Pelvic floor muscle holding tension can be a barrier to usual rehabilitation. Whether there is pain, restriction, weakness or the pelvic floor muscles just haven’t been exercised there will always be benefit to releasing muscles.
We should FIRST RELEASE the pelvic floor muscles achieving a balance across the pelvic floor. Once we have achieved this release then we can strengthen in a way that optimises the performance of the pelvic floor
This concept of maximal releasing is one of the key things this web site will teach you.
We introduce a very specific breathing technique called SNIFF, FLOP AND DROP. This technique targets release of the pelvic floor through a type of diaphragmatic breathing.
DIAPHRAGM UP……….. PELVIC FLOOR HELD
The diagram shows as if there is a taut elastic band from the pelvic floor up to the diaphragm.
How is the tension created?
If the diaphragm is held or if breathing is restricted, the pelvic floor will be held upwards too.
The abdomen will also be held but inwards feeding in to the same pattern of tension.
NOW LET’S MAKE SOME CHANGES
We are practising the release so.. Use the diaphragm to initiate the release.
- Breathe inwards using a “SNIFF” (diaphragm descends)
- At the same time the abdomen releases outwards with a “FLOP”
- This in turns leads to a “DROP” of the pelvic floor.
In this diagram the elastic band can be seen to slacken allowing this release. This slackening is a softening through the fascia and the abdomen to the pelvic floor .
DIAPHRAGM DOWN……… PELVIC FLOOR RELEASED
‘THE SNIFF’ – an inbreath through the nose
The breath in should be through the nose, it should be an audible “SNIFF” indicating that there is sufficient volume of air to make the diaphragm descend. It should be sustained softly for 3 seconds.
- As you breathe in make sure to keep the chest down
- The diaphragm descends making the stomach fill up
- This can be described as a tummy breath
REMEMBER
It must NOT be forced and the stomach must stay completely soft or it will not allow the diaphragm to descend.
If your chest rises each time with effort you will need to think of leading with your stomach and not with your breath. See the next section on Flop.
BREATH OUT
By contrast the breath out is quiet and passive. It should not equal the volume of air of the in breath as much of this air will have ‘disappeared’.
This out breath can be likened to cleaning a pair of spectacles, and SHOULD come from the stomach not the chest.
The pelvic floor release happens on the in breath; all tension in the body should have already let go on the in breath so there should be no more to release on the out breath.
THE FLOP – an abdominal release
Lying down on your back with your knees bent this can be counter intuitive because it does not easily flop up against gravity – nonetheless this is the idea!
Both hands are placed on the upper stomach at the level of where the ribs form a triangle up to the sternal bone. As you “SNIFF” inwards the diaphragm descends and the stomach fills up into the finger tips or flops out.
The stomach should be soft and flop out.
It is helpful to press into the stomach before you start to check that it is completely soft. Then having sniffed in to press into the stomach again to check that it has stayed completely soft. Stay with the stomach filled out like this for 3 seconds.
A correct flop will result in an effective drop of the pelvic floor.
CAREFUL!
If forced or performed incorrectly the flop will result in stomach tension instead of a soft release.
If you try too hard to release the pelvic floor by pushing the stomach out it will tense up. Feel for this with your finger tips.
REMEMBER
It is the upper stomach you should concentrate on mostly. You should NOT flatten the upper stomach in order to fill up the lower stomach but rather fill up the upper stomach and the lower stomach will automatically follow.
PELVIC FLOOR RELEASE – THE DROP
The pelvic floor should be held just a little up from its fully extended state in order to support the organs and pelvis. This is normal.
However it should be possible to easily let these muscles go to a fully released or extended state at will. If this is not possible then the pelvic floor may be held in a raised or ‘hypertonic’ state even at rest. This can become problematic and even painful over time causing symptoms.
This part of the exercise series focuses on the pelvic floor drop.
The exercise
Lie on your back with your knees bent and feet supported or lying on your side.
Make an image of your pelvic floor as seen in the diagram here. Think of the muscles around the back passage and out to the hips i.e. not just to the front at the bladder.
Make sure that:
– Your stomach is completely soft and that you are not pushing your pelvic floor down or pushing your stomach out.
– Your chest is not lifting and make sure that you are not either breathing in or out just stay still with your breath.
Now simply let the muscles of you pelvic floor go – the back passage goes backwards towards the coccyx (base of spine) or the supporting surface that you are lying on. Think of opening at the back passage but not pushing. The muscles of the vagina open or the scrotum and penis drop. The bladder simply softens.
Remember
This can be impossible to feel at first when the muscles have increased tone and the pelvic floor is held very taut.
The perception of the movement and the range of movement improves when the Sniff and the Flop are used at the same time bringing it all together as the Sniff Flop & Drop.
START BY lying on your back with your knees bent or lying on your side.
Exercise: 5-10 min/day
(increase to 3 times/day if in pain)
SNIFF in through the nose
Breathe or SNIFF in through the nose, keep the chest down and allow the stomach to fill up or FLOP out keeping it soft.
Stay on the in-breath for 3 seconds keeping the stomach soft.
When your timing and effort is correct you should notice that your in-breath is considerably longer than your out-breath, your out-breath should almost disappear, this indicates that you have let all your tension go on the in-breath. It should be as if the air has disappeared.
Your out breath should sound like ‘hah’ as if cleaning you glass
The less effort the better the connection will be – don’t force it
FLOP swell or fill out your soft stomach
Flop swell or fill out your soft stomach into your fingertips placed under your ribs on your upper abdomen.
DROP release or open at the back passage -backwards
When your abdomen is soft and filling out sufficiently while you keep your chest down as the diaphragm descends, you can then expect to feel a connection to the pelvic floor as it too lets go- the DROP.
THE LESS EFFORT, THE BETTER
you must think of going into a state of complete relaxation and almost meditation
Speed
The sniff should be relatively swift to ensure a complete release, if it is slow the muscle tends to hold on and control the release.
The maximal release of the pelvic floor should happen as you start the sniff in.
Direction
Think of the direction of release of the pelvic floor, it lets go backwards towards the base of the spine.
Think of the arms of the U-shape of muscle lengthening backwards to the base of the spine. Small u becomes capital U!
Speed
The sniff should be relatively swift to ensure a complete release, if it is slow the muscle tends to hold on and control the release.
The maximal release of the pelvic floor should happen as you start the sniff in.
Direction
Think of the direction of release of the pelvic floor, it lets go backwards towards the base of the spine.
Think of the arms of the U-shape of muscle lengthening backwards to the base of the spine. Small u becomes capital U!