Your ability to consciously relax your pelvic floor muscles is a critical part of your recovery program. You must learn to relax these muscles before they can become functional again and pain-free. Relaxing your pelvic floor, or reverse kegels is also called downtraining the muscles. The feeling of dropping your pelvic floor is similar to the moment of relief when you have reached the bathroom; when you urinate or have a bowel movement, you first drop your pelvic floor, and let the pelvic floor muscles (PFM) go. Pay attention to this, and see if you can feel that happening. The key to dropping your pelvic floor is visualization, and Deep Breathing. The best way to consciously release tension from the PFM’s is to try to release the muscles while you inhale. When you inhale properly with diaphragmatic breathing, your diaphragm actually lowers to make room for the breath, so it is natural to also lower and relax the pelvic floor muscles at the same time. When you exhale, your diaphragm rises to push the air out, and you then naturally raise or contract your PFM’s on the breath out. If you can get this Pelvic Floor Rhythm, reverse kegels will be much easier to do.
In order to do a reverse kegel, start by gently contracting your pelvic floor to feel what tightening the muscles feels like. Now relax, and let that tension go. Feel the difference between tension and relaxation. Try to go one step further now, and visualize that the muscles between the pubic bone and tailbone lengthen by gently moving your pubic bone towards the ceiling (if you are lying on your back), and gently move your tailbone towards the surface you are lying on. Imagine that the pelvic floor muscles are getting longer as this happens creating more space in your pelvic floor. Do this at the same time that you take a deep breath in. Don’t tilt your pelvis as you do this. Keep your spine still and let the movement occur in your pelvic floor. Be patient. This takes some time to feel the letting go or lengthening of these muscles. This can be practiced in sitting and standing as well.
It is helpful to take a mirror to look at your contraction and relaxation. When you perform a pelvic floor contraction (Kegel) a woman’s clitoris should move slightly downward, her anus should wink, and the perineal body (area between the vagina and anus) should move up and in. For men, the same should happen, except the penis and testicles should lift slightly. On the reverse Kegel, you should see the anus release and your perineal body move downwards towards the mirror. It should also feel like you are creating more space between the pubic bone and tailbone. Don’t make it happen, visualize and let it happen!
Eventually, once you have mastered the art of relaxing your pelvic floor muscles, you will need to check in with your pelvic floor throughout the day, and let go of any tension that you discover.