Pelvic Floor Rehab-Beginner & Intermediate Workouts

Now that we have massaged/stretched/turned on all of the things, it’s time to do some coordinated movement.

This beginner workout video is targeted to those recently in pain or currently in pain. It’s a series of gentle, mindful movements to connect these areas we’ve covered in the course and start to build some basic strength connections. We start with some cat/cow, thinking about it from your pelvic floor over just the breath or what the spine is doing. Then, we do a series of exercises to connect your legs into the fascial line of the pelvic floor, closely mirroring what should happen as you walk. We then migrate up into glute and hamstring strength, combining it with some ankle work. Our grand finale is a 1 minute squat, focusing on relaxing and releasing the pelvic floor and then pulling up energetically for some grounding work.

In the intermediate workout, we start with various exercises with the legs in a diamond shape to target the inner and outer thighs. Have a 12 inch ball or foam roller and a towel/yoga strap nearly. We then move to some hip exercises weight-bearing in the arms for a bit of a stability challenge. Then, using a towel or yoga strap, we do an exercise to isolate the adductors/inner thighs. We wrap up the workout with a series of squats to work the thighs and ankles as well as the pelvic floor.

Pelvic Floor Rehab-Energetic Connections

An aspect of my approach to bodywork is looking at emotional stressors or energetics and how that contributes to someone’s pain patterns. I always say, there are a lot of crooked people out there, but not all of them are in pain.

The root chakra and sacral chakra come into play with the pelvic floor. The root chakra can close off with anything that involves fear. I think all of us can agree that we’ve felt some amount of this over 2020-21. Any history of abuse or trauma, at any point in life, can contribute to issues in the root. Fear usually involves the breath to tighten, and as we’ve discussed, the breath mirrors into the pelvic floor. If the root gets closed off, it shuts off connection to the feet. I often feel that a lot of knee/foot issues are not just about the pelvic floor in terms of mechanics, but also this holding from current or past fear patterns.

The root is also all about stability. So any type of lack-of-safety feelings would play into dysfunction here as well. This could be financial, physical or emotional.

The sacral chakra obviously involves sexuality, but also creativity and sensuality. If you don’t feel safe, how can you feel like you have the energy or bandwidth the be creative or truly yourself?

You can bring more opening and awareness to these areas by visualizing the sphincters of the pelvic floor opening up like a valve and that water is coming down the legs. If color is your thing, the corresponding colors are red for the root and orange for the sacral.

Take this for a walk and you can visualize those colors going down one leg, back up and over to the other leg like a light up yo-yo. Check in with your body and see as you put those colors in your mind’s eye, are they vibrant? If they start off more dusky or dark, let the old stuff drop out of your feet and into the ground. Then as the light comes back up the leg, can it be a bit brighter? If you continue to do this, the colors will become clearer and you’ll feel better—promise.

This is my favorite book on energetic systems. The author connections modern psychology with the chakra system. It’s a great balance of ‘woo woo’ and philosophy.

Pelvic Floor Rehab-Release Pelvic Floor Muscles & How to Activate the Pelvic Floor

We’re finally into the meat! In this video we go over how to release SUPER common problem spots for pelvic pain and lower back pain—the pesky pectineus, iliacus and obterators.

You can use just your hands to get some relaxation in these areas and they do *wonders* for relieving pain all over the body, including the neck and shoulders.

To release the pectineus, you’ll want to pin the pocket of the groin, and then you can use the weight of your leg to act as a stretch. In massage it’s called a ‘pin and stretch’. I go over the details in this video—promise you’ll feel like your leg not only gets longer, but more relaxed afterward.

The iliacus lines the ilia of the pelvis and can be a major core compensation muscle. This muscle can be tight if you also have digestive issues or hold tension in your ‘guts’. Releasing this before attempting core work may help you get more abdominal engagement.

