Pelvic floor stretching/release

[jaja]

I was thinking if Kit or anybody in the forums have experience with releasing tension in the pelvic floor. Tightness and weakness in this area — often times happening at simultaneously — are quite common and can lead to a wide array of dysfunctions. Ladies are usually the primary target and therefore the ones that most often seek Pelvic Floor Therapy (which is in itself a rare specialization of physiotherapy).

With my history of pubalgy and tight HF, I've always known my PF muscles are tight and possibly weak. Recently I had a wake up call: sudden prostatitis (the most obscure male genitalia disease), which I suspect is caused also by the current state of my pelvi.

Does Stretch Therapy have some protocols to deal with these muscles?

[Nathan]

Interesting question. Hope you are doing okay - I read that acute prostatitis can be life-threatening 

I figured if the pelvic floor were addressed anywhere, it would be Stretching & Pregnancy, so I took a look. It does have a whole section on pelvic floor strengthening but I didn't see it talking about directly stretching the pelvic floor muscles. My (uninformed) guess is that the standard groin stretches will do what can be done. I did a quick Google search and most of the "stretches" being recommended are not actually stretches, but relaxation of the muscles, in child's pose or the deep squat, for example. It seems like daily deep squatting and lying relaxation would cover most people's needs, but perhaps your case is different.

Hopefully @Kit_L can add more.

[Kit_L]

I had a quick look around the net to see if anything new has emerged since I wrote Stretching & Pregnancy. Not much, it seems. This URL immediately below pretty much summarises the current state of knowledge:

https://nafc.org/bhealth-blog/how-to-relax-your-pelvic-floor/

The reason I still recommend the Kegel exercises is that doing these helps identify exactly where these muscles are—with that experience, concentrate on the relaxing and letting go part, which is more likely to be the more helpful activity for you.

But there are more subtle distinctions and practises, too. For example, in some schools of yoga, three separate pelvic floor control techniques are recognised: ashwini bandha (contracting the anal sphincter), mula bandha (contracting the perineum between the anus and genitals) and vajroli bandha (contracting the genital muscles; for men this makes the penis harder if erect; for women tightens the grip of the vagina). All may be combined as 'maha bandha", the 'great lock', or 'great seal'. In my experience, each can be distinctly felt and practised. The sense of how to contract each one is best achieved with extremely gentle contractions in the beginning, because the beginner finds it hard to distinguish these, and all the pelvic floor muscles tend to contract all at once. Some suggestions for how to separate the sensations:

When next urinating, gently stop the flow a few times; this will locate vajroli bandha clearly. Towards the end of the urination sequence, you can grip the same muscles vigorously to more forcefully expel the urine. I recommend urinating while sitting, too, to make the sensations clearer (and neater!). The same muscles can be activated when sexually aroused; the act of relaxing these muscles is even clearer then.

Ashwini bandha can be practised any time: imagine you are trying gently to stop defecation. The sensation is completely different to vajroli bandha, once you have felt it a few times.

Once ashwini and vajroli bandha can be located, felt, activated, and let go, then mula bandha can be practised: feel the space between the anus and the genitals and try to contract, and relax, only that area.

Once you can distinguish all three areas, try to contract, then relax, each in turn, then contract and relax all together (maha bandha), then go back to the individual sensations; do a few rounds of all four. Make sure you let all tension go from each area before moving on, or ending the practise.

And when you do your lying relaxation practise, recall the sensations of exactly where each set of muscles is, and feel if there's any residual tension there, and on each breath out, let that area soften and relax completely.

Finally, you may consider finding a pelvic floor therapist who does manual releases (myotherapists as well as physiotherapists do this)—the experiences of a number of friends has found this effective. I won't discuss the release techniques here; best to discuss this with the right therapist.

[jaja]

Thank you, I appreciate your take on the concept.

20 hours ago, Nathan said:

Hope you are doing okay - I read that acute prostatitis can be life-threatening

If bacterial, yeah. My case it's just a pain in the butt (quite literally). It seems to be improving, however.

