Category: pelvic floor therapy

4 Tips for Strengthening Your Pelvic Floor

Posted on by Grayson Schultz

photo of a femme with their butt clad in a pair of black bikini bottoms with pink hearts on them; they have their right hand reaching back around on their right buttcheek; white bar at top above photo and larger white bar at bottom with black text "4 Tips for Strengthening Your Pelvic Floor" and "Chronic Sex"

TW: gendered language in most of the links šŸ™

Going to pelvic floor therapy this year really taught me a lot. Many of us have been taught that Kegels are the be all end all exercise for our pelvic floor. The reality is much, much different.

The Continence Foundation of AustraliaĀ (CFA) has a great explanation of the pelvic floor, complete with visuals. I highly suggest familiarizing yourself with these muscles. At the very least, visualizing them helped me to understand more about the muscles I was using and which ones I wanted to target with various exercises.

Please check with your doctor before doing these exercises. There are people for whom these will be more harmful than helpful.

Contract, Hold, Relax, Push-Out, Relax

This is one of the most basic pelvic floor exercises (Kegels with a twist!).

Most Kegel-type exercises only focus on the contract, hold, release aspect. However, this ignores a lot of what our muscles need to do. For example, I’ve been doing Kegels at least once a week (usually more) for close to two decades. My pelvic floor was still shit because it would getĀ tooĀ tight and tooĀ tense. You can overwork these muscles – and I was doing just that.

What you want to do with this – after learning more about the pelvic floor and how it works for your genitalia – is tighten your pelvic floor. Do not go 0-100, though. Start low and slow – tighten gradually and go maybe to 50% of what you think you’re capable of. Hold that for ten seconds and release, focusing on getting back to your resting level of tension. Then, push out with those same muscles. Again, go low and slow.

Squats

You can do these on your own, against a wall, or using a leg press. The leg press method might be best for those with mobility issues in their lower body. However, if using this method like I do, there are a number of things you have to keep in mind.

Keep the weight low and your repetitions steady. What you should aim for is a low weight you can press 8-10 reps easily 1-2 times. Using a high weight or trying to do too many repetitions can lead to problems for your pelvic floor, knees, hips, and back.

Regardless of method, you want to contract your pelvic floor during this exercise, but not at 100%. Always aim for a lower intensity with your contractions. You should never extend your knees to the point where they go past your feet.

Bridge

The bridge exercise is one of those mainstays in the exercise world. It’s used in yoga, pilates, and more. It’s a versatile one because it helps us to strengthen our core as well as our back and hips. Wikihow has a great run-down of how to do this.

One of the biggest benefits to this is that you can target different muscles depending on what your goal is. Want to focus on your abdomen? Tighten that as you lift your body. Glutes? Tighten those! The possibilities aren’t endless, but there are a plethora.

I’ve been doing bridges on and off since I was 12. It was one of the very first yoga-type exercises I learned (thanks, Seventeen!) and it’s very helpful. During the time I was in pelvic floor therapy and other physical therapy, this was one of the go-to exercises for both my pelvic floor and my back.

When focusing on your pelvic floor, you want to contract with your stomach as you lift your torso off the floor. Don’t go to 100% here – just focus on tightening a bit to where you’re not uncomfortable.

Core Exercises

Your core helps support your entire body. Strengthening this area can help to alleviate pressure and stress on both your pelvic floor and back. You can have a strong core without having six-pack abs, so don’t feel that you need to subscribe to unrealistic body image ideals.

CFA once again has a great resource for this (PDF). The important thing is to aim for exercises that will strengthen your core without overtaxing your pelvic floor muscles. Things like crunches and sit-ups? Those are things to avoid because what do we do? Clench more muscles than we need to. This can cause or increase problems with our pelvic floor.

Instead, stick to exercises such as wall push-ups, doing the bridge with an exercise ball, modified planks, etc.

Some Notes

The pelvic floor is a complicated thing. It’s a set of three muscle layers that move in ways no other muscles in your body do.Ā These muscles help you in the bathroom, the bedroom, and all throughout the day.

Ignoring them is like always skipping leg day at the gym. You just shouldn’t do it, regardless of your gender or genitals. Being mindful of how you hold tension is very important to ensure your body isn’t harming itself with that tension.

You can snag some lacrosse balls or spiky balls to use on tense muscles in your hip and butt like the piriformis. There are a few other good things you can snag to help with tension in these muscles – I’ve got my favs over on Amazon.

There are some great pelvic floor exercisers out there, too! Take a look at these offerings from Vibrant, Peepshow Toys, and SheVibe.

When in doubt, I’d suggest talking with a pelvic floor therapist for more pointed tips. You can also download CFA’s Pelvic Floor First appĀ for more ideas. I highly suggest browsing their site, too, as it has some great information.

Discharged from Pelvic Floor Therapy

Posted on by Grayson Schultz

dark background with light teal letters "Discharged from Pelvic Floor Therapy" and darker teal letters below that "Chronic Sex" - under this is an illustration of two glasses with reddish liquid clinking together between two intricately designed squiggles

TW gender dysphoria, molestation/sexual abuse mention

It’s been a while since I did an update on my pelvic floor therapy journey. The truth is that, while it’s been immensely helpful, it’s also been quite dysphoria-inducing.