Lastly, we go into the obterators, which are super deep at the base of the pelvis. These get tight from sitting as well as from breath-holding. Many of us also ‘pinch pennies’ down there when we’re stressed, which makes this area chronically tight. Think about the pelvis like a butterfly with its wings spread. Pinching the bottom of the wings together pulls the upper wings apart. Thus, releasing that tether on the bottom wings, relaxes the upper portions. Doing this can be a huge help in lower back pain.

I would not suggest using something like a Theragun on this area—you aren’t trying to pummel your pelvic muscles. This massager has some helpful attachments that help to hook onto bones and it has a vibrational/percussive element instead of just percussive. Also, if you gently try to push those upper edges of the butterfly wings (the ilia) together and that feels relaxing to your body, you may want to invest in a pelvic floor belt. There’s a lot of variety here and you want to find the right thickness for you as if you buy one that has too much depth, it will ride up as you bend over. Here’s the one I’ve heard the best feedback on from clients. You can find my favorite book on the pelvic floor with helpful exercises here.

Again, massaging these spots will help you relax all over and will make it easier to breathe. Please comment or reach out if you have any questions and thanks for watching!

Pelvic Floor Rehab-Glutes and Hamstrings

Continuing on in all-the-things-connected to the pelvic floor journey, we arrive at the derrière and hamstrings. Since this sit cradled in a chair for days and years, it’s incredibly common that adults have underachieve and weak muscles in these areas. The pathway I’m recommending to get them back on…

Massage

In short, foam roll just about everything. Hit up your calves, hamstrings, quads, glutes and back first. Tight adductors (groin) is a super common reason the glutes don’t fire correctly, we covered them in the last episode. Here’s a link to a shorter version of how to foam roll those.

Another crazy connection I’ve seen over the years is the opposite shoulder blade being an issue in glute/hamstring recruitment. The body balances itself on diagonals. Think about your footprints in sand, they’re not in a tightrope-like line, they zig zag. In proper gait (how you walk), the upper body should rotate over the forward leg. When working with clients, this element is often off, leading to a kind of waddle instead of a swagger. These folks are often in my studio because of back pain, knee pain and neck tension. All of it can connect to this diagonal element being lost in their walk and instead they pogo stick side-to-side. So, massaging the shoulder blade is critical as well before we get into trying to activate the rear end.

Stretch

The video details a couple approaches to stretching the hamstrings to start—we stretch the muscle as well as the fascial chain. What’s the difference? Stretching the muscle means working the joint in its full range of motion, versus the fascial chain is more like stretching the skin. Someone who taught a training I once attended likened it to if you were wearing jeans or a wetsuit—if there’s greater pull on the fabric, that’s more like a fascial stretch.

The action of the hamstrings is to bend the knee. Therefore, stretching the hamstring muscle would mean actively pulling open the knee like a clamshell. We have 3 hamstrings muscles, so stretching at different angles means we can target each one.

When most of us think about stretching the hamstrings, we think about a pike stretch or putting a leg out and leaning over it. This is our fascial stretch. Something easy like putting your foot up on a chair and leaning over it, while waving your leg side-to-side to pick up those 3 hamstrings will do the trick.

For the glute and the deeper hip rotational muscles, pigeon pose is a straightforward and good bang for your buck in terms of what it hit and the time you’re in the stretch. There’s a few options in this video to add the active stretch element to pigeon as well as some different fascial components.

Activate

We then move into a couple of simple activations you could even do pre-walk or run. To activate the glute max, gently press your foot into a wall. Make sure your thighs are parallel or have the active thigh slightly behind the standing leg. Feel your rear tone up as you press.

The hamstrings bend the knee, so have the same thigh orientation as above and then pull your heel to your bum. Taking the leg and foot at different angles will help to activate the different hamstring muscles. This is all explained in the video and you can fast forward to 20:23 for details. You can do the same exercise lying on your stomach and it will automatically keep your thighs in that parallel position, making it harder to cheat in the motion.

