Stage 1 Education

Welcome to stage 1.

This stage is all about relaxing the Pelvic Floor and getting it moving through basic range of motion. Contrary to common beliefs, many women have a tight pelvic floor and not a weak pelvic floor. If you have been practicing kegels with no improvement, it is very possible that it is because you do not have a strength problem and instead have a muscle tone problem. Basically, you could have knots in your pelvic floor that stop you from being able to contract the muscles properly. In this stage, we use deep breathing as a way of stretching out these knots and mobilizing the pelvic floor. If you do not have muscle knots, and actually have a weak pelvic floor, this stage will is also necessary to start moving the muscles and “prepping” them for recruitment.

If you have just given birth, have a lot of pelvic pain, or are experiencing a lot of stress, you may need to stay in this stage for several weeks. This stage is all about reducing irritation and pain levels and prepping you to be able to contract the pelvic floor properly.

Alternatively, you might find this stage "easy" and be able to complete the exercise video while achieving the advancement criteria right away. If this is the case, you are ready to progress to the more challenging stage 2.

In this stage we use breathing to help relax the pelvic floor (as described in the education video above). The below image shows what happens to the diaphragm when we are deep breathing, as taught in this stage. When we breath in, it moves down, creating a downward force on our organs, and pelvic floor below it. This stretches out the pelvic floor. When we breath out, the diaphragm relaxes and the downward force reduces, allow the pelvic floor to move back to its resting position.

Stage 1: Frequently Asked Questions

Stage 1 seemed easy! Why was it so basic?

Good! We hope it was! Stage 1 is considered the most basic of all the stages. But, just because it is basic, does not mean it is not extremely beneficial and necessary. The pelvic floor must be able to move and stretch in order to start strengthening. Skipping this step will lead to issues down the line. Any program that does not start with ensuring the pelvic floor is not "tight" and jumps right into strengthening is not following recent suggestions in research. If this step was easy for you, and you are sure that you completed it properly, then that simply means you are ready to build on the solid foundation that you have just ensured that you have

I was able to do the stage 1 exercise video properly based on the advancement criteria after the first try, do I move on to step 2?

Yes! If you are able to complete the entire exercise video properly, without dysfunction, based on the advancement criteria, then you are ready to move on. In some cases, this might mean you are technically ready to move on after only completing the exercise video once. That being said, we recommend you stay in each stage for at least a week and therefore complete the video the recommended 4x/week, just to be sure before moving on. Remember, it is all about quality of movement. Powering through all of the stages without ensuring you are doing them properly will lead to no improvement.

You repeat some of the exercise many times. I find I am doing the same exercise for 2-3 minutes. This is not very exciting. Is this necessary?

You are right, this is not thrilling stuff! But it is absolutely necessary! In fact, this is one of the reasons that following an exercise video is so beneficial. It forces you to repeat your exercises the necessary and recommended amount in order to gain maximum benefit. In order for an exercise to be beneficial, it has to be repeated again and again. Lack of adequate repetition is one of the leading causes of failure in an exercise program. Unfortunately, many women think they are repeating an exercise enough, but in reality, they move on too quickly (life is busy, and it is amazing how many of us think we are holding a stretch for 30 seconds, but actually just speed count to 10). If you follow the videos exactly, you can be sure that you are completing the recommended sets and repetitions for maximum gain. Let us do the counting. You just come along for the ride!

I have seen other postpartum programs with hundreds of hour-long exercise videos. Why are there only 5 stages and why are the exercise programs only 10-15 minutes?

This program is boiled down to the basic functional movements that a pelvic floor needs to do in order to function optimally. When you walk into a Pelvic Floor Physiotherapists office, you are not given hundreds of exercises. You are given only a few that very specifically target different areas of your pelvic floor. You are then told to practice those few, and are only given progressions to those exercises once you are able to execute them properly. Specificity, repetition, and quality of movement are some of the highest influencing principles when it comes to optimizing muscle performance. They are therefore the building blocks of this program. That is why the educational component is such a key factor in this program.

Many programs that go through hundreds of different exercises are actually just enabling you to practice hundreds of different ways of NOT engaging your pelvic floor properly. The methods taught in this program will NOT teach you “100 different exercises to get a 6 pack”, but it WILL teach you how to do those 100 different exercises without leaking. When you progress quickly through hundreds of different exercises, it can result in you continuously practicing (that is, without engaging the right muscles in the right way). You can think of this program as building back your pelvic floor as the foundation of your body. Not rehabilitating your pelvic floor after having a baby is like building a mansion on a crumbling foundation. You can have strong and beautiful walls (or a long and lean body), but with no foundation (pelvic floor), there are going to be some issues down the road…and some leakage.

What kind of issues can come from pelvic floor dysfunction?

The pelvic floor is a set of muscles that makes up the bottom of your pelvis and runs from the tailbone to the pubic bone. The muscles act as part of the core, stabilizing and supporting all of the contents above it (from your muscles to your organs!). The pelvic floor muscles can be injured or stop functioning just as any other muscle in the body can. Trauma, increases in load and pressure inside the pelvis, and lifestyle changes can majorly affect the muscles (notice that all of these things happen when you have a baby?). Dysfunction of these muscles can cause incontinence, pelvic pain (including pain with intercourse), constipation, back and hip pain, and pelvic organ prolapse.

If a weak pelvic floor, will the relaxation and stretching exercises in this stage make it worse?

No. Most likely not. Most women have a little bit of weakness and tightness. It is rare for a pelvic floor to be only weak, or only tight. The pelvic floor is complex and full of many muscles at different angles that function differently (refer back to the picture in the introduction video). If you are someone who has a very weak pelvic floor and stretch it with deep breathing, it is very unlikely to get worse. In fact, deep breathing mimics some natural reflexes that can help to initiate and engage the muscles and ultimately help with strengthening. Fear not!

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