19 hours ago, Kit_L said:

Finally, you may consider finding a pelvic floor therapist who does manual releases (myotherapists as well as physiotherapists do this)—the experiences of a number of friends has found this effective

Yes, it's something I plan on doing. My urologist said it's best to treat the inflammatory state first, though. In the meantime I searched the web for infos and found very little useful advices. Then I turned my eyes here, since this place it'd hands down the best resource for knowledge related to stretching and less known type of therapies.

Thank you for the detailed explanation about the bandhas! I'm going to try them and report back.

19 hours ago, Kit_L said:

The reason I still recommend the Kegel exercises is that doing these helps identify exactly where these muscles are—with that experience, concentrate on the relaxing and letting go part, which is more likely to be the more helpful activity for you.

I'm familiar with kegels. My understanding is that kegels are the contractions used to stop the urine, while the reverse kegel is forcefully push the urine out and cause the same muscles to stretch. Nobody taught me any of this, I've read on the Net one should be careful because there's a risk to make the PF overly tight with kegels. However, if I've understood correctly, you suggest to tense the muscle and then let go to relax, similarly to what is done in yoga nidra. Am I correct?

[Kit_L]

36 minutes ago, jaja said:

However, if I've understood correctly, you suggest to tense the muscle and then let go to relax, similarly to what is done in yoga nidra. Am I correct?

Yes; Kegels are closest to the vajroli bandha I mention above, but the relaxation part is at least as important as the strengthening part. For now, I recommend trying to locate the three areas using the techniques described above but with zero effort—instead, after locating the area as accurately as you can, put all your attention into letting go of all tension there. Tiny repeat contractions will help you in this. And once the area are clear in what I call your "sensorium" (your proprioceptive body map) concentrate on letting any tension go from these specific places when you do your lying relaxation practises. 

[jaja]

First feedback. I don't seem to have issues in locating the various muscles.

Vajroli bandha is easy enough to do, but it's challenging to completely isolate that muscle. If I initiate a somewhat strong contraction the anus gets also activated. Side note: it's surprisingly hard to do while on my back during yoga nidra.

Ashwini bandha is the easiest and I can contract strongly without issues

Mula bandha: I think I can do it, but it's hard to tell. I imagine to push my anus and scrotum towards each other. Again, extremely subtle sensation.

-------

On a separate note, this unfortunate medical condition led me to discover some interesting proprieties of substances such as resveratrol and quercetin. Potent stuff, if you manage to increase bioavailability. I'm now symptom free, if I discount a funny feeling I sometimes get in the pelvic floor area.

Another interesting data I collected, last week: a 3 days fast managed to get rid of all the symptoms (actually they were gone after 24h or so). Got them back with the first sip of coffee though.

[Kit_L]

To discern the subtleties clearly takes time—months or more, rather than a week or so. Keep going, in other words.

And I did not suggest doing the contractions during your relaxation practises; instead, use the practises at other times to identify the different sensations and the locations of these, and once the areas are clearly located, use the relaxation practises to let any tension in the areas identified go, and go completely, when doing the relaxation exercises.

[jaja]

I'm still working on proper muscular activation and subsequent relaxation, but today happened something odd. I practiced yoga nidra for 30 minutes or so, using one of the recordings. Near the end of the session I noticed my prostate had inflated. I have no clue on why, I can speculate it might have something to do with hips position relative to the organ…maybe it was getting compressed because I have APT. I hope the inflammation will subside by tomorrow morning.

[Kit_L]

If it were a position thing ("it might have something to do with hips position relative to the organ"), I expect that this would have happened before—you have done hundreds of these by now. Ask your doctor to check, if it stays in this condition.

[jaja]

Once again, you were right @Kit_L. Although PF is a surprisingly deep and complex topic that requires rather specific knowledge.

A lot happened in the latter part of 2023. For the longest time I tried to relax my perineum with yoga nidra practices as well as kegel exercises the way you suggested it. Prostatitis was recurrent though and forced me to practice with legs rested on the sofa. Eventually I got sick of this and consulted different practitioners. The first was a proctologist (suggested by mu urologist). He stated everything is fine down there, aside from my PF: apparently I contract when I'm supposed to relax and vice-versa. He of course instructed me to consult a PF therapist (which was going to be my next move anyway).

