How to do Core & Pelvic Floor Exercises Correctly
As a woman, your core & pelvic floor muscles are incredibly important. The pelvic floor muscles have 4 vital functions- they control our bladder & bowel, support our internal pelvic organs (preventing prolapse), have a sexual function and work with our deep abdominal muscles (called Transversus Abdominis) to stabilise our pelvis & spine.
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How to do Core & Pelvic Floor Exercises Correctly
Understand your anatomy
Before we get into how to do core & pelvic floor exercises correctly, let’s start with a little anatomy lesson. Your pelvic floor muscles run from your pubic bone to your tailbone, forming a sling at the base of your pelvis. They wrap around your front passage (urethra), middle passage (vagina) and back passage (anus).
Along with the pelvic floor, the deep abdominal muscles make up part of our “core”. They run deep to the internal oblique muscle, wrapping around the trunk from your ribs to pelvis. Your deep abdominal and pelvic floor muscles co-contract, which means when one contracts, the other does too.
Start with optimal posture
To achieve the strongest possible core & pelvic floor contraction, you need to do your exercises with optimal posture. It’s a waste of your time trying to do them slumped on the couch!
The most function position to do these exercises is sitting and standing, but you can also do them in lying. When you’re sitting, make sure you sit on a supportive, firm surface and sit up tall. When you’re standing, place equal weight through both feet and stand up tall.
How to activate your deep abdominal muscles
Sitting or standing up tall, place your fingers just inwards of your hip bones.
Now imagine you have a string between your hip bones, and gently draw your hip bones together, as if you’re shortening the string.
When you do this you will feel a slight bulge underneath your fingers.
You shouldn’t feel your belly button sucking into spine, as this is activating your superficial muscles rather than your core.
The activation is subtle due to this muscle being deep to the spine.
How to activate your pelvic floor muscles
When you do a pelvic floor contraction you need to focus on lifting your pelvic floor muscles rather than squeezing. This is because squeezing tends to bring on your bum muscles, inner thighs or upper abdominal muscles, which should all remain relaxed.
A pelvic floor contraction can be broken up into 3 parts:
- Lifting up around the front passage as if you’re stopping the flow of a wee.
- Lifting up & closing the opening of the vagina as if you’re pulling up a tampon, and
- Lifting up around the back passage as if you are holding in wind.
Each time you contract your pelvic floor you need to engage all 3 areas so you can achieve a maximal contraction.
Relaxation phase
The relaxation of your core & pelvic floor is equally as important as the contraction. After you have lifted your pelvic floor, you need to release the muscles completely, back to their resting position.
Sometimes the release can feel harder than the lift, so take 1-2 deep breaths into your belly to ensure you fully let the muscles go.
Similarly make sure you don’t walk around holding your pelvic floor or abdominal muscles on, as this will only create tension in the muscles & likely dysfunction.
Breathing
Before you contract your core & pelvic floor, take a breath in, then as you breath out engage your muscles as described above. When you hold the contraction your aim is to keep breathing naturally and try not to hold your breath. Breathing will get easier as you practise!
Slow and fast exercises
Our pelvic floor muscles are made of 2 different types of muscle fibres- slow & fast twitch fibres. The slow fibres are the endurance part of the muscle, and the fast fibres allow us to cough, sneeze & jump without leakage. We need to work both.
1. Slow holds: engage your deep abdominals muscles and lift your pelvic floor (as described above) & hold this contraction for as long as you can, until you feel your muscles start to fatigue, then let the muscles go.
This is likely to range between 1-10 seconds. Make sure you don’t try to hold your muscles past their limit, as your upper abdominals or bum muscles may switch on instead.
Repeat this 3 times, counting the number of seconds you can hold each time. Take the average of the 3 attempts. This number is your endurance- make sure you remember it for later!
2. Fast contractions: lift your pelvic floor muscles & instead of holding them, release them straight away. Repeat this 10 times so the pelvic floor moves “on-off-on-off” etc.
Make sure you relax your muscles completely between each contraction.
Your exercise regime
To strengthen your core & pelvic floor, you need to do 10 repetitions of the slow holds (holding for your endurance established above) and 10 repetitions of the fast contractions, 3 x day in the different positions- sitting, standing & lying.
You can also incorporate the exercises into Pilates & gym work, activating your core muscles before the hardest part of the movement/exercise.
Assessment with Women’s Health Physiotherapist
To reliably determine if you’re doing your exercises correctly, I highly recommend being assessed by a Women’s Health Physiotherapist, who does internal examinations (or uses a Real-time Ultrasound machine).
This way the Physiotherapist can feel your muscles & give you exact feedback.
About Anna
Anna Scammell is a Masters-trained Women’s Health Physiotherapist in Sydney, Founder of The Whole Mother and new mum to a beautiful baby girl.
Anna specialises in pregnancy, postpartum & the pelvic floor in women of all ages, offering home visits, clinic consults and online sessions.
She is also the Founder of The Pregnancy Academy and The Postpartum Academy – online programs teaching women how to have a healthier pregnancy, informed birth and an empowered, stronger recovery.
Join now so you can chat to Anna and ask her about any concerns!
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