The pelvic floor exercise you might be missing.

A lot of us are familiar with Kegels and are becoming more familiar with things like “Reverse kegels,” diaphragmatic breathing, or yoga-based relaxation stretches for our pelvic floors. Don’t get me wrong, I think this is wonderful, but oftentimes I still see some people doing these things ineffectively. The movement of the pelvic floor might be off, or the breath is still stuck in the chest or too much in the belly, or the stretch is too intense that all those muscles – especially the pelvic floor – are just holding on instead of letting go. So how do we change this?

One of my favorite ways to teach effective pelvic floor movement and breathing patterns is to use a mirror. Whether it is a compact, handheld, or sits on the floor, a mirror provides so much feedback while learning about your pelvic floor. Our brains use various forms of feedback to learn about our muscles and movement: visual, verbal, tactile being the most common. Well, a mirror is all about the VISUAL. Since the movement of the pelvic floor can be hard to feel or see – compared to flexing your bicep and seeing your arm curl up for example – a mirror stands in as a perfect stimulus to see those muscles.

So grab a mirror (and probably a private space), and let’s practice!

  • Sit on the floor or bed and prop yourself up with some pillows. You can also sit on the toilet with your feet propped on a stool or box. To get the most out of this exercise, you will want to see your perineum and vagina or penis so you can see the small movements that are usually hidden by pants and underwear.
  • Place or hold a mirror in front of you so you have a good view and can be in a relatively relaxed position. Now, just start to find a relaxed breath and keep an open mind. You can close your eyes initially to help relax.
  • Once you find a comfortable breath, begin to bring awareness towards your diaphragm and pelvic floor. When you breathe in, imagine opening an umbrella out into your abdomen, ribcage, and lower back. Then move an elevator down from your rib cage to your pelvic floor. When you breathe out, let the elevator come back up and the umbrella close. Try not to force anything, remember these are small movements.
  • Now look into the mirror to keep that rhythm going. Inhale to open out and down while you see the perineal tissues start to spread downward – depending on your view you might even see the anus or vagina open a little. Exhale to let it go and see the perineal tissues move back up.
  • Lastly, you can see what happens while contracting the pelvic floor muscles. Try to do this on the exhale so the diaphragm and pelvic floor are moving together. Inhale as before, let everything move down. Exhale, squeeze the pelvic floor muscles (“stop flow of urine,” lift an elevator, suck up through a straw, pull penis in…) and watch for more upward movement in the perineum, anal “wink”, or clitoral “nod.”

I realize this probably sounds like a strange and uncomfortable idea at first. But that’s also the point. Stigmas throughout our culture have put a lot of shame, disconnect, and lack of self-confidence between ourselves and our vaginas, penises, and pelvic floors. When those things linger, our pelvic floor muscles may stay in a guarded or protected state that prevent the natural flexibility and movement that keep urinary, bowel, and sexual functions in line. Spending 2-5 minutes a few times per week to connect with your pelvic floor within an open mindset can break those barriers and restore function. Don’t expect perfection or comfort to come the first time, but remember that your body is extremely adaptable and responds to consistent effort.

Mirror feedback is an option for anyone, but is particularly helpful in the following situations to rebuild a connection between your brain, nervous system, and pelvic floor muscles:

  • pelvic pain
  • painful sex or vaginismus
  • pelvic organ prolapse
  • postpartum recovery
  • urinary incontinence
  • urinary urgency or frequency
  • constipation

I’d love to hear your thoughts on this exercise. Share with me in the comments or send me a message. If you are eager to learn other pelvic floor exercises and get a specific treatment plan for your needs, you are always welcome to reach out to us or book a treatment session.

–Courtney Edgecomb, PT, DPT

Please note that this is not direct medical advice, and you will always benefit from speaking with your healthcare provider to find out how this can be the right fit for you.

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