The PT assessed me and said I have hypertonia (so excess of tension) of the PF, poor proprioception, and difficulty performing voluntary contractions. If I don't re-educate my pelvic floor, I'm on the right track for future incontinence and perhaps even inguinal hernias. The good news seems to be that I am responding better than expected to rehabilitation. The therapy sessions are mostly focused on internal massages aimed at stretching and releasing the muscles. Then I have to relearn the way I brace during squats and deadlift, as well as doing some breathing exercises to learn how the PF moves and how to relax it. The tricky thing here is that those muscles elongate during the inhale and contract during the exhale; I have to focus a lot to really get into this pattern.

[Kit_L]

@jaja: all good to hear. Do keep checking in from time to time and keep us updated. This is a subtle and important realm of exploration.

[apat7]

Hi, I saw this thread and while I haven't totally resolved my own similar issues, I thought I'd cross post my thread since it deals with similar issues (haven't posted updates there lately although I intend to, my journey is continuing) and leave some thoughts in case it's helpful. Take all this with a grain of salt since I'm not 100% better, but I do think I've made progress and might have something to offer.

For context, since August 2023, I had/have dull pain in my pelvic floor that comes and goes, occasional sharp nervy sensations there, and have had intermittent non-bacterial prostatitis in the past as well (both before and during this period). Since then, I've seen regular doctors, a urologist, a spine doctor, a chiropractor, a pelvic floor PT, a sports doctor, and I've done a lot of personal reading/research along with DIY PT. I also had an MRI of my back and pelvis, and several blood tests to rule out vitamin related neuropathies.

So far, doctors can see I have symptoms and can see some hypertonic muscles, but otherwise I seem to be normal. The most likely culprit so far after much time spent on this is that I've developed some runaway muscle imbalances that have caused my adductors to cause trouble in my pelvic floor. I wish I kept some links to things I read over this time, but among the helpful things you might explore that I've read about are:

- non-bacterial prostatitis often has nothing to do with your prostate (specifically if you're young), but mimics the symptoms (unless a doctor verified an inflamed prostate). Tight pelvic floor muscles can cause burning when urinating etc

- aggravation of the adductor or rectus abdominis insertions to the pelvis can radiate pain into the pelvic floor and cause hypertonicity

- adductors can get overworked by many things including an imbalance between anterior (adductors and rectus abdominis) and posterior chain. I notice you mentioned having APT and pubalgia at points which may point to this being a helpful thing to explore (I also had pubalgia like symptoms in my abdominals, but no seeming actual damage)

- the obturator internus muscle (deep external rotator) is a common culprit in pelvic pain in men and can be triggered by issues in larger muscles

- while the muscles of the legs aren't necessarily directly connected to the pelvic floor there's shared fascia that can be overstretched

Most of my symptoms were not easy to reproduce via specific actions, but one reproducible sharp pain I got was around my ischium was doing a 90/90 type stretch on the ground. My pelvic floor PT did trigger point massage on my abdominals (seemed unrelated at the time and I didn't even know I had trigger points there but I had a ton of bad ones) and that pain disappeared completely.

My current approach to resolving my symptoms is to regain lost strength in my posterior chain and deep core muscles to rebalance (I've really let this go) (long term fix), try to address trigger points as they come up (short term fix), and try to get hypertonic muscles (left adductors in particular due to old injury) to chill out without doing "hard" stretching (light stretching is ok). I'm also seeing an acupuncturist, but can't say yet if it's helping.

I hope some of this is helpful! I'll end this with a strong recommendation to read "A Headache in the Pelvis" by David Wise and Dr. Rodney Anderson which is a book my pelvic floor PT recommended. This could give a lot of insight into strategies to try. Good luck in your recovery!

