At Barefoot Physiotherapy we enjoy helping people across the lifespan to maintain and regain control of their pelvic floor muscles. Cuing a ‘Kegel’ or a correct pelvic floor activation and relaxation is an essential part of pre and post-natal physiotherapy. Pelvic floor muscles work hard to support the pelvic organs, especially throughout pregnancy when the weight on them significantly increases. Therefore, it is important to work with clients on activating their pelvic floor correctly to ensure no unneeded compensations occur. When there is poor pelvic floor strength or control, clients can experience worsening abdominal separation, lower back pain or pelvic/SIJ pain. A great way to start strengthening your pelvic floor is by learning how to correctly engage it. Below we’ve listed our top 5 pelvic floor activation cues. Once a client can activate the pelvic floor it is important to teach a correct relaxation as well.
Pelvic Floor Activation Cues
- Squeeze and lift: this is the cue most people will start with to try and initiate a pelvic floor contraction. The idea is you are relaxed and breathing normally while you try and engage the muscles in the pelvic region to squeeze and lift around the vaginal opening.
- Elevator Cue: in this cue we ask clients to imagine their pelvic floor is a lift. And that it’s resting tension is the ground floor, then you are taking it to the first and second floor and then you’re going to lower it gently back down against gravity. If they have trouble fully relaxing, you can cue for them to lower it to the basement as well.
- Posterior cue: hold in the passing of wind – this is a good cue to try and initiate a pelvic floor contraction from the posterior side. Some clients find this visualisation easier making for a more effective activation.
- Stop the flow of urine mid-stream: Similar to a squeeze and lift this cue again focuses on the anterior pelvic floor muscles.
- Zipper cue: this cue focuses on asking the client to imagine there is a zipper from their vagina to pubic bone. Then asking the client to imagine doing the zipper up.
There are many more visualisation cues to use for pelvic floor activation. If you want to learn more about how to strengthen your pelvic floor or to address any pain or symptoms of pelvic floor weakness book in to see one of the team at Barefoot Physio. In addition, if you want to learn more about what a women’s health physiotherapy session looks like at Barefoot click here .