How familiar are you with your pelvic muscles? For many, becoming pregnant or having a baby is the first time considering this part of the anatomy. Curious about what you need to know about your pelvic muscles and how to care for them during pregnancy and beyond? I’m a pelvic floor physical therapist, aka an expert on all things related to the pelvis and the muscles attached to it. Let’s talk about it!
What is a pelvic floor?
First, when we talk about pelvic muscles, we are really talking about something called the “pelvic floor.” Your pelvic floor muscles are a group of muscles that line the bony pelvis and act as a hammock for your internal organs including your bladder, uterus and rectum. Besides offering physical support and stability, these muscles work together to control your urethra and rectum, helping you stay continent (no leaking). The muscles also have an important role during sexual activity. During pregnancy, the newly added weight of a baby can strain the pelvic floor muscles over time, causing them to weaken. Combine that with constipation, a common symptom during pregnancy, and the pelvic floor muscles may not function at their best, resulting in pelvic floor dysfunction. This dysfunction could look like urinary leakage, fecal/gas leakage, vaginal/pelvic heaviness, pelvic pain, abdominal discomfort, or lower back pain.
Photos by: Zita Laura Szasz
How can I protect my pelvic floor during pregnancy?
We cannot change the added pressure to the pelvic floor muscles during pregnancy, but here are some things we can try to control in order to reduce or prevent pelvic floor dysfunction. We know that constipation can strain and weaken the muscles, so if you experience this, it is important to address it right away. You can try to resolve this with regular exercise, correct toileting posture, and magnesium supplements (always check with your doctor before adding in a new supplement). A pelvic floor physical therapist can guide you on how to properly and safely exercise during pregnancy. Additionally, they can teach you how to set up correct toileting posture. Regular exercise can also help strengthen your pelvic floor muscles. Learning if your muscles need to be strengthened is something that your physical therapist can assess during your initial evaluation to determine what exercise program is best for you and your body.
Can pelvic floor physical therapy help with labor and delivery preparation?
Yes! During your prenatal physical therapy sessions, your physical therapist can teach you how to coordinate your pelvic floor muscles with your breathing, exercise to help the baby move into the most optimal position, and to perform labor exercises. Your physical therapist can also show you some pain management techniques, as well as teach you various pushing techniques, delivery positions, and perineal stretching.
Is there something I can start doing at home right now?
Something that you can begin working on anywhere is learning how to coordinate your breathing with pelvic floor muscle movement. If you have a minute or two, give this a try. Let’s begin with something called “diaphragmatic breathing.” It is easier than it sounds!
Diaphragmatic Breathing Exercise
Get into a comfortable position of your choosing, whether that is sitting, lying down on your back, or in a reclining position. Place one hand on your chest, and your other hand at the top of your abdomen, by the bottom of your rib cage. Take a few normal breaths first.- Next, on your inhale, allow the air to slowly fill your belly and feel your abdomen rise.
- As you exhale slowly and fully, let everything settle back into a resting position.
- Repeat this a few more times. You should barely feel the hand on your chest moving. However, with the hand on your stomach, you should feel your abdomen expanding and filling with air.
Now let’s try adding in pelvic floor relaxation and lengthening:
- Begin to perform diaphragmatic breaths, allowing air to fill your belly, lower back, and all the way down into your pelvic floor. The goal is to feel your pelvic floor muscles “lengthen” or open. It may help to imagine an elevator slowly going all the way down to the bottom floor.
- On your exhale, let everything settle back to its resting position. You may feel the muscles move back “up.”
- Repeat the steps above, allowing the pelvic floor to expand in a down and outward movement on each inhale.
- Extra tip: If you’re brave, it may be helpful to use a mirror and watch your vaginal opening expand as you inhale, so you can see that you are doing it correctly
Be Patient with Yourself & Pelvic Muscles
Depending on what your pelvic floor muscles are doing, you may or may not be able to feel movement at first. Be patient and continue to practice. If you’re having trouble with this breathing exercise at any point, check in with a physical therapist.
If you are interested in learning more about how you may benefit from pelvic floor physical therapy, you are welcome to schedule a free consultation with me, Mariam, or get on the mailing list to learn about upcoming prenatal & postnatal fitness classes. Feel free to email Mariam@TahaPT.com or reach out via Instagram @TahaTrainingandPT.
About The Author
Mariam is a Doctor of Physical Therapy specializing in pelvic health and owner of Taha Training and Physical Therapy. Mariam received a Bachelor’s Degree in Exercise Physiology and Doctorate of Physical Therapy from the University of Massachusetts Lowell. She has done extensive continuing education coursework in pelvic health and has a Certificate of Achievement in Pelvic Health from the American Physical Therapy Association. She is also a strength and conditioning specialist. Mariam always strives to make physical therapy an enjoyable experience and is motivated by working with a variety of patients. She believes in helping everyone achieve a healthier lifestyle.
Taha Training and Physical Therapy offers prenatal and postpartum physical therapy, personal training, and small group training. They specialize in pelvic floor therapy as well as labor and delivery preparation. Sessions are offered virtually and in-person at their Brookline location. Check out their website to schedule your free consultation to learn more!
**Photos by: Zita Laura Szasz**
