Hi, I'm Michelle Kenway and welcome to Pelvic Exercises. Today I'm going to teach you some
strategies to find and feel your pelvic floor muscles working. If your pelvic floor muscles
are weak (or if you've never exercised them before) it can be really hard to know whether
you're actually contracting those muscles at all, or whether you're doing the exercises
correctly. It's really important that you know how to find the muscles and feel them
before you start exercising them.
Before we start doing that, I'd like to show you how to find where your pelvic floor muscles
are. This is a pelvis (a female pelvis) just like yours. Just to orientate you, these are
your pubic bones at the front, and this is the tail-bone at the back. Underneath is the
pelvic outlet. Now your pelvic floor muscles actually sling, like a hammock, between the
front bone and the tail-bone, and they're a supportive hammock in through that area,
holding your insides in and helping you with your continence.
So they perform a very important role in that area. There's a couple of layers through that
area, and these bones here are the bones that you sit on. You can see that they're not muscles
outside your pelvis; they're actually inside. They're not your buttocks. They're not the
inside of your thighs. They're actually inside, in and around that area where you sit.
All right, now I'd like to show you some techniques, to find and to feel those muscles working.
The first technique I'd like to show you is a technique that involves you feeling or using
a finger on your perineum, which is the area between your vagina and your anus to actually
feel that area of skin lifting as you contract your pelvic floor muscles.
A proper pelvic floor contraction feels like a lift and a squeeze inside that area. It
feels like tightening and squeezing in through the anus (or your back passage.) It feels
like a lift and squeeze through your vagina, and also it feels like a tightening, squeezing
sensation in and around your urethra (or the urine tube) where your urine passes through.
So that action happens inside, in that sort of an action.
Let's try and do that and find that feeling by actually touching our perineum.
To get yourself comfortable to perform this technique if you lie on your side (and
I'll use a pillow between my legs so I can access that area of my perineum.) Lying on
your side, take your first or second finger and place it on that area of skin between
your vagina and anus. You can do this with clothes on (as I'm clothed now) or you can
do this directly onto your skin. Now if you feel that area (lying comfortably there, make
sure you've got a really nice inward curve in your back,) what I want you to do is try
and lift and squeeze through your back passage. Try and draw up through your vagina. Try and
tighten around the urethra, as you're feeling that area. What you should feel is that the
area of skin above your finger (or that your finger's resting against) just lifts inwards
slightly. Can you feel that as you draw up and in? Can you feel that area just lift inwards
just a fraction? Can you keep lifting it? Can you keep going and keep breathing? Keep
lifting inside and keep breathing, and slowly lower it right down and fully relax. How did
you go? Could you feel those muscles contracting? If you can feel an area lifting, that's your
pelvic floor muscles. If you can feel a bulging, you're probably not doing the right action.
Okay, let's try again. See if you can feel that area between your vagina and anus lifting
up inside. Here we go, ready? And go: Lift it up inside, keep lifting keep lifting keep
lifting and squeezing through that area and keep breathing. Slowly, relax it down. That's
definitely an exercise worth practicing.
All right, let's move on to our second strategy to find your pelvic floor muscles. The second
technique is to help you find and feel the muscles in and around the front part of your
pelvic floor. The area in and around your urine tube (in and around the urethra,) which
can often be very hard to find and feel. The first thing you need to do is sit yourself
nice and tall, so good posture is very important for pelvic floor exercises. The second thing
you need to do is take your hands and place the heel of your hands over those pelvic bones
at the front there. Then point your fingers down in the direction of the pubic bones that
I showed you before. So you're resting your hands gently over your abdomen (you can also
do this exercise lying down if you prefer, too.) What you need to do is try and visualize
or imagine drawing your fingers together and drawing those bones (of your pelvis) together
(the bones underneath your fingers so that they're moving together. Obviously you can't
move your bones, but try and imagine that you're actually doing that and you should
actually feel your lower abdominal area tightening just a fraction.
Let's try and do that. Try and feel that area moving, and those bones moving together and
that area tightening in and around that area.
Can you feel that contraction? Keep holding it. Keep holding it. Can you feel the area
around the urethra just tightening a fraction? and relax down. Did you feel a gentle inward
movement of your lower abdomen? That tells us that you're actually contracting those
lower deep core muscles, as well as some of your pelvic floor muscles.
Let's try that one more time. Hands over your hip bones (your pelvic bones,) fingers over
those pubic bones, and try and imagine drawing your hands together, but using your muscles.
You can also imagine trying to stop the flow of urine, so if you're drawing up and squeezing
through your urethra (that urine passage,) try and hold that there. Keep holding it.
Keep holding. Keep holding and relax down, and rest.
Okay, how are you going with all those techniques? Going okay? Let's start to try and use a third
technique which involves actually feeling the muscles inside your vagina. This is a
technique that physiotherapists use to assist and feel how your muscles are working, and
to check and see whether your muscles are strengthening as well.
So, if you imagine my hand is my vagina, the back vaginal wall is the wall that's closest
to the rectum (or back passage) and the sides of the vagina on the circumference of my hand.
So use one or two fingers (lubricated,) and you can try inserting them (so if I insert
them this way, so you can see what I'm doing,) in and against the vagina to a depth of about
three to four centimeters. What you'll feel is the back wall of the vagina just tightening
and lifting slightly forward against your fingers. It's just a very very gentle movement
(so you'll see just a gentle lifting forward of that back wall as you lift and squeeze
in through your pelvic floor muscles) and down.
If you separate your fingers apart, what you should feel is the sidewalls squeezing together
against your fingers, so a gentle squeeze, inside. You're looking for both actions to
happen at the same time as you contract your pelvic floor muscles (the back wall of your
vagina moving slightly forward, and the sidewalls actually squeezing towards the mid-line.)
Now, the best position to practice this is is lying on your side once again. So let's
go back into side-lying (that first position we were in,) coming down, once again put a
pillow between your legs. Lying right down. Obviously then, you'd be disrobed in a private
place.
Lubricate one or two fingers, and actually use those fingers inside the vagina, against
the back wall or the side walls. Try to draw up and in and try and feel your vagina tightening
and lifting and squeezing as you contract those pelvic floor muscles. Remember once
again it's important to have an inward curve in your back and keep breathing normally as
you hold your pelvic floor muscle contraction.
Let's try that together if you're trying that now. Inserting your fingers into the vagina,
and try to lift and squeeze inside (keep breathing and lifting,) breathing and lifting, breathing
and lifting and then relaxing fully and letting the muscles completely relax back to their
comfortable resting position. Remember it's important to take a moment to rest and recover
your muscles before trying again. You're trying to feel that lifting and squeezing action
(once again, not a bearing down action.) You're not feeling your bottom muscles tightening.
You're not feeling your inside thigh muscles tightening. All that exercise, all that action
is taking place inside your pelvis.
Okay. So let's summarize what we've done today. We've talked about the location of your pelvic
floor muscles, inside your pelvis. We've also talked about some strategies to finding your
pelvic floor muscles. We've talked about using your finger on your perineum to actually feel
a lifting sensation. We've talked about trying to use your hands on the front of your pelvis
and trying to feel a gentle tightening feeling, (a tightening in and around the front part
of your pelvic floor.) Very finally, I showed you how to actually feel the muscles inside
your vagina.
So once again, it's a matter of practicing regularly and finding out which technique
works best for you. You'll find that after practicing using these techniques you should
no longer need to use them as often or frequently when you're practicing, and you'll start to
feel the pelvic floor muscles working without using those techniques at all. Practice makes
perfect.
Here's to your healthy pelvic floor with lots of pelvic floor practice.