Pelvic Floor Exercises: How to Do Them Lying Down for Optimal Results

How to do pelvic floor exercises lying down?

Pelvic floor exercises, often called Kegels, can be effectively performed while lying down, a position that minimizes gravitational forces and aids in isolating the target muscles for optimal engagement and relaxation.

Understanding Your Pelvic Floor Muscles

The pelvic floor is a sling of muscles and connective tissues that stretches from your pubic bone at the front to your tailbone at the back, supporting your bladder, bowel, and uterus (in women). These muscles play a crucial role in continence (bladder and bowel control), sexual function, and core stability. Strengthening them can prevent or alleviate issues like urinary incontinence, pelvic organ prolapse, and contribute to better sexual health.

Benefits of Lying Down for Pelvic Floor Exercises

Starting pelvic floor exercises in a supine (lying down) position is highly recommended, especially for beginners or those with significant pelvic floor weakness. This position offers several advantages:

• Reduced Gravity: Lying down minimizes the pull of gravity on the pelvic organs, making it easier to feel the "lift" of the pelvic floor muscles without the added challenge of supporting body weight.
• Enhanced Muscle Isolation: It helps to prevent the recruitment of larger, stronger muscles like the glutes, thighs, or abdominals, allowing for better focus on the specific pelvic floor muscles.
• Relaxation: Being in a relaxed, supine position can help reduce overall body tension, which is crucial for proper pelvic floor engagement and, equally important, complete relaxation.

Identifying Your Pelvic Floor Muscles

Before attempting any exercises, it's vital to correctly identify the muscles. This can be challenging as they are internal muscles, but here are common cues:

• For Bladder Control: Imagine you are trying to stop the flow of urine mid-stream. The muscles you would squeeze are your pelvic floor muscles. Do not actually stop urine flow regularly as an exercise, as this can interfere with normal bladder emptying.
• For Bowel Control: Imagine you are trying to stop yourself from passing gas. The squeezing and lifting sensation you feel around your anus is your pelvic floor muscles contracting.
• Combined Sensation: Think of gently lifting and drawing in the muscles around your vagina/scrotum and anus, as if you are trying to lift them up towards your belly button. You should feel an internal "lift" or "squeeze."

Crucial Note: You should not feel your glutes clench, your thighs squeeze together, or your abdominal muscles bear down or visibly contract forcefully. The movement is subtle and internal.

Step-by-Step Guide: Pelvic Floor Exercises Lying Down

Once you can identify the muscles, follow these steps:

1. Preparation:

   • Lie on your back on a firm surface (like a yoga mat on the floor).
   • Bend your knees, keeping your feet flat on the floor, hip-width apart.
   • Rest your arms comfortably by your sides, palms up or down.
   • Ensure your spine is in a neutral position – not overly arched or flattened.
   • Take a few deep breaths to relax your body.

2. The "Lift and Squeeze" Technique:

   • As you exhale gently, imagine you are trying to stop the flow of urine and stop yourself from passing gas simultaneously.
   • Gently squeeze and lift the muscles around your anus and vagina/scrotum upwards and inwards, towards your belly button.
   • Visualize these muscles lifting away from the floor, as if you are drawing a zipper up from your tailbone to your pubic bone.

3. Holding and Releasing:

   • Hold this gentle squeeze and lift for 3 to 5 seconds. During the hold, continue to breathe normally and avoid holding your breath.
   • Slowly and completely release the contraction. It's crucial to feel the muscles fully relax and drop back down to their resting position. This relaxation phase is as important as the contraction.
   • Rest for 5 to 10 seconds between repetitions to allow the muscles to fully recover.

4. Breathing:

   • Maintain normal, relaxed breathing throughout the exercise. Do not hold your breath or strain. Holding your breath can increase intra-abdominal pressure, counteracting the intended effect.

Progression and Variations Lying Down

As you become more proficient, you can introduce variations to challenge your pelvic floor muscles further.

• Quick Contractions (Flicks):

  • Perform a quick, strong squeeze and lift of the pelvic floor muscles, holding for just 1-2 seconds, then immediately and completely relax.
  • These "flicks" train the fast-twitch muscle fibers, which are important for quick responses, such as preventing leakage during a cough or sneeze.
  • Aim for 10-15 quick contractions per set.

• Longer Holds:

  • Gradually increase your hold time for the sustained contractions as your strength improves.
  • Work towards holding the squeeze for up to 10 seconds, followed by a full 10-second relaxation. This trains the slow-twitch muscle fibers, crucial for sustained support and continence.

Recommended Repetitions: Aim for 3 sets of 10 repetitions (both long holds and quick flicks) daily, or as advised by a healthcare professional. Consistency is key.

Common Mistakes to Avoid

To ensure effectiveness and prevent counterproductive efforts:

• Using Other Muscles: Do not squeeze your glutes, inner thighs, or abdominal muscles. The movement should be subtle and internal. Place a hand on your lower abdomen to ensure it doesn't bulge or suck in excessively.
• Bearing Down: Never push down or strain. The action is always a lift and squeeze upwards and inwards.
• Holding Your Breath: Breathe normally throughout the exercise.
• Incomplete Relaxation: Fully relaxing the muscles between contractions is vital. Constant tension can lead to muscle fatigue or even hypertonicity (over-tightness), which can cause pelvic pain or other issues.
• Overdoing It: More is not always better. Start with manageable repetitions and gradually increase as strength improves. Fatigued muscles won't perform optimally.

Incorporating Pelvic Floor Exercises into Your Routine

Consistency is paramount for seeing results. Aim to perform your pelvic floor exercises daily. Once you master the technique lying down, you can progress to performing them in other positions like sitting and standing, which adds the challenge of gravity. Integrate them into your daily routine – while watching TV, waiting in line, or during other quiet moments.

When to Seek Professional Guidance

While pelvic floor exercises are generally safe, if you experience any of the following, consult a healthcare professional, such as a physical therapist specializing in pelvic health:

• Difficulty identifying the muscles.
• No improvement in symptoms after consistent practice.
• Pain during or after exercises.
• Worsening symptoms.
• Concerns about pelvic pain, incontinence, or prolapse.

A pelvic health specialist can provide a personalized assessment and guidance, often including internal examination and biofeedback, to ensure correct technique and address specific concerns.

Conclusion

Pelvic floor exercises performed lying down offer an accessible and effective starting point for strengthening these vital muscles. By mastering the subtle art of the "lift and squeeze" in this gravity-assisted position, you lay the foundation for improved pelvic health, enhanced core stability, and better quality of life. Consistent, correct practice is your strongest tool in maintaining a resilient and functional pelvic floor.