Relaxing Your Pelvic Floor

The question "How do I relax my pelvic floor?" is one I hear often from clients. It's a crucial inquiry because the ability to relax the pelvic floor is essential for healthy tissues, continence, intimate function, and managing pelvic pain or pressure complaints. 

Hey, y’all!  It’s me, Dr. Kelly Sadauckas, one of a handful of Doctors of Physical Therapy in the world who are double board certified in orthopedics and pelvic health, and your go-to expert for pelvic questions and wonders.  Today, I’m going to help you demystify how to relax your pelvic floor!

Understanding Pelvic Floor Dysfunction

Before diving into relaxation techniques, it's important to know that most pelvic floor disorders stem from pelvic muscles being too short and stiff (making them weak) rather than being too long and loose. This might sound counterintuitive, but let me explain.

Imagine making a fist and holding it for eight hours. Now try to perform daily tasks. Your hand struggles, right? Similarly, if pelvic muscles are too tight (hypertonic), they can't function properly, leading to weakness and dysfunction.

More of a visual learner?  Check out these Instagram Reels that use tight arm or leg muscles as an example. 

Why Can't I Just Tell My Pelvic Floor Muscles to Relax?

Your Pelvic Floor Muscles Form a hammock at the literal base of your core and torso–they’re the ‘bottom of a soda can’, if you will. 

Telling our pelvic floor muscles to “just relax” is easier said than done because, in many cases, once we have noticeable dysfunction (pain, leaks, pressure), our brains stop receiving and controlling the pelvic region appropriately. The nerves are all still there, just “mis-wired” temporarily, if you will. 

Pain, especially after trauma or childbirth, often prompts the brain to try to 'ignore' the problematic area, which is useful for a very short period of time (like when we are outrunning a lion).  But after that short-chase, the brain isn’t made to ignore pain forever…so if it keeps trying, it won’t ignore the pain, but what it will end up doing is hindering our ability to sense where our pelvic floor muscles are in space..which in fancy language is called “proprioception.”

The Importance of Proprioception

Proprioception is the ability of our brain to sense "where" certain body parts are in space, or how they are moving. Like if you put your hands in front of you, close your eyes and turn "palms up/palms down...palms up/palms down"...chances are, you know 100% of the time where your hands are in space.  When we don't know where our body is in space, this is called "reduced proprioception." 

Reduced proprioception signals from our pelvic region might make us “think” that our muscles are relaxed…but in 95% of individuals, upon pelvic muscle examination, we find moderate to extreme tissue tightness, as well as a full blown lack of awareness of where are pelvic muscle are in space, and what they’re actually doing (or not). 

And this sucks.  It hampers our ability to use the pelvic floor properly during rest and activities, setting the stage for additional and persistent pain and dysfunction.

But the great thing is that proprioception can be regained, as well as lost...so there is hope for ALL OF US, regardless of how little (or how long) we've been suffering pain, leaks or dysfunction!  Here's 5 easy steps to restore your pelvic floor proprioception and find and relax your pelvic floor!

How to Relax Your Pelvic Floor in 3 Easy Steps

But don’t worry, I’m not a fear-monger.  There are MANY tangible, simple things YOU can do RIGHT now to improve your brain-body connection to your pelvic floor muscles, and learn to relax your pelvic floor.  Here they are, enjoy :)

1. Learn where the muscles are. This 4-minute video might help :)   

2. Try these Four Exercises to Improve Pelvic Floor Health

These 4 exercises help to improve the way the brain connects to your diaphragm, deep abs and pelvic floor.  In a perfect world, the brain has excellent, independent control of these groups, and can activate them alone, or in combination, in ANY combination it sees fit.

In dysfunction, though, these groups get “coupled”, which means the brain can’t control the groups individually, and instead just uses an “all or nothing” approach to muscle firing, which will lead to pain and leaks over time…even just small improvements in muscle coordination can lead to BIG functional gains.  (translation: even tiny improvements in how your brain can use ONE pelvic muscle independently of another can lead to less pain and leaks!)

