A physio’s favourite pelvic mobility stretches
Brisbane physiotherapist Lissy Changuion takes us through her favourite exercises and stretches for pelvic mobility and flexibility – and why this is so important. Keep reading to find her photos and instructions to guide you.
The pelvic floor muscles attach between our pubic bone and tailbone, positioned in the base of our pelvis. Based on where this muscle group is located and attached, the pelvic floor muscles interact very closely with adjacent joints and muscle groups.
For muscles to be functional and strong, they need to have flexibility. We also need our muscles to be at an ideal length so that they can ‘optimally’ activate and produce force. By having optimal (great) muscle length and mobility (ability to move) around the hips, pelvis and lower back, we can help our pelvic floor muscles to beat an ideal pelvic length in order to work well.
A common example I use to explain this is when we suspect ‘overactive’ pelvic floor muscles. Imagine a biceps curl (when you bend your elbow). If you were to try and engage your biceps when your elbow is very close to a bent position (shortened muscle position), you would not be able to produce nearly as much force as when your biceps muscle is in an optimal muscle length position (at 90 degrees bent).
Tension in the pelvic floor muscles (PFM), is often referred to as an ‘overactive’ or ‘hypertonic’ pelvic floor. This is when there is increased tension in your PFMs at rest or a reduced ability to relax the PFMs. Please note, just because pelvic floor muscles are ‘tight’, does not mean they are ‘strong’.
Common signs and symptoms which we observe in clinic include pelvic pain, inability to feel a pelvic floor muscle contraction, pain during or inability to have sexual intercourse, and more. Read more about the hypertonic pelvic floor on Pelvic Floor First.
This is a fairly common condition, but one that many people do not know about or understand fully.
Thankfully, many cases will respond to treatment for symptoms. If you experience any of the signs or symptoms, it is recommended to consult with a Pelvic or Women’s Health Physiotherapist.
Treatment with a physiotherapist may involve learning the correct technique of how to relax the pelvic floor muscles, along with improving mobility and muscle length of the pelvic floor, hips and lower back.
Some of my favourite daily stretches and mobility exercises are shown below. These are beneficial for general mobility even if you don’t experience any overactive pelvic floor muscle symptoms. Give them a try!
Cobra exercise – great for lower back stiffness. Lying on your stomach, gently push your chest off the floor to a comfortable position. Can be completed on elbows, or on hands for an increased stretch. Hold for 15-30 seconds, repeat x 5.
Widened child’s pose
Widened child’s pose – stretches hips, thighs, PFMs and is a great relaxation pose for breathing. Bring your pelvis to touch your heels in a child’s pose. Gently open your knees apart to a wide and comfortable position. Focus on slow, deep breathing. Hold for 30 seconds, repeat x 5.
Hip flexors stretch
Hip flexors stretch – helps lengthen hip flexors. Place one foot forward, with your opposite knee on the floor. Keeping your hips facing the front, lunge forward towards your front knee. Hold each for 30 seconds, repeat x 3 (each side).
Cat/Camel (1&2) – improves thoracic spine and lumbar/pelvic mobility. Start on your hands and your knees. As you inhale, draw your belly button towards your spine and arch your back. As you exhale, allow your stomach to relax down, allow your spine to lengthen and stick out your tailbone. 15 reps, 2 to 3 sets.
Glute/pelvic hip stretch
Glute/pelvic hip stretch. Lying on your back (or seated), place one ankle onto your opposite knee. Gently push this knee away from your chest until you feel a light stretch. Hold 30 seconds, repeat x 3, each side.
Supine dead bug
Supine dead bug – This may not be suitable for moderate to severe cases of pelvic organ prolapse. Please consult with your health professional if you are unsure. Lying on your back, bring your feet into the air. Using your hands, gently pull your feet apart to open your pelvis towards the sky. Hold for 10 to 30 seconds, repeat x 5.
Diaphragmatic breathing – relaxed and correct breathing technique is important to help us let go of increased tension in PFM. While it is important to contract PFMs, it is especially important to ensure that we are ‘relaxing’ them and able to fully let go of this activation. Deep breathing also helps with stress management which can be very beneficial for overall relaxation.
Find a comfortable position lying down and place your hands on your lower rib cage. Focus on inhaling through your nose for five seconds and exhaling through your mouth for five seconds. As you inhale, feel your ribcage expand and focus on relaxing your PFMs. Visualise yourself letting go of any tension you may be holding onto within the pelvic floor.
As you exhale, gently engage and contract your PFMs. Repeat this relaxed (inhale) and contracted (exhale) for the count of 10 breaths in and out. Rest then repeat 10 times. Your whole body should feel more relaxed after this, and hopefully you were able to notice the difference between your relaxed PFM and your activated PFM.
Written by Lissy Changuion, Physiotherapist in Women’s Health @lissychanguion