Prenatal yoga and your pelvic floor
This week a student had a great question in my prenatal yoga Canberra class - how hard you should hold your pelvic floor muscles when doing yoga?
There are two main times you will engage your pelvic floor – in short, quick time such as when you need to sneeze, and in longer or weightbearing times such as when you are holding a standing posture or lifting a weight.
Training pelvic floor muscles (kegel exercises) are slightly different to the instructions for engaging pelvic floor that you hear in a yoga class. In the yoga class, we are aiming to hold the muscles without them fatiguing, as part of the core strength that supports your torso and posture. So we only engage lightly and ensure we can hold the muscles for a long time, and we use the ‘core stability’ muscles of the transverse abdominus to turn on those pelvic floor muscles.
However, in doing pelvic floor strengthening exercises (kegels) on their own, the instructions are to tire the muscles, so that they strengthen. Thus you hear the instruction to hold them ‘as tightly as you can’.
Only one problem - if you’re not doing them correctly, you could actually be doing yourself damage. Pelvic floor exercises are not easy to do correctly, or easy to describe – and this is why up to a quarter of women don’t do them correctly (research by Moen et al 2009). If you bear down instead, you’ll be doing it wrong – with implications for prolapse and incontinence in the long run.
That’s why my physio recommends all women receive individual training with an ultrasound machine to assess exactly what you’re doing. It’s better to do it during pregnancy than afterwards, when your pelvic floor might be harder to feel.
I would also recommend that if you EVER have any incontinence in pregnancy, even a little when you sneeze, do something about it. It could be a sign that you might not be doing your pelvic floor exercises correctly.
I also find that having a close look at a diagram of pelvic floor muscles can really help. The side view is the common one you see, but the view from below is very instructive.
Rebecca Perry
