Part 2: Annie’s Story
In Part 1 the functions of the pelvic floor were discussed, along with ‘self-image’ and cultural birthing choices. The Feldenkrais Method was outlined as an approach to somatic learning that addresses the pelvic floor as part of a whole coordinated system. Part 2 features one woman’s story.
Annie came for a Feldenkrais lesson for some help with her pelvic floor. The childhood memories she had of her mother’s incontinence had left a vivid impression. Annie remembers her mother holding her crutch each time she sneezed or coughed, and being unwilling to run for fear of leaking. This had Annie worried. Annie herself had experienced a “slow recovery” following the birth of her son, with control of her rectum returning only 6 or so weeks after the birth. For her sense of security Annie stayed at home close to the toilet during this time, wanting to get there fast at the first hint of a bowel motion. Whilst everything was “back to normal” by the time she came to see me, Annie was pregnant with her second child and sought to avoid some of the problems she’d encountered last time. Annie also hoped for a different experience in later life to that of her mother.
To begin our session, Annie and I looked at some simple diagrams showing the pelvic floor. Then we used touch to give Annie a sense of the “geography” of her pelvis and where we’d be working. Clarifying the bones of the pelvis can sometimes be so enlightening for a person as to immediately change the way he or she moves and relates to this area.
Annie lay down with bolsters under her knees, ankles and head which helped to reduce tension in her body. When Annie felt comfortable I asked her to gently expand her pelvic floor muscles (by pushing out and down), and then follow with a contraction (drawing them in and up). She found it difficult to differentiate between these two states. She sensed that she kept everything “very tight” especially around the anal sphincter, perhaps having developed this habit after the birth of her baby during her time of fecal incontinence. This was valuable information for us both and gave us a starting place. I noticed that Annie’s breathing was confined to her upper chest and that she would lift her shoulders to help bring the breath in. It didn’t seem easy for her to breathe.
I asked Annie to sense her breath low in her belly, even down to the pubic bone. At first this was difficult for her. As she inhaled I asked her to notice or imagine the opening/ swelling/ expanding of her pelvic floor, and the contraction/ drawing in as a natural consequence of exhaling. After a few minutes focusing on these movements Annie began to feel her two sitting bones move slightly apart with the inhalation as she imagined a balloon expanding deep and low within her pelvis. Annie was feeling the pulsating movements of her pelvic floor in harmony with her breath for the first time – all without effort. This new experience began to change the image Annie had of her pelvic floor and how it could work.
The reason I asked Annie to focus on contracting the pelvic floor as she exhaled rather than inhaled is because of the function we want to improve. When coughing, sneezing or laughing we are exhaling. It’s during these times that we especially want control of our pelvic floor in order to avoid leakages. By contracting with an exhale we are also taking advantage of the natural harmony between the pelvic and breathing diaphragms.
Annie and I then explored some of the ways that she carried tension throughout her body. This was important for Annie to recognise and observe, because by knowing what she’s doing in everyday life she can start to make some different choices. A person experiencing tension and pain will have a hard time making clear distinctions in their pelvic floor.
I brought Annie’s attention to her face and mouth. She noticed that these areas felt tight and she sensed that her lips were pursed. I guided her through some gentle movements of her jaw and tongue. At the end of these she observed a softening through her face, mouth and neck. I observed that her breath deepened and filled more of her torso. I asked Annie to start combining her breath with some movements of her mouth and pelvic floor. From an outsider’s perspective it may seem curious to coordinate different parts of the body in this way. Relaxation of the mouth and jaw correlates directly to the ability of the cervix, vagina and anus to open to full capacity. (This is very useful information for birthing a baby!) It makes sense then that an integrated approach to closing the sphincters and strengthening the pelvic floor following birth will also prove most effective.
The coordination of opening/ closing mouth and pelvic floor flowed easily for Annie, and I could see her become very deeply relaxed. Later she told me that she had been visualising the expanding/ contracting of her pelvic floor – like a flower opening and closing – from a place deep within her pelvis. This was an exciting new way for Annie to imagine doing pelvic floor exercises. No more straining and squeezing with little effect.
By the end of our time together, Annie was able to breathe more fully with her whole torso. She felt more relaxed, grounded and at ease. When Annie sat up at the end of the lesson she was aware of how her pelvis supported her, and of sitting comfortably upright without having to think about it. She could feel the bones of her pelvic outlet against the table and a relaxed perineum. When she contracted her pelvic floor with a gentle ‘drawing in and up’, Annie said she could actually feel what she was doing! The movement was calm and clear. No desperate grabbing for control. No sense of panic or confusion. Just a simple movement as it’s meant to be. This achievement gave Annie a great sense of hope and excitement. She was delighted that pelvic floor “exercises” could feel so vastly different to that which she’d experienced previously. They could even be “relaxing and fun to do!”
The journey towards empowering our pelvic floor is a very individual one. As unique as each person is, so too will be their self-image, the history of their pelvic floor and the way that they have embraced (or not) this part of themselves. My hope is that each woman may find a gentle way of being with the ups and downs of her pelvic floor and her life, and that she may come to know and trust the intelligence of her body and its remarkable design.
A full length article entitled “Empowering your Pelvic Floor” (of which this article is an excerpt) is freely available upon request.