The pelvic floor forms the floor of the abdominal cavity and runs from the pubic bone to the coccyx. The muscles of the pelvic floor consist of three muscle layers. The outermost layer is located directly under the skin layer, runs from front to back and is composed of two sphincters.
This outer muscle layer controls bowel movement by tensing or relaxing the sphincters. The middle layer of the pelvic floor muscles (diaphragm urogenitale) runs transversely and consists of two individual muscles, one of which is superficial and the other deeper. In this layer of the pelvic floor muscles is a connective tissue plate of the perineum (Centrum tendineum perinei).
This connective tissue plate is the center of the pelvic floor, where many muscles radiate. The middle layer mainly stabilizes pelvic organs and laterally narrows the bony pelvis. The innermost layer of the pelvic floor muscles (diaphragm pelvis) is formed by a fan-shaped muscle (Musculus levator ani) and another muscle (Musculus coccygeus).
All three layers of the pelvic floor muscles secure the position of the abdominal and pelvic organs and ensure the controlled closing and opening of the urethra and the bowel movement. If the pelvic floor is too weak and untrained, this can have many different consequences. After birth and pregnancy, overweight or even in old age, incontinence or even a lowering of pelvic organs can occur. In these cases pelvic floor training helps to improve.
Guidance/perception
Before starting the pelvic floor training, the perception of the pelvic floor is first of all in the foreground. We usually do not notice the movements of the pelvic floor in everyday life, but the pelvic floor actually takes part in many movements. In contrast to the inner layer, the outer and middle layer of the pelvic floor muscles can be perceived.
The movements that can be perceived are only very slight and easily felt. To perceive the outer layer of the pelvic floor muscles, sit on a hard chair with an upright posture. The feet have contact with the floor.
Close your eyes and take a deep breath. Concentrate on the middle of your pelvis. Now try to perceive a movement in the pelvic floor.
You may feel the pelvic floor rise and fall slightly as you breathe in and out. If you don’t feel any movement at all, blink your eyes and pay attention to your pelvic floor and its movements. To feel the middle layer of the pelvic floor muscles, palpate your ischial tuberosity with the palm of your hand.
You can also slide back and forth a little on the chair and then sit on your palms. Now try to pull your ischial tuberosities together. You should now feel a small movement in your palms.
The articles Physiotherapy for Coccyx Pain during Pregnancy and Exercises for Coccyx Pain during Pregnancy may also be of interest to you. During pregnancy the pelvic floor is put under much more strain. The additional weight on the abdomen pulls the body weight forwards and thus pregnant women fall faster into a hollow back.
To prevent this, adopt an upright position and try to keep your spine straight. In this way the body weight is distributed more evenly. It is also important to learn how to relax the pelvic floor during pregnancy.
The more relaxed the pelvic floor is, the easier the birth will be. Perception exercises are suitable for this. Those who can perceive the pelvic floor can also relax it during the birth.
Exercise 1 Now perform the principle on the left side of your body and then lie on the mattress for a short time. You can put the ball aside. Now feel how your pelvis feels.
Are you lying comfortably in the pad? Do your legs now feel heavier or looser than before? Take a little moment to feel the pelvic floor.
- For this exercise you need a soft ball. Lie down with your back on a pad. Now place the ball under your right foot and rotate your foot in both directions.
Move your foot with the ball back and forth, to the side, exert pressure on the ball and let go again.
- Then place the ball under your right knee and move your knee inwards and outwards on the ball. Your feet remain on the ground. Now you can apply pressure on the ball again and relax again after a short time.
- Next, place the ball under the right side of your pos.The left side of your bottom remains on the base.
Now circle with your buttocks on the ball. This may seem a bit complicated at first, but you will soon get the hang of it.
Exercise 2 Perform this exercise several times until you can clearly perceive your pelvic floor.
- Sit on a soft surface and lean your back into a soft cushion.
Sit down relaxed and bend your legs. Now support your legs by placing your hands on your knees from the outside. Now let your legs fall into your hands.
