Hi friends! Last week we talked about the ways to find your pelvic floor muscles, so now it’s time to move on to isolating the pelvic floor muscles. It’s important to have awareness of where these muscles are and how to engage them, but it’s equally important to know how to isolate these muscles.
Now there are some varying opinions on the importantance of being able to isolate a contraction of the pelvic floor muscles. However, here are a few of our favorite quotes from a world-renowned physical therapist and researcher Dr. Kari Bø who has published hundreds of papers on pelvic floor research:
“Our reason for attempting to isolate the PFM contraction from outer pelvic muscles when training is not because we do not appreciate that all muscles in the body act together and never work in isolation. However, such simultaneous contractions of outer and more commonly used larger muscle groups outside the pelvis may mask the awareness and strength of the PFM contraction.”
“After having found the PFM, the patient needs to learn how to perform a correct contraction of the PFM. Feedback from the PT is mandatory.”
“Most importantly, to train and build up a muscle or muscle group’s strength and volume it is mandatory to work specifically on the targeted muscle.”
To be clear, pelvic floor muscle exercises focused solely on contracting or relaxing the muscle are often not the only answer to treating dysfunction. Treating pelvic floor muscle dysfunction often requires a comprehensive approach looking at the pelvic floor muscles, the hips, the back, breathing patterns, behavioral patterns, and so much more. But imagine going to therapy for your elbow but only ever doing exercises for the shoulder. The two joints are interrelated, and you may see some improvement; however, you might see more improvement if the therapist had you improving both the elbow and shoulder joints.
Last week, we discussed ways to find the pelvic floor muscles to contract and squeeze them as well as to relax and let go. When practicing turning on or turning off the muscles, it’s important to be able to isolate them. When you squeeze the pelvic floor muscles, do you feel other muscles squeeze, too? Some common muscles that try to “help” the pelvic floor are the butt muscles, the inner thigh muscles, and the abdominal muscles.
During our daily activities, we want our pelvic floor to work alongside other muscles, but we don’t want them to be dependent on other muscles to engage. We want to have the coordination to engage the pelvic floor muscles, either by themselves or in conjunction with muscles of our choosing. For example, we want to be able to engage the pelvic floor muscles when sneezing as we walk down the street to prevent urinary leakage. However, good coordination that allows us to do two things at once starts with being able to do each separate thing well first.
Practice engaging the pelvic floor muscles and pay attention to the rest of your body to see what it’s doing. If other muscles are engaging, try to keep them quiet and relaxed.
It’s important to remember that knowing how to relax the pelvic floor muscles is just as important knowing how to contract them. In fact, if you are suffering from pelvic pain or other issues like constipation, squeezing the pelvic floor muscles may make symptoms worse initially. Those muscle needs to learn how to lengthen and let go before starting to strengthen them.
As you try to relax the pelvic floor muscles, other muscles should also stay relaxed. The abdominal muscles should not tense and you should not bear down to try to relax the muscles—this often causes the opposite effect and encouraged the pelvic floor muscles to tighten.
If you are struggling to contract or let go of the pelvic floor muscles, a pelvic floor physical or occupational therapist can be a great resource. In fact, studies have shown that pelvic floor muscle training with the help of a pelvic floor therapist has been shown to be more effective than training on your own (Felicissimo 2010, Ferreira 2010, Hung 2010). To find a physical therapist near you, ask your providers for a referral or find one at www.mypfm.com/find-a-pt.
Ready to learn more about pelvic health? Here are some helpful resources:
Find a pelvic floor PT or OT near you at www.mypfm.com/find-a-pt
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Watch our YouTube playlist on Pelvic Floor Muscle Training
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The BasicsOrder myPelvic Bra perineal support
Sign up for our email newsletter!
Visit our Instagram page for more on pelvic health.
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources. At myPFM Academy you’ll find courses like:
Pelvic PT Evaluation of the Pelvic Floor Muscles with Dr. Samantha Richter, PT, DPT, WCS
Pelvic Floor PT and OT How-Where-What: How to Become One, Where They Work, and What They Do with Jeanice Mitchell, PT, MPT, WCS, BCB-PMD
New Structure for PFM Assessment Using ICS Terminology with Beth Shelly, PT, DPT, WCS, BCB-PMD
Written by Emily Reul, PT, DPT
References
Felicissimo MF, Carneiro MM, Saleme CS, Pinto RZ, da Fonseca AM, da Silva-Filho AL. Intensive supervised versus unsupervised pelvic floor muscle training for the treatment of stress urinary incontinence: a randomized comparative trial. Int Urogynecol J. 2010;21 (7):835-840.
Ferreira M, Santos PC. Impact of exercise programs in women's quality of life with stress urinary incontinence. Rev Port Saude Publica. 2012;3(1):3-10.
Hung HC, Hsiao SM, Chih SY, Lin HH, Tsauo JY. An alternative intervention for urinary incontinence: retraining diaphragmatic, deep abdominal and pelvic floor muscle coordinated function. Man Ther. 2010: 15(3):273-279.
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