Pelvic Floor for Dummies

In my clinical practice, I meet women daily who do not know what the pelvic floor is and even less about how to work on it as the case may be. It is almost a common denominator of the lack of knowledge about the female genitalia and even more importantly its care.

Here I want to share some tips that I suggest to the women that I am fortunate to accompany in their recovery processes or who decide to work to prevent dysfunctions.

I call it Pelvic Floor for Dummies because they are the BASIC recommendations to keep in mind to train the pelvic floor at a level of awareness and strength, for women who have never worked on their pelvic floor before. There is a note at the end of the post that I leave for special cases and that I recommend getting professional advice before carrying out the exercises

Pelvic Floor for Dummies

1. Mirror it will be the first thing that we will do, know the area involved in work: the vulva (external area of the genitals), the clitoris (the glans, which is the one that we can observe), and the vagina (a hole that connects with the uterus), in some women the opening of the urethra (where the urine comes out) will be visible. Have you ever stopped to look at yourself?
2. ContractHere I make particular emphasis, on why? Many women come to therapy sure that they know how to contract their pelvic floor and realize that what they are doing is pushing it (which we should not do), or they contract hip muscles such as the gluteals or adductors (crotch muscles). . With the mirror you can help yourself to see if the vagina and anus close when contracting. They should not go outside.
3. Don't forget the anus:The most significant amount of perineal musculature is the deep one (levator ani), therefore, in addition to feeling that you are contracting from the vagina, help yourself by contracting the anus. Don't forget to relax your buttocks and crotch muscles. Some images that I usually recommend to carry out the contraction is to imagine that they stop the urine (for more superficial muscles) or that they have a gas that wants to escape and not let it out (for deeper muscles).
4. Breath: While you learn to connect your brain with your perineum, it is normal for you to contract even between the eyebrows! XD While you are having the practice you will learn to contract only the necessary muscles, but NEVER stop breathing. Breathing will be very important during the exercises.
5. Touch yourself: Sensory stimuli help connect the body with the brain, that is, if you touch yourself you will be able to learn how to contract as you get to know your body. You can insert a clean finger into the vaginal opening and feel how the walls of your vagina embrace it while you contract, you can also feel how it strengthens as you work with the days! If you want to do the exercises sitting you can help yourself with a pillow or a fitball, you sit on it and the feeling of the object in your perineum will help a lot.
6. Time: This is a sensitive point to touch. We should be able to contract up to 10 seconds sustained, but in most women this is not the case. What we do in physiotherapy is called PERFECT, it is a way of measuring and having a 4-digit number that helps us measure the fast and slow fibers of each woman. In this way, we could work each pelvic floor in a personalized way, progressing at its own pace and without overloading it. If you don't reach 10 seconds, you have some pelvic floor dysfunction and you haven't had a pelvic floor assessment yet, my recommendation is that you do it now. While you know your PERFECT you can contract the seconds that you can maintain, taking into account the previous recommendations, they can be 2, 4, 6, or 8 seconds, any number is possible and it is also likely that it is not very high, perform the contraction for as many seconds as you can and rest the same number that you hold the contraction, that is, if you contract 4 seconds then you rest 4 seconds. And how long can you do it? About 10 or 15 minutes, 1 or 2 times a day, would be fine.
7. Posture: If you notice the contraction of your pelvic floor very weak, use facilitating postures: lying on your back, lying on your side, in quadruped (on all fours like a dog) or Mohammedan posture (lying on your legs); When you feel stronger, you can start working sitting or even standing.

IMPORTANT! :

These suggestions are not a substitute for pelvic floor therapy. If you have a particular situation such as incontinence, pelvic organ prolapse, pain during intercourse (dyspareunia), the impossibility of penetration (vaginismus), or some other condition that must be attended to by a professional, avoid doing these exercises on your own because they could worsen some dysfunctions, especially dysfunctions associated with pain since they could present with some hypertonus, and strengthening the pelvic floor could make it worse.

If you have any questions, do not hesitate to let me know, and I will read you in the comments. If you want to have a pelvic floor assessment (online or in person) you can book your appointment in the "Schedule your appointment" section or write to me via e-mail or Whatsapp!