You will feel how the pelvic floor relaxes. Take your time and concentrate on your pelvic floor.
- After taking a few deep breaths, let go of your knees quickly. As soon as you remove your hands from your knees, the pelvic floor tenses together with your legs to prevent your legs from falling.
After birth, pelvic floor training is especially important.
If the pelvic floor is too weak, incontinence and the lowering of the pelvic organs can occur, as mentioned above. A common problem after birth is urination. It is quite possible that the urethra is irritated during childbirth and therefore urination is accompanied by a burning sensation.
This can lead to incontinence in the long term and a weak pelvic floor only intensifies this. In this case, it is important to do pelvic floor exercises. If the uterus in the puerperium sinks sharply, it is also very important to strengthen the pelvic floor and, above all, to relieve the pressure.
In this case, avoid movements that create strong pressure in the abdomen. In the first week after the birth, you should avoid housework and lifting or carrying heavy objects or children. If the sphincter muscle is injured, it is usually the innermost layer of the pelvic floor that is injured.
Here too, pelvic floor exercises are very important for lifting incontinence. In the first days of the postpartum period, the pelvic floor should be sensitized above all. After the birth, women who have recently given birth are often not able to sensitize the pelvic floor as they did before the birth because the tissue is very irritated.
For this reason, postpartum exercise begins with light pelvic floor training, which should first activate the muscles before strengthening begins. Exercise 1 Bring a rhythm into the alternating tensing and relaxing. If you find it difficult to mentally build up a rhythm, you can also listen to music with a suitable rhythm or train to the beat of a clock.
Exercise 2 When getting up, it is particularly important to relieve the pelvic floor. If we stand up with a round back, lowered gaze and weight shifted to the heels, the pelvic floor slackens. Here too, it is particularly important to activate the pelvic floor.
You should do this exercise every time you stand up, as this exercises the pelvic floor regularly. Exercise 3
- You can do this exercise right after birth. Here the pelvic floor is stimulated very carefully.
You can perform the exercise in any position you like. Try to stimulate the outermost layer of your pelvic floor muscles very gently and carefully. This is a minimal and very short-term movement.
Then relax your pelvic floor again.
- During the last tensing, hold the tension for a few bars and then release it again. Do this exercise as often as possible. The more often you activate the pelvic floor, the faster you will feel success.
- If you want to stand up, make sure that your posture is straight.
To do this, push your breastbone towards the sky as if someone wanted to pull you up on a string. Also look slightly up and forward with your face, not down. Support your hands at the sides behind your bottom.
The feet are tightened so that you can shift your weight to the front part of the foot when you stand up. Now tense your pelvic floor. To do this, you first move to the outermost layer of the pelvic floor.
Here you should feel a movement at the anus and the vagina. Next, you pull the ischial tuberosities together. Hold this built up tension while you stand up.
- There is a simple trick to relieve the pelvic floor at home.
Take a blanket or a large pillow. Now lie with your stomach and pelvis on the pillow or blanket. You can lay your head on the crossed arms.
This position is very relieving for the pelvic floor and promotes regression.
Pelvic floor training with balls also strengthens the pelvic floor. This can help with complaints such as incontinence and also promote sexual excitability.These balls are prescribed by doctors, but you can also buy them in a drugstore. Make sure that you use the balls only twice a day for a maximum of 15 minutes.
If you use the balls for longer periods of time, you may experience muscle soreness and thus overuse your pelvic floor muscles. The balls are small balls on plastic with different weights.
- Start with the lightest ball and insert it like a tampon until you can no longer feel the ball.
The pelvic floor now works independently and tries to hold on to the ball. It may happen that your pelvic floor is too weak at the beginning even for the lightest ball. In this case do not give up directly, try again.
When using the balls, it is important that you move while doing so.
- After two weeks you can use the next heavier ball and continue working like this. However, when training with such balls, it should be noted that the pelvic floor activity is not optimally controlled. Active training, in which you personally deal with your pelvic floor and learn to control it, has a more positive effect on your pelvic floor and your overall body feeling in the long run.
