Grace Lillywhite on protecting your pelvic floor

If you have ever had a baby or experienced pelvic floor problems, it is likely you have at some point been told to ‘do your pelvic floor exercises’ or kegels. This relates to the tensing and relaxing of the pelvic floor named after the gynaecologist who first studied them.

There is lots of evidence to show that there can be benefits from doing these exercises but it’s important for us to understand that this is not the only way to work on your pelvic floor. We can improve pelvic floor function by addressing the body holistically and we can get amazing results by working like this!

Your pelvic floor is not just an isolated muscle that works on its own - it is part of the whole body system and so we shouldn’t be looking at only working it in an isolated way. Posture, daily movement habits, breathing and exercise all have an impact on our pelvic floor and so addressing these can make huge changes to how it functions.

Posture

The way we sit, stand and move has an effect on our pelvic floor. When we slouch, we put extra pressure into the pelvic floor so addressing posture is vital. When we sit with our pelvis tucked under, it shortens the fibres and causes tension in the muscles which stops them working effectively.

Breathing

Our breath patterns have a huge impact on our pelvic floor health. When we breathe in, the pelvic floor moves down and lengthens, when we breath out, it lifts up and contracts. It works in opposition to the thoracic diaphragm and the two muscles form the top and bottom of our core. If our diaphragm and/or rib cage have restrictions this can mean excess breath moves into the belly and pelvis and creates an increase in the pressure that goes into the pelvic floor. When we exhale and the pelvic floor moves upwards, we can co-ordinate movement with the breath to help to strengthen the pelvic floor. I often use the term ‘exhale on the effort’ so for example if you are lifting up a heavy bag of shopping, do this as you breathe out and this will provide you with more support for the pelvic floor.

Daily movement habits

Here are some tips that will help you to look after your body, even on the days when you don’t have time to do something more formal. Remember, don’t put too much pressure on yourself! Just move mindfully when you can.

When sitting: Be mindful of the back of your ribcage aligning over the back of your pelvis. Sit on top of your ‘sit bones’ allowing your tailbone to untuck.

When standing: Be aware of the position of your pelvis in relation to your feet and ribcage. Try to keep your pelvis aligned over your ankles. When you move to stand from lying on a bed, or the floor, always roll to the side, rather than ‘doing a sit-up’.

When using the toilet: Reduce the need to strain by elevating your feet on toddler steps, books or a squatty potty.

When picking things up: Avoid ‘loaded rotation’, or twisting, whilst picking up something heavy. Squat when lifting, rather than bending at the waist, to reduce pressure on your back. Try not to ‘flare’ your ribcage when you reach up to take something from a kitchen cabinet. Use your breath to support you each time you pick up something heavy. Exhale on the effort to help your pelvic floor and abdominals control the Intra-Abdominal Pressure that is created.

When carrying heavy items: Try not to balance heavy things you are carrying on your hips to take their weight, if you can carry them in your arms, even for as little as 5 minutes, this will be as useful as just 5 minutes of exercise.

Grace Lillywhite is the founder of Centred Mums and has been teaching Pilates for thirteen years. She specialises in Women’s Health and can’t imagine a job that is more enjoyable or rewarding! Grace has taught in Pilates studios throughout London and has lectured for the Pilates Foundation on postnatal wellbeing, pelvic floor health and Pilates for Menopause. She was a UK faculty member for The Center for Women’s Fitness from 2018 - 2022 before leaving to start her own teacher training programmes. Grace has appeared in Women’s Health magazine, Stylist and Fabulous as well as contributing to the books Move More At Your Desk and Your Postnatal Body. Grace’s mission is to teach as many women as possible to tune into their bodies and learn to exercise in a way that is nourishing and energising. Her online programmes Pelvic Confidence and Pelvic Habits are helping women to stop leaks, reduce prolapse symptoms and feel confident in their bodies again. www.centredmums.com