I canceled a few appointments here and there. It felt like going in would do more harm than good. On top of that, I haven’t ‘come out’ as genderfluid to any of my providers. Hell, most of them assume I’m straight because I’m married to a dude. It’s hard to find providers that fit right for me and I fear losingĀ them to bigotry by coming out.

Plus, honestly, having someone play with my vagina is… a little PTSD-inducing, too. I was molested as a child and, no matter what I did, I couldn’t erase concerned thoughts from my mind. On top of that, we don’t talk enough about our sexual parts which makes communication around this awkward.

There are a lot of factors that make this less accessible to many of us.

That said, I kept up with my home exercises and added in newer ones along the way. Things that allow me to work outside of appointments really let my ability to learn and expand on that knowledge shine.

On Monday, I got the great news that we’re done with pelvic floor therapy. It was certainly a relief to hear.

The intense spasms that led me to therapy have drastically decreased in frequency and intensity. Instead of waking up several times a week in the middle of the night at 8/10 pain, I’ve only had a handful of occasions over the last few weeks. The most recent middle-of-the-night spasm was last week. Instead of being 8/10, I was sitting at 5/10. It took less time for the pain to ease, too. The pain I’ve had testing toys and being sexy has gone down as well.

Learning more about my pelvic floor and how to strengthen it has been immensely helpful. I’ll be highlighting some of my favorite tips next week. For now, though, it’s time to celebrate!

Pelvic Floor Therapy: Appointments Three and Four

Posted on by Grayson Schultz

B&W photo underwater with teal overlays and white text "Pelvic Floor Therapy: Appointments Three and Four" and "Chronic Sex"

I had my fourth pelvic floor therapy appointment yesterday. I left with a very massaged butt.

For some reason, it feels a little odd that an older gal is the one that did it. It works, though!

When I last wrote about PFT, I was struggling with a lot of pain. Trying new exercises – especially with my spine/neck – is rough. Now that I’ve weaned off the daily use of muscle relaxers, the PFT stuff is catching up to me, too.

Appointment three consisted of an external exam focused on my butt. What we found was that I have a very tight piriformis muscle too! This connects the spine with your leg and helps control your hip movements. It can even cause some sciatica-like pain!

It also explains a lot. My left hip is very painful at times, something that seems to be related to my overly tense muscles. I’m having to do a lot of exercises or movements around opening up the hips, like sitting crosslegged.

For appointment four yesterday, we focused on manual manipulation of this muscle… so, like I said, a sweet older lady spent a while rubbing my butt. Between her, my new acupuncturist, and the hubs, I’ve really been getting a lot of butt action!

It’s a really odd sensation. There’s a lot of tension there. I don’t seem to notice it unless someone is applying pressure, though. It’s very similar to having a tight IT band. It makes sense – the pelvic floor muscles, leg muscles, and back muscles all work together. It’s part of why my lower back pain makes so much sense, too.

I mean, that and my bulging disc.

I should’ve expected it, but I’m dealing with increased pain as we try to improve these muscles. It’s not my favorite thing, especially when it means waking up with more vaginal pain.

For now, I’m focusing on a few exercises: squatting, hip flexor stretches, and squeeze/contract. The only ones that seem to help are the hip ones, though, so that’s where my focus is. Hopefully, things won’t be quite as painful soon.

Pelvic Floor Therapy: Second Appointment

Posted on by Grayson Schultz

photo of a catcus plant in a terra cotta pot, flowers on two of its stems, sitting on top of a table; to the left, white text "Pelvic Floor Therapy: Second Appointment" and "Chronic Sex"

If you missed the first post on PFT, click here to catch up.

Yesterday, I had my second pelvic floor therapy appointment. I should’ve had it last week, but wound up feeling really crummy while tending to a very nervous guinea pig.

Jaq lays on my chest (clad in a grey tee) and under a yellow/grey/white quilt; he's a white and tan guinea pig with gorgeous dark eyes

(Jaq’s doing a lot better by the way.)

I’d been doing exercises my therapist asked me to do. I didn’t think they were helping. In fact, in conjunction with these exercises, I have weaned off my muscle relaxers… which is great, but also not.

Since last week, I’ve actually had several instances of waking up in the middle of the night with these spasms we were concerned about in the first place.Ā At my appointment, we discovered that the reason my pelvic floor muscles were so good that first appointment wasĀ becauseĀ of that med.

We hoped I would at least keep some of that strength and less of the tension. Alas, that’s not what’s happened.

When MJ got in there for a pelvic exam, it was instantly uncomfortable. As she moved to working on the left side, it felt like she was scraping my vagina with the jagged ends of paper clips. A dull ache started and persisted through the rest of the exam – and even into exercises.

The muscle on the left that’s struggling seems to be one that’s also involved in my hip. This could be a part of why my hip and back both hurt.

