Pelvic floor training improves sexual health; get to know – 03/08/2023 – Equilibrium

The pelvic floor muscles are perhaps the most important muscles not exercised in a workout. Like a springboard that sits at the base of the pelvis, they contribute to overall core strength and hold various organs in place – including the bladder, bowel and, for some, the vagina and uterus – ensuring they function properly.

However, many people don’t even know these muscles exist, says Amy Park, chief of female pelvic medicine at the Cleveland Clinic — at least not until they stop working properly. “There’s a general lack of awareness about the pelvic area,” Park points out. “I educate women several times a day about the fact that we have pelvic floor muscles.”

They may not be as visible as the triceps or quadriceps, she says, but they’re vital for everything from basic functions like going to the bathroom, to sexual health, to sitting and standing — and they benefit from workouts that target fitness. .

The pelvic floor is “as important in your daily life as the Achilles tendon is for running, because we use it for everything,” says Liz Miracle, head of clinical quality and education at pelvic floor physical therapy provider Origin.

Historically, talking about this region of the body, even with doctors, seems strange to many. That shyness has caused years of unnecessary suffering, says Evelyn Hecht, a pelvic floor physical therapist in New York who began practicing in the 1990s. Many conditions could be treated or simply prevented if women would feel more comfortable discussing their symptoms or if the public were better informed about these muscles.

Nearly 1 in 3 American women suffer from a pelvic floor disorder, most commonly in the form of urinary incontinence, bowel incontinence, pelvic pain, pelvic organ prolapse, or some combination of these problems.

But pelvic floor problems are not inevitable. Many can be prevented or mitigated by regularly stretching and strengthening these muscles. Most of us can reap the benefits of “a personal pelvic floor trainer,” says Lauren Streicher, medical director of the Center for Sexual Medicine and Menopause at Northwestern University.

Miracle, who is also a physical therapist and a personal trainer of sorts for the pelvis, recommends that all women who are not currently suffering from a disorder or injury to these muscles incorporate six basic exercises into their routine, aiming to do at least three of them. Times a week.

1. Diaphragmatic breathing

Learning to move the diaphragm is the key to connecting and conditioning the pelvic floor muscles.

• Sit on a chair with your feet flat on the floor. Place one hand on your stomach and the other on your chest.
• Inhale and feel your belly expand, then exhale slowly through your mouth. (Imagine a balloon in your belly: as you inhale, the balloon fills with air; as you exhale, the air is released slowly, as if your thumb were covering the opening and gradually letting it out.) Repeat 10 times.

2. Stretching

Relaxing and stretching the pelvic floor muscles so they reach their full range of motion is especially important for basic functions like using the toilet effortlessly (avoiding constipation) and having pain-free penetrative sex.

• Lie comfortably on your back with your knees bent and feet flat on the floor.
• Begin diaphragmatic breathing by inhaling deeply and allowing air to fill the bottom of the lungs. Feel your lower belly, lower back and pelvic floor gently stretch – or lengthen – outward with your breath.
• Exhale slowly through pursed lips, allowing your belly, back, and pelvic floor to passively relax. Do not contract any muscles during exhalation; keep your pelvic floor fully rested. Imagine the aforementioned balloon expanding 360º in all directions as you inhale. One of these directions is down between the legs and towards the perineum (the area between the vagina and anus). As the belly passively rises, the perineum also passively inflates and expands. Repeat 10 times.

3. Sitting Kegel

While the previous exercise helps us relax the pelvic floor muscles, kegels train us to contract them. This exercise helps us to hold urine, stool or gas when we feel the urge to go to the bathroom and also works to increase the resistance of the pelvic floor muscles so that they are able to support our organs and balance the pressure exerted on the pelvic floor. abdomen throughout the day.

• Sit up straight, with your feet flat on the floor.
• Inhale through your nose, relaxing your pelvic floor as your belly and ribcage expand.
• As you exhale, contract and lift your pelvic floor muscles, maintaining the contraction during the exhalation. Hold the position for 10 seconds. It can help to imagine the muscles contracting that stop the flow of urine in the front and trap gas in the back — or to imagine them picking up a marble and holding it in there. Use the muscles inside your body rather than simply squeezing your thighs or buttocks together.
• Fully relax for 4 to 10 seconds – or longer if you need to. Release is important, as contracting the muscles without fully releasing them can make them overly tense and restrict your range of motion. Complete three sets of 10 repetitions.

4. Fast moves

This exercise builds on Kegels, training the pelvic floor muscles to contract rapidly—a skill that allows them to respond effectively to sudden, automatic bodily functions that create pressure within the abdomen, such as coughing, sneezing, or laughing. (It can also help prevent incontinence or “leakage” from this pressure.)

• Sit up straight, with your feet flat on the floor.
• Repeatedly contract and relax the muscles that stop the flow of urine, doing at least seven contractions in 10 seconds. Complete at least 30 grips and releases.

5. Make the ‘Shhh’ sound

While quick movements train the pelvic floor muscles to respond quickly to bodily functions that put pressure on the abdomen, this exercise helps build strength and endurance in the face of that pressure.

• Sit up straight, with your feet flat on the floor.
• Inhale through your nose, relaxing your pelvic floor as your ribcage and belly expand.
• As you begin to exhale, contract and lift your pelvic floor muscles, then make a quick, forceful “shh” sound with your mouth, maintaining the pressure.
• From there, exhale fully and slowly with your lips pressed together, allowing your belly, back, and pelvic floor to passively retract. Complete three sets of 10 repetitions.

6. Exercise your belly

This exercise targets the transverse abdominis muscles, which sit in the lower abdomen and support the core. They work with your pelvic floor muscles to help you sit, stand, and do any exercise that requires balance or stability.

• Start on all fours, with your hands in line with your shoulders and your knees with your hips. She focuses her gaze on her hands.
• Inhale, filling your belly with air and relaxing it towards the floor.
• Exhale and pull your navel towards your spine. This should activate the transverse abdominis muscles. Keep your back straight throughout the movement. (Imagine that your belly is again filled with air, like a balloon – now squeeze the air out of the balloon using your abdominal muscles, squeezing them against your spine.) Repeat 10 times.

Translated by Luiz Roberto M. Gonçalves