• Relaxed Breathing:
  

  This important exercise targets retraining your brain to find and use your diaphragm (breathing muscle) against a relaxed stomach. “Breathe into your vag and butthole, as you consciously relax and elongate your deepest/lowest belly and pelvic floor.  When you exhale, you might then feel the pelvic muscles passively rebound back in towards your belly button.
  If you are having dysfunction, can you breathe into the butthole, and relax the pelvic floor…then exhale..belly comes in AND pelvic floor stays relaxed??This diaphragmatic breathing is crucial for those with hypertonic pelvic floors.  

• Supported Breathing:

  Keeping your pelvic muscles relaxed after relaxed breathing, can you now engage JUST your deepest/lowest abdomen to unload organ pressure off the pelvic floor. Think “scoping and hugging” your bladder, and JUST your bladder, up, away from the pelvic floor, towards your spine…
  …now can you do this…and breathe??...
  …AND keep your pelvic floor muscles relaxed?? This exercise (is #amazeballs) helps to differentiate between the specific roles of the abdomen, diaphragm, and pelvic floor.

• Kegels:
  

  The pelvic floor muscles are cool (this post tells us more about them) . Can you squeeze and lift the muscles of the rectum, urethra, vag or scrotum (whatever middle bits you have) away from whatever surface you are sitting on??
  …AND hold for 5 seconds??
  …AND now relax the muscles completely?? (all while still breathing??)

• Bearing Down:

  Finally, if you got a C or better on your Kegel AND relax, you can try this one. From the resting pelvic position, can you engage the butthole and urethra muscles to actively drop and open the pelvic floor further than its rest position.
  
  This is NOT pushing from your abdomen, but a specific use of the pelvic muscles that ‘opens’ the pelvic doors rather than closes them. Can you do this gentle engagement, WHILE breathing, for 5-10 seconds, then relax?? 

3. Watch this 10-minute Guided Pelvic Floor Meditation on how to relax your pelvic floor muscles.

This video guides you through breathing and stretching exercises to improve proprioception and understand how your pelvic floor should move during relaxed breathing, supportive breathing, and active efforts.

If we had challenges with ANY of those exercises, one:one PT (in person or online), OR my Online Pelvic Wellness Programs are for you!  Of the courses, Vag Lab for a 2 hour condensed lesson in self pelvic muscle awanress, assessment & wellness if you have a vag, or The Signature Series if you are ready for a deeper dive--The Signature Series guides you through 12-weeks of curated pelvic wellness and exercises designed to bring you to the point of actual wellness where you don't have to think about your bladder during daily life or exercise anymore!!  YAY!!

But Dr. Kelly, How do you know if it’s working?  How do you know if you are relaxing your pelvic floor?

You'll likely become more aware of your body position, feel more relaxed, and notice improvements in urgency, frequency, leakage, pain, or sexual dysfunction within a few days (and absolutely within two weeks) if it’s working.  

The #1 thing people tell me, after connecting to their pelvic muscles, is “I didn’t realize how much tension I held in my rectum.”

Conclusion

Relaxing your pelvic floor is a journey, and even small efforts can yield positive results. By incorporating these exercises into your routine, you can enhance your proprioception, improve muscle function, and promote overall pelvic health.

Seeking Further Assistance 

If you're unsure or not experiencing improvement, consider seeing a Pelvic Floor PT in person or online, or exploring Dr. Kelly's Online Wellness Programs for more specific guidance.  An investment in your body, your health and your future is worth every cent!

Vag Lab is the 2-hour “first date” with your pelvic floor. The Signature Series is a 12-week relationship, curated exercise progressions developed to deepen your understanding of how your pelvic floor muscles contribute to various complaints and improve your pelvic wellness for years to come.

Join my mailing list below to be kept up to date on all our fabulous progress with the Pelvic Floored Project, as well as new evidence updates on pelvic health in general. And be sure to follow me on Instagram for some excellent info on pelvic health, and a good bit of neon and free exercises!  

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Thanks for reading!

xoxo, Dr. Kelly