All women can benefit from this pelvic floor workout.

Robert Collins

Global Courant

The pelvic floor muscles may be the most important muscles ever worked in a workout. Like a springboard at the bottom of the pelvis, these muscles contribute to the overall strength of the trunk and hold various organs in place, such as the bladder, bowel and, in some cases, the vagina and uterus, ensuring they function properly. .

Yet many people don’t even know these muscles exist, says Dr. Amy Park, chief of women’s pelvic medicine at the Cleveland Clinic; at least, not until they stop working properly. “There is a general lack of knowledge about the pelvic area,” says Park. “I educate women several times a day on the fact that we have pelvic floor muscles.”

They may not be visible like the triceps or quadriceps, he says, but they are vital for everything from basic bathroom functions to sexual health, to sitting and standing, and they benefit from a fitness program.

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The pelvic floor is “as important in everyday life as the Achilles tendon is in running, because we use it for everything,” says Liz Miracle, clinical quality and education manager at pelvic floor physical therapy provider Origin.

Historically, talking about this region of the body, even with the doctor himself, has been out of reach for many.

This modesty led to years of unnecessary suffering, says Evelyn Hecht, a New York-based physical therapist specializing in the pelvic floor who began practicing in the 1990s: Many conditions could be treated or avoided entirely if women felt freer to talk about it. their symptoms or if the public were better informed about the pelvic floor.

Nearly one in three American women has a pelvic floor disorder, usually in the form of urinary incontinence, bowel incontinence, pelvic pain, pelvic organ prolapse, or some combination of these problems.

When our pelvic floor is strong and flexible, the muscles work together — or “co-contract” — with our core muscles to allow us to live our daily lives with ease and stay active as we age, said Hecht, who now runs the digital provider of pelvic health PelvicSense. In addition, the pelvic floor helps maintain balance and mobility during sports.

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Pelvic floor problems can be caused or aggravated by any activity that puts pressure on the muscles over time, causing them to tear or weaken, such as running, dancing, chronic constipation or even the usual cough, pregnancy and childbirth. .

Injuries can also arise when muscles become too tight, which may be due to regular “holding in” when you feel the need to go to the bathroom, overtraining of the core, or even prolonged stress and anxiety. (When stressed, many people reflexively clench these muscles.)

Recently, pelvic floor specialists have reported an increase in pelvic muscle strain disorders, a trend they termed a pandemic pelvis, as the most common cause appears to be stress combined with excessive sitting.

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But pelvic floor problems are not inevitable. Many pelvic problems can be prevented or mitigated by regularly stretching and strengthening these muscles. Most of us could benefit from “a personal trainer for our pelvic floor,” says Dr. Lauren Streicher, medical director of Northwestern University’s Center for Menopause and Sexual Medicine.

Miracle, who is a physical therapist and personal pelvic trainer of sorts, recommended that all women who do not currently have a pelvic floor disorder or injury incorporate six core exercises into their training routine, aiming to perform at least three of them. times per week.

The pelvic floor muscles hold various organs in place. Photo. NYT

diaphragmatic breathing

Learning to move the diaphragm is essential to connect with the pelvic floor muscles and condition them.

-Sit in a chair with your feet flat on the floor. Place one hand on the belly and the other on the chest.

-Inhale and feel how your belly expands, then slowly exhale through your mouth. (Imagine a balloon in your belly: as you inhale, the balloon fills with air; as you exhale, the air is slowly released, as if your thumb were plugging the opening and letting it seep out a little at a time.)

Pelvic floor lengthening exercise

Relaxing and lengthening the pelvic floor muscles so that they are capable of full range of motion is especially important for basic functions like effortless toileting (avoiding constipation) and painless penetrative sex.

-Lie comfortably on your back, with your knees bent and your feet flat on the floor.

-Start with diaphragmatic breathing, inhaling deeply and letting the air fill the bottom of the lungs. I felt my lower belly, lower back, and pelvic floor gently stretch out with my breath.

-Exhale slowly through pursed lips, allowing your belly, back, and pelvic floor to passively relax. Do not activate any muscles during the exhalation; Keep your pelvic floor fully relaxed.

Imagine the balloon expanding 360 degrees in all directions as you inhale. One of those directions is down between the legs and toward the perineum (the area between the vagina and the anus). As the belly passively rises, the perineum will also passively swell downward and out. Repeat it 10 times.

sitting kegel

While the previous exercise helps us relax the pelvic floor muscles, the Kegels train us to contract them.

This exercise helps us retain urine, feces or gas when we feel the need to go to the bathroom and also works to increase the resistance of the pelvic floor muscles, so that they are able to support our organs and balance the pressure exerted. on the abdomen throughout the day.

-Sit upright, with your feet flat on the floor.

-Inhale through your nose, relaxing your pelvic floor as your belly and ribcage expand.

-As you exhale, contract and raise your pelvic floor muscles, maintaining the contraction throughout the exhalation. Try to hold the contraction for 10 seconds. You may find it helpful to imagine that you are squeezing the muscles that stop the flow of urine in front and hold back gas in the back, or imagine that these muscles pick up a small ball and hold it inside. Contract the muscles on the inside of your body, instead of just squeezing your thighs or buttocks.

-Relax completely for four to ten seconds, or more if you need it. Relaxation is important, as contracting your muscles without fully relaxing them can overtighten them and restrict your range of motion. Do three sets of 10 repetitions.

quick push ups

This exercise is based on Kegels in that it trains the pelvic floor muscles to contract rapidly, an ability that allows them to respond effectively to sudden and automatic bodily functions that create pressure inside the abdomen, such as coughing, sneeze or laugh (It can also help prevent incontinence, or “drip,” from this pressure.)

-Sit upright, with your feet flat on the floor.

-Repeatedly contract and release the muscles that stop the flow of urine, with a minimum of seven contractions in 10 seconds. Perform at least 30 contractions and releases.

The “Shhh” Sound Trick

While quick squeezes train the pelvic floor muscles to respond quickly to bodily functions that put pressure on the abdomen, this exercise helps build strength and stamina against this pressure.

-Sit upright, with your feet flat on the floor.

-Inhale through your nose, relaxing your pelvic floor as your ribcage and belly expand.

-As you exhale, squeeze and lift your pelvic floor muscles and make a quick, forceful “shh” through your mouth while holding the pose.

-From there, exhale fully and slowly through pursed lips, allowing your belly, back, and pelvic floor to passively recede. Complete three sets of 10 repetitions.

belly lift

This exercise targets the transverse abdominis muscles, which are located in the lower abdomen and support the trunk. These muscles work with your pelvic floor muscles to help you sit down, stand up, and perform any exercise that requires balance or stability.

-Start on your hands and knees, with your hands under your shoulders and your knees under your hips. Focus your gaze between your hands.

-Inhale, filling the belly with air and relaxing it towards the floor.

-Exhale and pull the navel towards the spine. This should activate the transverse abdominal muscles. Keep your back flat throughout the movement. (Imagine your belly is again filled with air, like a balloon – now squeeze the air out of your balloon using your abdominal muscles, squeezing them against your spine.) I repeated 10 times.

©The New York Times

Translation: Patricia Sar

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