Lastly, we do a simple hip rotation activation of internal rotation and then external. It’s a gentle exercise, yet deceptively difficult. Another option is the clam series, which you can find here.

I always say my primary concern when doing this work is aging well and not necessarily the biceps and bikini-body. That said, I’m all for a butt-tastic body if it motivates you for some post-Covid fun as well as keeping your hips strong. 🍒

Pelvic Floor Rehab-Abductors & Adductors

As we travel up from the feet and ankles towards the pelvic floor, we hit the adductors and abductors (inner & outer thighs). These are the balance muscles of your legs, the I’m-falling-and-I-can’t-get-up muscles. The inner thighs run contiguous to the pelvic floor and core muscles. AND pretty much everyone is weak in these groups.

Massage

Par for the course of this Pelvic Floor Rehab series, we release, then re-engage. You have a few options for that here. The most cost effective is to purchase a foam roller. I always advocate buying a 36” roller as they are more versatile for things like core work in addition to release work. You have the standard density option (which can be pretty intense for certain areas of the body) or a less dense, softer version. Amazon has everyone beat that I ever see in terms of price, a link to purchase here. And here’s a link to a previous video on how to use a foam roller on the inner thighs as well as a trigger point release for the pubic bone.

You can also use a theragun or other self-massager. Two of my favorite options are here for a more affordable version and here for a more versatile version, particularly for when we get into the pelvic floor releases in a couple episodes. There are attachments to the latter massager that make it easier to access smaller muscles and yield a more pinpointed release.

Lastly, I love cupping the outer thighs/IT band. It’s an easy thing to do as you watch TV and is not rocket science. Here’s a link to the cupping set I’ve used for years. Alternatively, you can foam roll your IT band, link on tips for that here.

So, massage/roll/cup the inner and outer thighs. We also do some work on the Quadratus Lumborum (QL) in this video. This muscle causes a lot of issues for a lot of people and is often tightened up on just one side, lending someone to be crooked. I find that it becomes that way, in part, because of weakness in the muscles targeted in this video.

Stretch

You can easily stretch your IT band/abductors by putting a towel around your foot and pulling your leg across your body. Alternatively, you can put one foot on a surface like a chair or couch and then twist your body over that extended leg. Try to drop the targeted butt cheek towards the floor as you stretch.

For the inner thighs/groin, here is a shortened version of my favorite stretch that is also in this video.

To stretch the QL, stand inside of a doorway, bring your inside leg forward and grab onto the doorframe—you’re bending over the direction of whichever leg is forward. So, right foot in front, you’re bending to the right to grab onto the doorframe. You can gradually add a twist of your chest towards the doorframe and you may feel this stretch go all the way down your back.

Activate

My preferred way to activate the abductors is a simple side leg lift, a la Jane Fonda. I find that this isolates them better than doing a side squat walk with a band around the thighs. In a squat walk, I feel like people load more into the quads. Here’s a link to a shorter version of what I’m talking about.

For the inner thighs, you can adduct the legs (bring them together) with them up on a wall or in the air. Here’s a version in the air, which works the core more. If your hamstrings are super tight, the wall might be better. You can also start with a more gentle version like this with the knees bent.

The QL is the ‘hip hiker’ muscle. If you stand on an elevated surface like a curb or even a yoga block, you would pull the hip up directly to your ear on that respective side. You’ll know which side is your weaker if that motion feels completely foreign to your brain.

Having good stability in these muscles is a critical piece to balance and therefore aging well. This means aging well for all genders. Some of my male clients talk about these machines in the gym and refer to them as the ‘chick machines’. Balance is for everyone, so don’t forget to target these just as much as squats and lunges in your workouts—stability in these muscles will make things like lunges easier. And, these are the struts to the pelvic bowl, so inner outer thigh strength is pelvic floor strength. Channel your inner Jane Fonda, y’all.