Since that contract and release exercise was no longer helping, we decided to move to two other stretches – something similar to the wall hip stretch, but with the leg being leaned on fully on the floor, and squats.

These combined with the exercises I have from my spine/neck PT – it’s a lot. After back-to-back PT appointments today, I was really tired. My muscles are exhausted. Even more, my left hip isĀ soĀ tight it’s not even funny. I have to lean on things cooking or doing other tasks.

Still, I hope that this leads to solutions – even if it’s different than we thought before.

In other news, it’s World Mental Health Day. Learn five ways you can help end mental health stigma {gifs in link}.

Pelvic Floor Therapy: Day 1

Posted on by Grayson Schultz

B&W photo of a person with long dark hair wrapped up in a sheet and hiding their face; white text: "Pelvic Floor Therapy: Day 1" and "Chronic Sex"

Earlier this year, I made an urgent appointment with my primary care doctor. She’s also an OB/GYN, which I love. I had a spot ofĀ seborrheic keratoses on my pubis that alarmed me. I didn’t know what it was before the appointment but, in prepping for my boudoir shoot, I found this giant mole-thing.

It was kinda scary.

While I was there, though, I also brought up something I’ve been dealing with for a few months. I will wake up with pain in my pelvic region. At times, it can be throbbing, stabbing, or spasmodic. I’ll usually need to pee, but have a hard time easing up muscles to let myself pee. Afterward, the pain is still so bad that I have to get in the fetal position and shove a pillow in my abdomen.

After an invasive and dysphoria-causing transvaginal ultrasound, everything was found to be normal. Two weeks later, I reached back out to my primary care doctor to see if pelvic therapy might help. So now, in addition to spine physical therapy for a bulging disc, I get to do pelvic floor therapy.

Yay?

First appointment

Today was my first visit with my pelvic floor therapist. She is a little older and incredibly kind. I will admit, though, that I was a little nervous about the appointment.

Not only was I dealing with anxiety around having someone manipulate my vagina, but I also wound up dealing with some bowel incontinence earlier in the day.

a view of Kirsten's legs while she's on the toilet; her black boxer briefs from Tomboyx are visiable, as is a blue Ikea rug and while/beige tiles

Apparently, I’m not allowed to eat pineapple and drink juice anymore, says my GI tract.

I was worried about how this might affect things. Would we be able to do as much? Or, the more concerning question for me, was I going to just let loose everywhere?

Thankfully, I did not!

The first part of the appointment was spent talking about these spasms – when they happen, what might bring them on, etc. I mentioned my puzzling neurological stuff in addition to some rough abuse stuff I’ve been through.

It wasn’t exactly the easiest way to start a doctor-patient relationship.

Next, though, she pulled out a pelvis model and we talked through anatomy around the pelvic floor muscles.

pelvis model; the hip bones are visible along with the muscles that create the vaginal outside and the uterus poking out the top

Aside from the uterus popping out the top there, this is how a female pelvis looks. The hip bones are seen here in white with muscles in red. If you look closely, you can make out the urethra and vagina, too. One thing I always struggled to visualize was the different layers of muscles. This model comes apart so you can see the pelvic floor muscles both on the outside and inside.

The exam

It was really helpful to have a model to talk about the anatomy, but also for her to demonstrate what she was going to do with the exam.

The exam itself wasn’t horrible. I’m used to seeing my primary care doctor (who is also an OB/GYN) though, where I don’t have to make eye contact. That part got a little funky.

For those of you who haven’t had this type of therapy, the first thing is to switch from shorts to a hospital gown and lay on an exam table with a sheet over yourself. Next, the therapist feels around the outside of your pelvis – really, the outside of the labia and where it connects with your legs.

The exam moves to the inside, with the therapist using their fingers to check the muscles out. During different stages, they might ask you to clench or bulge/push out. This helps them to test the strength of your muscles.

My initial concern was that I might have loose muscles, but it’s the opposite! One thing we noticed quickly was that the left side of my pelvic floor was very tight. We then found the same at the bottom of my pelvic floor.

This isn’t super surprising. I tend to be tense in general. My left side is also the worst with every single health issue I have.

The treatment

For now, the first thing to do is start an at-home exercise. I mean, this is PT after all!

The one we decided to focus on for now is the submax:

This exercise is fitting for patients with pelvic floor tension or elevated baseline at rest. Begin at rest, contract your pelvic floor muscles gently, 70-80% effort. Hold the contraction for 5 seconds, then relax and release all tension for 5-10 seconds.

I am supposed to be mindful of my pelvic muscles, too. It’s easy to hold tension in pelvic muscles. Stress – ya know, like from begging Congress to not kill you – just makes that worse. Dealing with weakness in muscles can make them get tense trying to do their job, too.

There are some exercises that can help with pelvic floor tension as well. Right now, we’re avoiding those since I’ve got this bulging disc, but we will build up to them.

I’ll be seeing my pelvic floor therapist weekly before moving to biweekly. I’ll be documenting how things go here, too, because we need more resources on all this.

Have you ever tried pelvic floor therapy? What did you think?