[Kit_L]

Hello there, @apat7. Thanks for posting this detailed exploration. Please tell me: how well can you do parts 1 & 2 of the tailor pose? I have a short tutorial here:

https://www.youtube.com/watch?v=Ha3BgV5K1eQ&

The pelvic floor is definitely worked in this one, especially part 2 (which is more advanced, but basically asks you to pull your straight body and pelvis forward, pivoting only around the hip joints). I did not demo this, because this tutorial is for beginners.

In my experience, obdurator internus will be stretched in all the piriformis poses we use. And please take an image of the 90/90 pose you mention above, too; I'd like to try that.

One last thing: are you able to précis the recommendations of the book you mention above, and were these suggestions useful to you? Thanks again!

[apat7]

Prior to my injury/issue coming up, I was able to get fairly flat (calves to ground) in part 1 with my back against a wall, but had yet to be able to do part 2 in any meaningful way. For the time being, I've found that taking a break from stretching all together while gently strengthening has been improving my situation, so I'm hoping to make more progress there before returning to stretches like this. Once I return to stretching more again, is it valuable to do part 2 from a raised seat position (like a yoga block) to allow that movement forward, or should this progress on the ground from a more advanced version of part 1?

I don't have an image of me doing 90/90 readily available now, but this image from Google images captures the pose:

RE recommendations from the book, much of what it offers in practical action to take matches with what has been discovered already by @jaja in the posts above (internal massage, relaxations), but also discusses different trigger points that refer pain to that region as well as different manifestations of pelvic floor tightness. I found the trigger points perhaps most helpful, but I think it was enlightening to me to understand how different tight pelvic floor muscles can contribute to different symptoms that reflect things I've experienced at different points in my life and doctors couldn't find an answer to.

[Kit_L]

@apat7: re. part two of the tailor pose: using a block to help start the forward movement of the spine and pelvis as a single unit is perfectly fine (I say this, because this is exactly what I used to do, both for the tailor pose and for the pancake). Do keep us posted, and best wishes.

 

[jaja]

Thank you for your comment, @apat7. I didn't get notified until you mentioned me directly, so I'm only reading it now.

On 1/18/2024 at 3:29 AM, apat7 said:

non-bacterial prostatitis often has nothing to do with your prostate (specifically if you're young), but mimics the symptoms (unless a doctor verified an inflamed prostate)

100%. Not only this, I must add that tight muscles can overtime affect the prostate itself and make it swollen and tender (as it seems to be my case). I'm saying this because during my first urology visit I had actual inflammation there. Later on, a proctologist didn't found a relevant condition, despite the fact I was experiencing relapses from time to time. And now…I'm at it again.

Yes, brief update. It's been two days of mild discomfort at night, with relief after doing breath work and stretches like child poses. Most likely the cause right now is stress (lot is going on in my life), paired with more time spent sitting and high caffeine intake. Incidentally, last week my therapist said I was doing great and could skip our weekly treatment. I informed her of my symptoms and she said to stand by and watch if I can manage it by myself, she'll assess me in 3-4 weeks. Her words were: “you have to learn to manage stress, because it's part of life”.

[JamesFlex87]

On 2/1/2024 at 3:35 PM, jaja said:

Thank you for your comment, @apat7. I didn't get notified until you mentioned me directly, so I'm only reading it now.

100%. Not only this, I must add that tight muscles can overtime affect the prostate itself and make it swollen and tender (as it seems to be my case). I'm saying this because during my first urology visit I had actual inflammation there. Later on, a proctologist didn't found a relevant condition, despite the fact I was experiencing relapses from time to time. And now…I'm at it again.

Yes, brief update. It's been two days of mild discomfort at night, with relief after doing breath work and stretches like child poses. Most likely the cause right now is stress (lot is going on in my life), paired with more time spent sitting and high caffeine intake. Incidentally, last week my therapist said I was doing great and could skip our weekly treatment. I informed her of my symptoms and she said to stand by and watch if I can manage it by myself, she'll assess me in 3-4 weeks. Her words were: “you have to learn to manage stress, because it's part of life”.

Hi i was just wondering how you were doing, tight pelvic floor is the reason im also on this stretching journey. Some useful info in the chats above.

