Should be obvious right? But statistics show that 66% of women don't know where their pelvic floor is....
I didn’t believe this statistic when I first heard it, but then I started to think about the women (and men) I teach every day in my role as an Adore Your Pelvic Floor Coach... and on reflection this figure does sound about right. Not because we are all totally clueless but because we often think of our pelvic floor as being slightly external to the body like a panty liner. The knock on effect of this is that people then have problems working out how to recruit the pelvic floor and subsequently tend to over recruit their inner thighs, gluteals (buttocks), abdominals….. in fact any thing other than their pelvic floor so they just end up clenching anything and everything they can in a belt and braces effort to achieve the illusive kegel.
So where IS the pelvic floor?.... and WHAT does it do?
The simplest way to describe the pelvic floor is a sling of firm muscle that runs from the tail bone or coccyx at the back of the pelvis forwards to the pubic bone* at the front of the pelvis. The pelvic floor should function like a stretchy, flexible hammock almost like a trampette that supports the pelvic organs (bladder, uterus and bowel) and assists in closing the openings of the bladder and bowel to allow us to control emptying the bladder and bowel untill it is convenient. The pelvic floor also plays a huge part in sexual function and arousal for both men and women. Women's pelvic floors also support the baby during pregnancy and assist in the birthing process. As part of what I call the core canister (pelvic floor, diaphragm, transverse abdominus and multifidi) the pelvic floor is also part of the team of muscles that stabilise the spine and pelvis.
In this image I have highlighted some of the parts of the pelvis the pelvic floor attaches to (the pubic bone at the front and the tail bone or coccyx at the back). I have also highlighted where the labia are and added and arrow to show the distance between the lowest edge of the pelvic floor and the outer edges of the labia. You can see there is a gap between the labia and the pelvic floor. If you bear this in mind when you are trying to recruit your pelvic floor I find this really helps as you start to think of the pelvic floor as being a little deeper within the pelvis, rather than sitting external to the body like a panty liner.
So how should you recruit your pelvic floor?
To get a sense of where this hammock is firstly find your pubic bone…. If your not sure where your pubic bone is take your finger and run it from your belly button down the front seam of your pants until you feel a bone at the middle front of your pelvis... that should be your pubic bone. The same with your tail bone. If you start at the back of the waistband and slide down the back seam of your pants to the top of your butt crease…. you can actually continue down about a further inch until you feel the boney end to the spine curling inwards slightly, but this isn’t necessary.
Now keeping the forefinger of one hand on your pubic bone and the forefinger of the other hand on the tail bone at the back of your pelvis. Here you pretty much have one hand on the front attachment of the pelvic floor and one on the attachment at the back. Your pelvic floor will be creating a muscular hammock between these two points. Hopefully this will give you a good idea of how deep the pelvic floor is within the pelvis. I find many people go wrong because they are treating the pelvic floor as if it is something external to the body like the gusset of their panties.
Most people find the easiest way to feel a pelvic floor engagement is to sit on a firm surface with your feet grounded on the floor. Feel your "sits bones" or the knobbly bones you are balancing on underneath you. Now rock forwards and backwards and observe what happens.... As you rock forward onto the front edge of your sits bones the natural curve at the back of the waist band will increase a little and as rock backwards you will roll onto the back edge of your sits bones and notice how the natural curve at the back of the waistband softens and flattens as your pelvic tucks under a little.
Find a position in the middle where you feel you have good posture, with your head, ribs and pelvis stacked one over the other and you are able to maintain the natural curve at the back of the waistband. Now try lifting the hammock gently up and forward, up and away from the surface you are sitting on, on an out breath or exhalation. A classic cue here is to draw the tailbone forwards towards the pubic bone and gently up. However, I find allot of people tend to tuck the pelvis with this cue so often find women find it easier to think of drawing their vagina forwards and up a little. While men often respond better to the cue of lifting their scrotum up off of the chair or imagine the sensation of walking into cold water as the cold water just reaches their scrotum. The pelvic floor should engage from the back to the front in a forward lifting motion. Then release on the in breath you may feel the contact of the labia or perineum on the surface your are sitting on increase as you relax.
This is just one of the many cues I use when working with clients, but it is very personal and definitely not a one size fits all kinda deal. Its also worth saying at this point that I usually find that when people do "GET" the pelvic floor engagement they are usually surprised how gentle it is, while at the same time how powerful and supportive the engagement feels. But it should never feel grippy or clenching. Remember this is not a big movement, you are only lifting the bladder one centimetre at most.
Maybe you have a cue that you like that works better for you.... I would love to hear it.
There are a couple of other reasons that people have difficulty engaging the pelvic floor.
Clients are often trying to create a movement... the pelvic floor is within the bowl of the pelvis and while it does create a muscular movement and lift your internal organs about one centimetre it is not going to create any movements at the joints... no bones will move. If you are tucking your pelvis when you are doing your kegels you probably working your gluteals not your pelvic floor. Likewise I find people often squeeze their inner thighs together rather than engage their pelvic floor or use their upper abdominals to bear down. In all of these cases your probably not working your pelvic floor, in fact your are probably switching it off.
Another common thing that stops you recruiting your pelvic floor well is trying to hard... as humans we are programmed to over achieve so we approach pelvic floor training with the same gusto that we would use to do squat thrusts or pull ups. The pelvic floor is a group of fairly small muscles that support our internal organs you are not going to get a massively dynamic movement from your pelvic floor..... in fact you're are unlikely to see anything much at all.
The final thing I find commonly stops women working their pelvic floor is they don't know how to release it. If you have clenched your floor into a permanent spasm and tucked it behind your tonsils you're probably not going to feel like you can contract it because its already absolutely rigidly contacted . Diaphragmatic breathing and movements to mobilise the hips, and spine will often help with this and I find women are amazed when they can suddenly "feel" their pelvic floor engaging after you have shown them how to relax it or spent a little time releasing their hips, lower back or thoracic spine.
If you are interested in training with me as a pilates teacher or as an Adore Your Pelvic Floor Coach I'd love to hear from you so feel free to contact me directly. I teach in Edinburgh and the Lothians in Scotland as well as offering online training. https://www.fionacarterpilates.co.uk
To find an Adore Your Pelvic Floor Coach in your area: https://adoreyourpelvicfloor.co.uk/courses/adore-your-floor-course/
If you are interested in training to be an Adore Your Floor Coach: https://adoreyourpelvicfloor.co.uk/courses/teacher-education-classes/
This Blog is not meant to be used as a treatment programme. While I hope you find the information I have shared interesting it is based on what I have found useful in my teaching over the years and the best and most current research. However, you should always seek the guidance of medical professionals in treating any condition.
As a Pilates teacher I am not qualified to diagnose any condition. I would recommend seeking the advice of a good Physiotherapist or your General Practitioner. I would also recommend training with a Pilates Teacher who has completed a in depth training in the field. Pilates courses can vary vastly from short online trainings to three or four year comprehensive full time apprenticeships. don’t be afraid to ask questions about your teachers training and experience.