept it graphic and straightforward to make sure there was no confusion of what anything meant.
➡️ Now all of that together
On the inhale
→ ribs expand out to the side
→ belly expands out
→ pelvic floor relaxes
On the exhale
→ ribs come in and down
→ belly comes in
→ pelvic floor lifts
This is called the Core Breath- where your diaphragm, core ,and pelvic floor all work together as one unit. This breathing pattern in itself is a core exercise and a pelvic floor exercise. This is a whole-body core and pelvic floor exercise and solution. It no longer becomes a matter of ‘how many pelvic floor exercises should I do in a day’ or ‘how many times a week should you do pelvic floor exercise’ because this breathing pattern is a pelvic floor exercise in itself, we will work/practice to make it automatic, just like when you walk, you don't really have to think or focus on what muscles are working to keep you moving and balanced, you just walk. It was rough in the beginning and you kept at it . This breathing does take practice and we have a very guided program on how to make it natural again. We restore your natural breathing pattern so you don’t have to even think about it. This will also mean your core will be strong, your pelvic floor function will be restored and will respond accordingly and your spine will also be better protected since the surrounding muscles are working properly. If you are experiencing things like back pain, hip pain, pelvic pain, painful sex, leaking, urgency, diastasis recti, belly bulging, prolapse, and even shoulder pain, and neck pain, this is a sign you have this disconnect. Do you have a little bit better understanding of how working as a unit is the solution compared to isolated contractions? The body is an amazing machine, if we pay attention to the little cues it gives us (pain and discomfort), and make even the most minor adjustments, we can restore strength and function. Just like any muscle that you are strengthening, once you get the basics down, we add more resistance to increase strength. Like any regular exercise such as a squat, you make it harder by adding weight. In training your core and pelvic floor, we add different coordination to this basic breathing pattern to challenge the core and pelvic floor in different ways and in different directions. If you practice this breathing pattern for even just 5 minutes a day, it will become natural to you in a couple of weeks. Most of the women who have completed our Core and Pelvic Floor Restore program find relief from their symptoms in the first 2-3 weeks! Once the program is completed (takes about 3 months) I give a weekly maintenance class that is only 30 minutes just to make sure we keep things functioning as they should. Just as anything we keep in prime condition, needs a little upkeep. Experience for yourself, strength beyond kegels! Learn how to restore strength and function in this holistic whole-body approach! Every woman should be empowered by this knowledge and this program.
About Cheryl Coppa
✔️ A certified Core Confidence Specialist (Core and Pelvic Floor retraining)
✔️ A certified Personal Trainer specializing in women's fitness over 40
✔️ Low-Pressure Fitness / Hypopressive certified by creator Dr. Tamara Rial
✔️ Pre/postnatal corrective exercise specialist
✔️Instructor of the Pelvic Floor Health program, Ola Ka Ola
✔️ 40 years young, wife & mother of 3