I was going to ask the group and Kit, is the child's pose especially and happy baby pose not stretching the back pelvic floor muscles? it defintely feels like they are in a lengthened position when in this position, according to google ai it is but of course that cant be trusted. i do deep belly breathing and i feel them length further in this position. I would of assumed split stretches might also stretch the pelvic floor a bit as its stretching tissue crossing that area?

[Kit_L]

On 2/2/2024 at 2:35 AM, jaja said:

Her words were: “you have to learn to manage stress, because it's part of life”.

Words to live by; I know everyone reading here will have heard a form of this sentiment many times. THE solution, long-term, is to have the experience of being deeply relaxed embodied, so you can return to it any time. What we experience as "stress" is internally created—which is why two people witnessing the same event can have completely different responses to it internally.

Whatever you experience as stress creates tension in your body. Increase tension in all of the parts that we talk about on this forum is exactly the problem of modern life. This is what the relaxation part of our work is all about. And yet you all will have seen the tremendous resistance that some people have to doing a lying relaxation practice – even while they acknowledge the value of it. There is no other way of learning how to be relaxed than actually practising those exercises. They're all free from our site. They work.

The second point to consider for the problem you talk about above is mastering the tailor pose. The tailor pose definitely stretches the pelvic floor muscles, and in Iyengar's book Light on yoga, the tailor pose (Badhakonasana, Sk.)is regarded as being the most important pose for prostate health. It's not the first part that is the most important (getting the knees down onto the floor), it's the 'pulling the body with a straight back forward between the legs' part. That is the most important part. It's also the hardest part.

I can't comment on the pose of the child because I don't feel that that affects my pelvic floor directly. The tailor post does, I believe, but please try it yourself and report back here. This is an important topic.

[jaja]

On 5/9/2025 at 4:51 AM, JamesFlex87 said:

Hi i was just wondering how you were doing, tight pelvic floor is the reason im also on this stretching journey. Some useful info in the chats above.

Hi! My pelvic floor is still more or less a source of concern, but afaik my prostate is fine and I have no major symptoms. I take care of the area through weekly stretches, drills and relaxation practices. I'm also training it for strength because I definitely lack it. I'm much more knowledgeable now, mainly due to the degree I'm studying to obtain.

On 5/10/2025 at 1:14 AM, Kit_L said:

Words to live by; I know everyone reading here will have heard a form of this sentiment many times. THE solution, long-term, is to have the experience of being deeply relaxed embodied, so you can return to it any time. What we experience as "stress" is internally created—which is why two people witnessing the same event can have completely different responses to it internally.

True, simple, yet not at all easy. There's a handful of roads that leads there, but you need to have constant vigilance not to get overwhelmed by old patterns. Yoga nidra is fantastic, but I find it easier to carry the results into my messy life when I supplement with other practices and strategies. While I have some experience in this regard, I'm no master and I frequently get caught into pitfalls.

On 5/10/2025 at 1:14 AM, Kit_L said:

The second point to consider for the problem you talk about above is mastering the tailor pose. The tailor pose definitely stretches the pelvic floor muscles, and in Iyengar's book Light on yoga, the tailor pose (Badhakonasana, Sk.)is regarded as being the most important pose for prostate health. It's not the first part that is the most important (getting the knees down onto the floor), it's the 'pulling the body with a straight back forward between the legs' part. That is the most important part. It's also the hardest part.

Every muscle that has insertion on the hips can influence the pelvic floor. Adductors and hip flexors are commonly tight and even neglected strength-wise, so addressing them is a good idea. Personally I find that a long session of piriformis stretch has incredible effects across the whole pelvis. The key is experimentation to find the most crucial areas.

Drills can be good, but require time and dedication because you need to sustain a movement pattern or static pose for a long period of time, letting gravity and kinetic energy doing the work. I suppose hatha yoga can be beneficial, personally I have experience with Qigong-style training.

