Introduction to the pelvic floor and how exercises should be structured

Welcome! This is my pelvic floor master class! This introduction video will explain to you what the pelvic floor is, why it matters, and how this program takes your through 5 stages of exercise, each progressively more difficult, with the end result to be a strong and healthy pelvic floor.

As mentioned, program is decided into 5 stages. In each of the stages, there will be an education video and an exercise video. Make sure you watch the education video first. It will explain to you what exactly you should be thinking about while you are doing the exercise program. In the clinic, we spend as much time on the “education” component as we do on exercise. That’s because research has shown that you experience better results when you understand what and WHY you are doing what your doing. The education video will also explain how if you are doing the exercises correctly. Remember, its all about quality of movement. This is why many women will practice kegels for years and have no improvement! The education video will also give you a set of advancement criteria that you need to achieve before moving on to the next stage. You will complete the exercise video in that stage at least 4x/week until you are able to do all of the exercises while meeting the criteria. This structure mimics how I treat my patients in clinic. I give them only a few pelvic floor exercises, and I follow up with them regularly to ensure they are doing them properly. We ONLY advance to harder exercises when they have mastered the ones they are doing. This ensures their muscles have developed the strength foundation they need in order to progress.

First things first: what is the pelvic floor? The pelvic floor is a set of muscles that make up the bottom of the pelvis. It has three layers which have several functions in the body.

The first layer of muscles is the most superficial later and can actually be felt on the outside of the pelvis. This layer is mostly involved in sexual function. Dysfunction of this layer can greatly affect sexual function, and can also cause pain, burning, or pressure with sitting and light touch (even as light as the feeling of wearing undergarments).

The second layer is known as the “sphincter” layer. It primary function is to act as a sort of transitionary gateway between the first and third layer, and to open and close accordingly. It is primarily involved in continence.

The third layer is the innermost layer of the pelvic floor. This is the part of the pelvic floor that looks and acts like a hammock or trampoline. It is responsible continence, involved in stability of the core, and supports the organs above it. Dysfunction in this layer can lead bladder and bowel incontinence, pain with intercourse, low back and pelvic pain, and prolapse.

When we think about the pelvic floor and what it needs to optimally function, we cannot forget about all of the muscles that attach around the pelvic floor, to the outside of the pelvis. Though it is easy to think of the muscles on the “inside” and the “outside” of the pelvis as two separate systems, we must remember that issues in one can easily give dysfunction in the other, and vice-versa. Therefore, we must consider them one dynamic system and work on both, together, to create the perfect symmetry that is needed for good function.

If you are slightly overwhelmed by the above image, then its purpose has been achieved! The point of the above imagine is to demonstrate just that; that there is a lot going on in this area! Let’s break it down:

At the top you see the diaphragm. The flat, balloon like muscle at the bottom of the rib cage. When you contract it, its flattens down towards your belly button, which causes air to come into your lungs, ie. the diaphragm is the muscles that makes us breath.

At the inside of the pelvis. The muscles that run along the bottom of the pelvis are your pelvic floor muscles. This picture is a simplified version of all of the muscles. In reality, there are many small muscles that make up the pelvic floor.

On the outside of your pelvis. There are approx. 36 muscles that attach around your pelvis. This picture shows that muscles come and go from the pelvis, attaching anywhere from the back, the front, up the spine, and down the legs. The point of all of this is to show you how important it is to “isolate” the pelvic floor muscles during these exercises. It is much too easy to contract a muscle that is next to the muscle that we are trying to target.

Complete and Continue