Fri 6, Dec 2019

You can’t contract your way to a strong pelvic floor

Everybody likes a 2 for 1 deal! You’ve heard that you can strengthen your pelvic floor just by doing ab, hip or glute work. It sounds appealing, but what does the research say?

A 2018 study, published in Neurourology and Urodynamics, looked at this very question and investigated whether contracting [shortening] muscles other than the pelvic floor would be enough to provide a training effect for the pelvic floor.

The exercises tested included internal rotation of the hips, external rotation of the hips, abduction of the hips, adduction of the hips, contraction of the gluteal muscles, pelvic tilt, indrawing, abdominal crunch, deep inspiration and deep expiration.

The study found that targeted contractions of the pelvic floor muscle produced higher pressure for the pelvic floor than the above exercises. It did identify potential for further research in this area, to see whether exercising these other muscles over time would produce a training effect for the pelvic floor.

In its conclusion, the study did not recommend exercising ‘accessory’ muscles in an attempt to activate the pelvic floor for training, so back to good ol’ pelvic floor muscle exercises we go!

While exercises for the pelvic region can have benefits, Continence and Pelvic Floor Physiotherapist Samara Nanayakkara says it’s important to think about your individual needs before starting.

“Firstly, how do you know if these exercises are going to benefit or harm you? You may have an overactivity or underactivity in the inner thighs, gluteals, lower abdominals and back that could be worsened with these exercises,” she says.

We’ve established that ab, hip or glute exercises aren’t likely to magically give you a stronger pelvic floor, but there is a way for your pelvic floor to work together with these exercises.

You can ‘cue’ your pelvic floor, which is essentially lifting your pelvic floor before you move and relaxing it after.

Samara describes how this action can help.

“Switch on the muscles before you lift, jump or change position. If you are vulnerable to leaking urine or faecal matter, accidentally passing wind, or feel a heavy sensation in the pelvic floor, correctly switching on these muscles during exercise is one way of withstanding that downward pressure,” she says.

“Switching on these muscles will give your lower tummy, pelvic floor and spine more support during your exercise.”

Samara says each person will need different hold times and strengths, so she encourages a tailored assessment with a pelvic floor physiotherapist. They can also help with correct technique and determining whether strengthening your pelvic floor is what you need.

‘Cueing’ the pelvic floor can be done in a number of positions and exercises.

“Some people find that there are better positions to lift their pelvic floor. When you are lying on your back, the pelvic floor is most relaxed and has the least amount of weight on it,” Samara says.

“You can also try lying on your side, in a bridge, on hands and knees, or sitting and standing. Pelvic floor muscle exercises performed in these positions like dead bugs, bridges and squats will feel more stable, as cueing the pelvic floor switches on the lower third of your core at the same time.

“That’s right – your pelvic floor and lower core work at the same time!”

For information, advice and service referrals in your area, you can call the free and confidential National Continence Helpline on 1800 33 00 66.

This story was first published in the Pelvic Floor First eNewsletter.

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The Continence Foundation of Australia is the national peak body promoting bladder
and bowel health.

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