Where is the Pelvic Floor?

Dear Yogini: What is this pelvic floor you keep referring to? ~ Confused

Dear Confused:
I’m glad you asked. You’re not alone in your confusion. The pelvic floor muscles are important structural core muscles that are largely hidden from view. Many of us have no idea how to find them or why we would want to. What follows is a short primer, if you’d like more information my favorite description of the pelvic floor muscles can be found in the book Body3 by Thomas Myers. (for an image check out: http://lucy.stanford.edu/img/ImageCA_562_2.jpg )

The pelvic floor muscles lie in the floor of the pelvis. Take your awareness to this area of your body, note the position of your sitting bones, your pubic bone and your tailbone. These four bony landmarks bound an area shaped like a diamond. The pelvic floor muscles are a sheath of muscles spanning this diamond. The fibers in the muscles span all directions in the diamond: front to back, side to side, and figure-eights through the space. The area can be thought of as a diaphragm or even a trampoline. To function optimally these muscles need to be taut, resilient, pliable, strong, and able to relax completely.

If we think evolutionarily, these muscles evolved in a vertical position in our four-legged ancestors. In most mammals the pelvic floor is a door through which mating, birthing and waste release occurs. The area needs to be able to open and close, but doesn’t need to bear weight. When humans became upright walking creatures the pelvic floor rotated into its current horizontal position. In this position it bears most of the weight of the abdomen. Pressure changes within the abdomen (breathing, sneezing, jumping, and running) stress the pelvic floor musculature. For women the pelvic floor is particularly stressed during pregnancy and childbirth. Strengthening these muscles has many benefits, from preventing incontinence and hemorrhoids to increased sexual pleasure in men and women.

Western medicine generally teaches these exercises with the name “Kegel” Exercises after the MD who first introduced them to us. The exercises have long been part of yoga practice. The common yogic term for working the pelvic floor muscles is Mula Bandha or the ‘root lock.’ Mula Bandha is variously used to refer to subtle energetic work in the pelvic floor as well as to the engagement of very specific subsets of the pelvic floor musculature. For my purposes, I use the term to generically refer to engaging all the muscles of the pelvic floor.

Kegels are introduced by encouraging the student to stop and start the flow of urine. This particular exercise focuses on the urinary sphincter part of the pelvic floor. It is a good beginning. You can also isolate the muscles that contract the anal sphincter and the genital sphincter as you become more familiar with the area. Practice and explore to find the various parts of this region of your body.

For yoga, I encourage students to engage the entire area. If you come back to imagining that diamond shape underneath you, my first cue is to ‘narrow the diamond,’ to make it smaller by drawing front-and-back and side-to-side together. Do this 5 to 10 times. Then relax. As with any exercise the rest phase is as important as the work phase. Needless to say, you do not want these muscles to go into spasm or hyper contraction.

Once you’ve got the first exercise down you can begin to lift the diamond. Imagine the area lifting like an elevator one floor at a time. You might be able to lift 3 or 4 separate floors, stopping for just a second or two on each floor and then reversing the process and resting on the ground floor. Repeat this process 5 to 10 times as well.

In yoga class we engage the pelvic floor and attempt to hold a gentle engagement throughout our practice. We don’t want to clench the muscles but we do want to keep them lifted and taut. This is “Mula Bandha” – the support provided by the pelvic floor lift. You might also notice that when you contract the pelvic floor muscles that the muscles of the lower abdomen also engage. They are hard wired together and provide important support for the low back and spine.

For general health you should do something on the order of 3 sets of 10 Kegels each day. I have known some women who said they practiced every time they waited for a red light, or anytime they were standing in line waiting. You don’t want to make the habit of doing the exercise in the middle of urination because you can prevent your bladder from fully emptying and thus cause bladder infections. Use that technique only to identify the muscle sets and then establish another time and place where you can remember to do this exercise daily ~ maybe while brushing your teeth. I call it the secret exercise as you can practice anywhere, any time. Just make a practice of repeating daily.