I want to also mention breathing. The pelvic floor is also called “pelvic diaphragm” and has a synergistic relationship with the diaphragm muscle: it expands on the inhale and shortens on the exhale. Mastering a diaphragmatic breathing and learning to feel the pelvic floor to enhance the relaxation during the in-breath has been quite useful for me. Similarly, if one is trying to work on strength and do kegels, it's crucial to do the contractions while exhaling. Of course, if there's an issue of tightness down there, it's best to stretch/relax the area after strength training. Notice also that “pelvic floor” is a general term encompassing a set of muscles with slightly different functions. Contractions can be focused on the anus, on the urethra, or on the whole pelvis. Learning to feel the difference brings best results and could prevent side-effects.

[Kit_L]

7 hours ago, jaja said:

Every muscle that has insertion on the hips can influence the pelvic floor.

And the state of one's mind powerfully influences all muscles and fascia in the whole body. The mind's effect, in this regard, is the stronger, I believe.

7 hours ago, jaja said:

I find it easier to carry the results into my messy life when I supplement with other practices and strategies.

Please do outline any practices and strategies that you have found effective in this regard; we're all eager to find more effective methods, and the longer agent orange is in the W. House, the more pressing this is becoming.

I should also say here in case anyone thinks that my recommendation to 'embody the state of deep relaxation' is something that will happen after doing a few yoga nidras is made lightly, that I spent six months on retreat in New Mexico once where all I did during the daytime was walking and doing four or five extended lying relaxation practices and I have detailed those elsewhere. Achieving the embodied state of relaxation is something that will take some people many months if not years to achieve – but the changes in one's body and the experience of relief and the robustness of this new state in the face of new stressors will make it all worth it.

[Gareth O Connor]

Jaja regarding the pelvic floor has it anything to do with the root and sacral chakra?

[jaja]

9 hours ago, Kit_L said:

Please do outline any practices and strategies that you have found effective in this regard; we're all eager to find more effective methods, and the longer agent orange is in the W. House, the more pressing this is becoming.

• Yoga nidra, of course.
• A standing practice like this, if done regularly, can do wonders to ease hidden tensions. For me the tight links are hips and neck, but different people have different restrictions.
• Samatha-style meditation takes a while to kick in, but can sustain nearly any other practice and in itself induces relaxation
• Vipassana/Shikantaza. I'd like to make it a routine like I used to do years ago, but to make the most of it takes time and it's a very scarce resource these days. It's however useful when the mind is crowded with thoughts and/or when I need to figure out what I'm feeling
• Om chanting, as odd as it may sound, helps me relaxing my face and diaphragm. I just began doing it, so it's too early to draw final conclusions, but so far I have had good results.
• There's a practice Gurdjieff referred to as “self-remembering” and I believe it's quite similar to a yogic practice called “Abide in that which is unchanging”. It's basically the opposite of mindfulness, in the sense that you have to discard all transient sensations (basically everything) in search for what is constant within you — the observer. It can be done as a sitting practice, but I usually do it randomly during the day when I feel stress creeping in. What triggers this awareness for me is asking the question “Am I asleep or am I awake”?. Then a feeling pops up and as I focus on it everything else gets lower in intensity. Differently from other meditation practices, you can keep up this even while doing daily activities, you just need to keep that feeling into your awareness. Of course it's difficult and at some point you'll “forget yourself”.
• Physical training. I don't care if it's weightlifting, running, stretching or hatha yoga: if I don't discharge energy, I get tense easier.
• Occasionally pranayama. Mainly box-breathing. But it's not really a routine I have, just something I try when everything else seems to fail me.

The only thing I try do daily, with extremely high priority is Samatha. I feel focus is central to everything else and I can always find time for a quick session. These days I usually do Om chanting if I only have 10 minutes, otherwise it's 15-30 minutes of Samatha. The other practices, I do most days and sometimes circle between them. I've found that they seem to support each others well.

9 hours ago, Gareth O Connor said:

Jaja regarding the pelvic floor has it anything to do with the root and sacral chakra?

I'm not familiar with chakra systems, but I do know some practices require performing “bandas” and engaging with muscle contractions even at the perineum. So, yeah, I imagine pelvis is part of the chakra system.