Over the last year, I’ve witnessed a lot conversation centered around the social/emotional toll of the coronavirus pandemic and the abrupt changes it has imposed on our lives.

But what about the physical toll? If you are pregnant, if you’ve recently had a baby, if you already have any kind of pelvic health concern, you might have noticed that symptoms of pelvic pain, leaking, sensations of bulging or prolapse may have appeared (or reappeared) with a vengeance.

When we think about WHY pelvic floor symptoms crop up on a dime, here are some of the factors we might consider:

1) Lifestyle: Are you experiencing an increase in stress? A decrease in sleep?

2) Activity: Are you moving or not moving in ways you normally would? Are you experiencing new loads? Maybe you’re trying out a new online fitness class?

3) Diet: Have you changed what/how you are eating? Is your GI tract on the fritz?

Without knowing you personally, I can make a pretty educated guess that right now: stress is high, you might not be sleeping as well, your exercise routine is different than it was, you might be carrying kids a lot more than you were, and you’re eating in ways that are a little different from “before”. Any of these factors individually can influence our pelvic floor health and sensations of discomfort. Right now we’re bombarding our system with most or all of them.

If you are experiencing an uptick in pelvic health symptoms, please know, it’s pretty normal under the circumstances. It’s probably temporary. Also know, you can probably do a little bit to mange your symptoms.

If you are experiencing any pelvic floor symptoms like pain, pressure, sensation of bulging or increased leakiness, try out some of the following tools which may help reduce your symptoms.

1. Breathe.

Diaphragmatic breathing takes the pelvic floor through its full range of motion, including a lengthened or relaxed position.⁠ Making sure we BREATHE and RELAX in times of stress is the first line defense against many pesky pelvic floor symptoms.

Bonus: The vagus nerve, which is intimately involved in our body’s relaxation response, passes through the diaphragm. As you breathe diaphragmatically, you massage this nerve, activate it’s relaxation response and help your body chill out. A lot of us carry tension in our pelvic floor, just like in our shoulders, and that tension can be a direct contributor to pelvic floor symptoms. You may notice some reduction in symptoms just by reducing overall tension in the body.

Here’s a crash course in diaphragmatic breathing:

On your inhale, expand your ribcage in 360 degrees (like an umbrella opening). As your ribcage expands, relax and release your belly and pelvic floor (this means your belly should gently expand on inhale, not contract!!). Exhale completely (you can’t take a good inhale without a good exhale).

If your shoulders move towards your ears on inhale, your diaphragm isn’t working to its full potential. Focus on keeping the shoulders down as you inhale and letting the ribcage expand outward.

If you are experimenting with reducing pelvic floor symptoms, set aside 5 minutes a day to focus on breathing. It can take some time to get the hang of this, so don’t get discouraged if it doesn’t initially feel intuitive.

If you need more instruction or advice to help get the hang of diaphragmatic breathing, download The No B.S. Guide to A Stronger, Drier Pregnancy and Postpartum.

2. Practice relaxing your pelvic floor. 

To do this, try:

⭐ Hands and knees abdominal release: In a hands and knees position, let your belly relax and hang towards the ground. This gives your diaphragm room to expand and encourages your pelvic floor to reflexively relax.

⭐ Do you use progressive muscle relaxation to wind down? Try it for your vagina! Contract and RELEASE your pelvic floor. Contracting the muscles before you relax them may help you find a deeper release. Once you find the release, focus here for a while: Take a big diaphragmatic inhale and feel your pelvic floor relax (think about inflating your belly and pelvic floor with air), exhale and let it deflate. Spend a minute or two with your eyes closed using your in breath to relax your pelvic floor. A lot of folks walk around all the time with their pelvic floor clenched. Do you? Hard to know unless you can get a feel for what the release feels like.

3. Spend time in positions that lengthen the pelvic floor.

(Bonus: Incorporate diaphragmatic breathing to further relax the pelvic floor.)

A few options include:⁠

⭐ Reclined cobbler⁠: Decrease intensity by supporting knees with yoga blocks. Modify for pregnancy by propping your back up on bolsters or cushions so you are lying at an angle.

⭐ Happy baby: Decrease intensity by holding legs around the back of the thighs or hugging knees to chest.

⭐ Supported deep squat: Deep squats can be supported by placing a yoga block under the bum OR a rolled up yoga mat under the heals OR using something like a TRX or a doorknob to provide counterbalance. Whichever modification you choose, make sure you can maintain your back in a neutral, untucked position. If you can’t keep your pelvis untucked or if you can’t relax in this position, skip it!

4. Release the muscles that pull the pelvis into a tucked position (tucked pelvis –> tight pelvic floor).

Two great options:⁠

⭐ Calf Stretch⁠ with a half-dome

⭐ Standing Hamstring Stretch⁠

It can be discouraging when pelvic floor symptoms ramp during stressful times (I mean, it’s the LAST thing you need added to your plate). I get it. But give a few of these ideas a try. I hope that a few of these suggestions help you to take control of one piece of your life during a time when so much is out of your hands.

A few last resources for you:

• Download your FREE copy of the No B.S. Guide to a Stronger, Drier Pregnancy and Postpartum. This takes a deep dive into the inner workings of your inner core. It focuses on how to use breathing as a tool for strength, and it contains my favorite diaphragmatic breathing drills.

• Check out my blog post 10 ways to Modifying Exercise to Manage Pelvic Pain, Pressure or Leaking where I dig into ways to modify exercises to minimize pelvic floor symptoms. Even if exercise isn’t your number one thing right now, a lot of these strategies apply to activities of daily parenting.

• Consider booking a virtual pelvic health physical therapy consult. Many excellent pelvic health PTs are working with clients online. I’m happy to send a few names to you.

Learn how to dial in your breathing strategy to harness control of your pelvic floor and feel stronger in your workouts. Grab your FREE copy of The No B.S. Guide to Breathing for a STRONG Pregnancy and Postpartum.

My mission is to make sure that having a baby is not a reason why you can’t do all the things.

Contact me with questions about exercise or pelvic health pertaining to pregnancy or postpartum. I work with people online and in-person (Seattle-area, Bellevue, Redmond, Kirkland) to develop personalized pregnancy and postpartum exercise plans.

Certified Prenatal & Postnatal Coach, Pregnancy & Postpartum Athleticism Coach and Postnatal Fitnesses Specialist.