5 Exercises For a Weak Pelvic Floor

Guest post by OMC Provider Kelsey Dehmer, PT, DPT, OCS  of Therapydia Ballard

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Pelvic floor weakness can happen to anyone, whether you’ve had kiddos or not. It is sometimes hard to keep up with gravity itself and we often forget that just like our biceps, if we don’t use it we lose it. So here are 5 pelvic floor dysfunction treatment exercises that can help you KEEP IT, and avoid incontinence and prolapse as you age.

REMEMBER: Kegels are not for everyone. Although we may all need them at some point in our lives, if you are struggling pelvic pain, urgency, frequency, pain with intercourse, interstitial cystitis, painful bladder syndrome or anything similar, strengthening will not help.

Week 1: Diaphragmatic Breathing

The diaphragm is a dome shaped muscle that forms the floor of the rib cage. It is the most efficient muscle for breathing, but is also the counter balance to the pelvic floor, when it is contracted during an inhale, the pelvic floor should be relaxed, when it is relaxed on an exhale the pelvic floor should be contracted. This insures proper intrabdominal pressure during coughing, sneezing, laughing, etc. If your timing is off, it doesn’t matter how strong your pelvic floor is, so mastering this simple exercise can often be the cure to urine leakage.

How to do This Move:

1. Start by lying on your back or reclining in a chair in a relaxed position. Place your hands around the lower portion of your rib cage.
2. Relax your jaw by placing your tongue on the roof of your mouth and keeping your teeth slightly apart.
3. Take a deep breath in through your nose, focusing on letting your rib cage widen and your abdomen expand. As you breathe in keep your upper chest, neck and shoulders relaxed, relax the pelvic floor as well.
4. As you breathe out through your mouth, allow your abdomen and chest to fall drawing your belly button to your spine as you slowly complete a KEGEL (see below for proper instructions). Exhale completely. Remember to breathe slowly.  Do not force your breathing.

Practice this exercise for 5 minutes. 

Hint: A Kegel can be trickier than you think. Remember that the pelvic floor is made up of 3 layers of muscles that all serve different functions. To complete a proper kegel during your breath work follow these steps:

• Think about closing the door of your vaginal opening to activate the 1st layer
• Next, think about holding back pee and gas
• Lastly, think about lifting up and in, like you are trying to pick up a blue berry with your vaginal opening

If you have never been able to do a kegel or do not know what it’s supposed to feel like, we highly recommend finding a pelvic floor rehab specialist, they can help you find the perfect kegel through use of biofeedback machines and tactile cueing.

Week 2: Hooklying Kegels

Once you have mastered your breathwork, you are ready to incorporate Hooklying Kegels into your weekly routine. For week 2, add this move in addition to the exercise from week 1. 

How to do This Move:

1.  Laying on your back with your knees bent, exhale and kegel. Try to hold the kegel for 10 seconds.
2. Repeat this move 10 times or until the muscles are tired. Give yourself a 30-second break one your muscles are fatigued.
3. Repeat this exercise by contracting your muscles for 1 second to do a quick contraction and then fully relax. Keep repeating this move 30 times or until the muscles are tired.

We want to make sure both fast and slow twitch fibers are worked during this exercise

Repeat this sequence for 5 minutes per day.

Week 3: Sitting Kegels

 Repeat the exercises from week 2, in a sitting position to add gravity to the equation for increased difficulty. 

How to do This Move:

1. Sit in triangle pose, making sure that both of your sit bones and your pubic bone are in contact with the seat in order to achieve a neutral spine.
2. In the sitting position, exhale and kegel. Try to hold the kegel for 10 seconds.
3. Repeat this move 10 times or until the muscles are tired. Give yourself a 30-second break one your muscles are fatigued.
4. Repeat this exercise by contracting your muscles for 1 second to do a quick contraction and then fully relax. Keep repeating this move 30 times or until the muscles are tired.

Week 4: Standing Kegels

Repeat week 3’s move in a standing position to add more gravity to the equation. 

How to do This Move:

1. Stand with equal weight in both legs with legs hip-width apart while maintaining a neutral spine posture.
2. While standing, slowly exhale and Kegel. Try to hold the Kegel for 10 seconds.
3. Repeat this move 10 times or until the muscles are tired. Give yourself a 30-second break one your muscles are fatigued.
4. Repeat this exercise by contracting your muscles for 1 second to do a quick contraction and then fully relax. Keep repeating this move 30 times or until the muscles are tired.

Week 5: Jumping Jacks

Image Source POPSUGAR Studios

For this exercise, you will be combining all of your exercises into one.

How to do This Move:

1. Start in a standing position
2. Prepare for your jumping jack by taking a big breath in, relaxing the pelvic floor, then quickly exhale and complete a kegel right before you complete your jumping jack.

Repeat this move 30 times.

Completing this training series is a great jump start, but if you get stuck at a certain week or find that some of the positions are too hard, then again, please consider seeing a pelvic floor specialist today. There are many factors that can play a role in pelvic floor dysfunction including scar tissue, imbalance of other muscles within the hips and torso, fascial restriction and much more, so if you aren’t making progress, chances are there are other pelvic floor dysfunction treatment options that can be done to get your pelvic floor functioning the way you want it to!