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Dear female readers, happy holiday.
In the clinic, many mothers who balance career and family and insist on exercising are troubled by the same “embarrassing secret” – pelvic floor muscle training.
Friends who have heard and practiced, is the effect also not satisfactory? A cough during a meeting, a jump while playing with the kids, a sudden push of the barbell… awkward things happen.
Friends who haven’t started practicing yet, don’t be discouraged! According to the training methods in the following text, you may be able to find the right feeling for the first time.
Why is the effect of pelvic floor muscle training always not satisfactory?
Many friends think that pelvic floor muscle training is just “squeezing tightly”. But in fact, the way muscles work is not that simple.
1. Effective exercises cannot ignore eccentric contraction
The pelvic floor muscle is similar to a “resilient net” , like a hammock, fixed in the pelvis.
The four points in the right picture, from top to bottom, are the coccyx, a pair of ischial tuberosities, and the pubic symphysis
This net is composed of two intertwined ropes （thick and thin myofilaments） :
Why can’t we just focus on “squeezing tightly”? Let’s look at the muscle movement pattern:
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During concentric contraction (squeezing), these two ropes pull tightly against each other, overlap and shorten, and the “resilient net” will lift up as a whole.
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During eccentric contraction (controlled relaxation), the two ropes slowly slide apart, the “resilient net” becomes longer and thinner, but still remains taut —this is very important, it is the “resilience” we need to cope with the changes in abdominal pressure caused by laughter and coughing.
This is the same principle as fitness. Taking the biceps curl as an example. It is important to bend the arm and lift the dumbbell （concentric contraction, similar to “squeezing”） , but it is also important to straighten the arm controlledly, stably let the dumbbell return to its place, which is also very important for muscle training.
If all the attention is on “squeezing tightly”, it may cause the muscle fibers to remain in a “stuck” state, and even lose elasticity.
2. Effective exercises must first establish “proprioception”
Proprioception (Proprioception) , refers to the brain’s precise perception of the body’s internal state. Let’s test it!
STEP 0 Preparation: Compare with the picture above, imagine our torso as a “container” full of liquid, the top is the diaphragm, the bottom is the pelvic floor muscle, and the surroundings are the core muscles such as the transversus abdominis.
STEP 1 Inhale first: Feel the contraction and descent of the diaphragm, and the abdominal pressure increases accordingly. At this time, a healthy pelvic floor muscle should perform eccentric contraction , like a folding fan opening, naturally expanding and descending from the coccyx to the surroundings, bearing this pressure.
STEP 2 Exhale: The diaphragm rises, and the pelvic floor muscle follows suit performing concentric contraction , lightly lifting and rebounding upwards.
How to scientifically exercise the pelvic floor muscles?
Try these 3 home exercises
Before starting, please remember: “Feeling” is more important than “exerting force”. If the brain cannot correctly perceive the position of the muscles, any high-intensity training is ineffective.
Exercise 1: Lily and Fan Breathing
Awareness and Relaxation Training
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Purpose: To establish the original connection between the pelvic floor and the diaphragm, increasing the elasticity of muscle eccentric contraction.
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Preparation Pose: Lie on your back with slightly bent knees and gently place your hands on your lower abdomen.
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Action: No picture, please imagine according to the text——
Perception Self-test: Do you feel a slight sinking sensation in the pelvic floor when inhaling? This sinking is not a downward pull, but an elastic extension.
Exercise 2: Pelvic Clock and “Seesaw” Practice
Flexibility Training
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Purpose: To activate the mobility of each pelvic joint and establish control over the “keystone” skeleton.
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Preparation Pose: Lie on your back with your knees up.
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Action:
When exhaling and leaning backward, the ischial tuberosities will naturally come together; when inhaling and leaning forward, they will move apart from each other. This small “skeletal dance” can re-calibrate the neural control system.
Feedback Comparison: After completing one side of the exercise, stand up and take a few steps. Do you feel that this side of the leg has become longer? Or does it feel more stable? This is a sign of improved proprioception. (This movement is indeed more complex, and if you can’t find a stable feeling, you can practice under the guidance of a physical therapist)
Exercise 3: Seated Pelvic Floor Fan Awareness
Perception Training
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Purpose: To integrate training into daily life.
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Tool: A rolled-up towel or physical therapy ball.
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Preparation Pose: Sit on a hard chair and place the towel roll horizontally under the two ischial tuberosities.
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Action:
Core Logic: We emphasize the coordination of muscles, not the isolated exercise of a single muscle.With the feedback of the towel, help the brain reshape the control of the pelvic floor “fan area”.
These small habits related to pelvic floor health
are as important as exercise
The health of the pelvic floor is not only about the 30 minutes on the training mat, but also about how to coexist with the body for the remaining 23 hours and 30 minutes.
The “Double Arrow” Rule of Posture Management
The perfect posture is not a stiff chest. Whether standing or walking, two images can be established:
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Down Arrow: Imagine a downward gravitational arrow at the sacrum/tailbone, relaxing the tailbone.
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Up Arrow: Imagine an upward lifting arrow at the pubic symphysis.
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These two opposite forces keep the pelvis in a neutral position, reducing the static burden on the pelvic floor.
Breathing Rhythm During Defecation
When defecating, do not hold your breath and exert force excessively, this will bring huge and destructive eccentric pressure to the pelvic floor.
It is recommended to perform the defecation action while exhaling, using the natural relaxation of the pelvic floor muscles during exhalation, with slight adjustment of abdominal pressure, to protect the “hammock” from being torn.
Avoid “Preventive Urination”
Many women go to the toilet frequently “just in case” (preventive urination) , but this is actually detrimental to pelvic health.
Under normal circumstances, it takes 3 to 4 hours for the bladder to fill up. If the time to urinate is less than 8 seconds, it means you went too early.
Frequent emptying before it is full not only forces the bladder to “overwork” and disrupts its normal physiological rhythm, it also completely disrupts the precise coordination mechanism between the pelvic floor muscles and the bladder, which contracts when storing urine and relaxes when urinating.
Other Toilet Misconceptions
In addition to overexertion during constipation, forcibly tightening the pelvic floor muscles during urination (trying to do Kegel exercises) , and hovering over the toilet for hygiene, all these send “relax and tighten” neural instructions to the pelvic floor muscles, or subject them to extreme abnormal pressure.
In the long run, this is not only bad for the bladder but also weakens the support efficiency of the pelvic floor muscles, and even increases the risk of pelvic organ prolapse.
If you are a sedentary person, or are in the pre-pregnancy or postpartum stage, please pay attention to “mechanical compensation”. Many stubborn back pain and knee discomfort often stem from the loss of pelvic floor power, causing other parts of the body to work overtime.
Finally, I want to emphasize – our muscle strength enhancement almost all starts from neurological changes. When we can accurately perceive the opening and closing of the ischial bones, the slight movement of the tailbone, rather than blindly completing actions or doing, we truly hold the key to controlling the body.
Peer Review Expert Mou Tian
Distinct OB/GYN Doctor Ph.D. from Peking University Health Science Center
Peer Review Expert Wang Ying Sui
Distinct Physical Therapist Bachelor’s degree from Auckland University of Technology, New Zealand
References
Content Editor Falco
