Your pelvic health is incredibly important, but it's not something that we often talk about. There are simple, easy things that you can do at home to help out this incredibly important area of your body.
1. Take a Hot Bath
Life always looks better after a hot bath. It's a great way to relax at the end of a long day. Putting on some relaxing music, lighting a nice candle, or picking up a good book in the bathtub can help calm your nervous system and reduce the stress hormones that we generate through the day. The rosy flush that your skin gets in warm water is the result of blood moving to the surface; a hot bath increases blood flow through the region and can help carry away inflammation. The warm water helps to loosen your tight muscles too, including the pelvic floor muscles and the big muscle groups like the hamstrings, quads, lower back, and more that connect to the pelvis. For extra work, add a little meditation or some light stretching in the bathtub as well, or just sit back and allow the hot water to work deep into your muscles.
2. Practice Deep Breathing
Many of our patients are surprised when one of the first 'exercises' that we often give is how to breath deeply. Most of us are in the bad habit of taking shorter, shallow breaths that mostly move the chest. Instead, we should be focusing on letting the belly expand as we breath in. This lowers the diaphragm, allowing the lungs to fully expand. This type of breathing can actually help relax the pelvic floor as well, restoring normal motion to the lower abdominal region.
Deep breathing is also a great way to relieve stress. The short, quick chest breathing we do is associated with stressful situations, while deep breathing reassures the body that it is safe and comfortable, letting the nervous system start to relax. Start with just five deep breaths, concentrating on filling the belly with air and releasing it slowly. You'll be amazed at the benefits, and eventually breathing this way will become more of a habit, so you'll be unconsciously helping your pelvic floor throughout the day.
3. Act Like a Happy Baby
The pelvic floor is difficult to target directly with most stretches, but one that works directly on the muscles of the pelvic floor is the yoga position 'Happy Baby.' Lying on your back, bring your knees up to your chest and grip your ankles. Practice deep breathing through this stretch, and you'll feel the pelvic floor relax or 'drop'. You can hold this for at least a minute, feeling the stretch in your pelvic floor, inner thighs, and even in your lower back. (Photo courtesy of The Interstitial Cystitis Solution, and Rebecca Beckler of Pilates949)
If you're dealing with pelvic pain, urinary symptoms, or other pelvic floor issues, this stretch can be one of your first 'go-to' moves when you're feeling a flare coming on - for many of our patients it's a major part of their Flare Busting Plan. As a maintenance or preventative measure, this stretch is one of the most valuable. You can also check out the complete PelvicSanity Pelvic Floor Stretching Regimen, but be careful to modify these stretches if they cause discomfort or run them by your pelvic floor physical therapist.
4. Take up Yoga
Yoga is a great way to combine two of the other areas on this list - deep breathing and stretching. The movements of yoga are timed with the breath, forcing you to breath deeply as you move into the different positions. And many of the yoga positions work on stretching the inner thighs, abdominal muscles, lower back, and gluteal muscles that often contributing to pelvic floor dysfunction. If you start taking up yoga, make sure to progress gradually through beginner classes or routines to the more challenging positions. Often 'Restorative' yoga classes spend more time in the different positions and are more about relaxing and flexibility, while 'Flow' classes feature more challenging poses and movements. Consult with a physical therapist or doctor if any of the positions are painful or exacerbate symptoms.
5. Avoid Prolonged Sitting
We've now shifted to being a much more sedentary culture than even a few generations ago - the average American, according to one study, sits for 13 hours each day. Experts recommend making sure we stand at least two hours during the workday, yet many of us struggle to do so. It's not just at work either; much of our leisure time is devoted to sedentary activities like watching television or being on the computer. This takes a toll on the body, slowing our metabolisms, increasing joint problems, raising the risk of heart disease, and more.
The pelvic floor bears the brunt of this daily sitting. When you sit, your glute muscles slide up, leaving all of your weight resting directly on the muscles of your pelvic floor. This can cause your muscles to tighten up, compressing the nerves that run through the pelvic floor and causing pain, urinary symptoms, or other pelvic problems. Many pelvic patients report their symptoms are exacerbated by prolonged sitting.
There are some great strategies to combat these sedentary tendencies we have. Getting in the habit of pacing while on the phone can help break the monotony at a desk. Set a timer on your phone or an alarm on your Fitbit to make sure you get up and move every 30 minutes. Use the time watching TV to stretch. Try to do some of your work standing up, either with a standing desk or just by standing to read the paper. Building just a few of these habits can have major benefits for your pelvic health!
6. Go for a Walk
The pelvic floor doesn't exist in isolation - it works in concert with all of the major muscles around it. The act of walking engages the muscles of the legs, abdomen, lower back, and the rest of the core.
If you've been having trouble with your pelvic floor, a gentle walk can be a nice form of exercise, but strenuous uphill or downhill hikes can put additional strain on the pelvic floor. If you notice any symptoms or irritation with walking, you can work with your pelvic floor physical therapist to see what's going on and what you can comfortably do. Sometimes even walking in the pool can be helpful for patients who have been struggling with pelvic pain. Walking also causes movement in the area, increasing blood flow and mobility. Plus, there are plenty of other health benefits to a quick walk!
7. Give yourself a Massage
Just like other areas of the body, the muscles around the pelvis can also get tight and strained. When we get a knot in our back or neck, for example, we rub out the painful area - you can do the same thing with the muscles surrounding your pelvis. The hamstrings, quads, and glutes are great to stretch and massage.
A foam roller is a great tool for this self-massage. By slowly rolling your body body over the roller, you can massage out tight spots that may be causing pain or dysfunction. Linger for just a few moments over areas that are tight or painful, and then move on. After massaging the muscle, you can stretch it out and see the difference! Here's a great foam roller that we use for our patients, and you can now find on Amazon.
The abdomen is another area that can become tight and put a lot of strain on the pelvic area and bladder - this can be especially true if you have any abdominal scars from a C-section, appendectomy, hysterectomy, or other surgery. In this case you can do what is called fascial release, where you gently lift the skin up and away from the body. Be gentle with yourself, and slowly work over the abdomen to help the skin slide smoothly over the muscles underneath. Afterwards, you may be amazed at how easy it feels to take a deep breath or to stretch.
These techniques can be helpful, regardless of whether you're using them to maintain a healthy pelvic floor or working to alleviate pelvic pain, symptoms, or dysfunction. Even just incorporating a few of these into your daily routine can benefit your pelvic health for years to come.
Dr. Nicole Cozean is the founder of PelvicSanity physical therapy, Orange County's premier pelvic floor physical therapy clinic. One of only 270 PTs to be board-certified in the pelvic floor, and the first PT to serve on the ICA Board of Directors, Nicole is the author of the acclaimed and best-selling book The Interstitial Cystitis Solution (2016). She is an adjunct professor at her alma mater, Chapman University. The PelvicSanity blog focuses on presenting practical, positive information to help patients beyond the walls of Nicole's clinic.