Feel like you could do with a little lie down? 

Adopting postures that are restorative and restful can have lots of benefits for our health, especially our pelvic floor health.

In the last few weeks, we’ve been looking at how our posture, how we sit, and the position of our feet can affect our pelvic floor function. 

This week, we’re talking about how lying down might be just what your pelvic floor needs. 

Lying down is the perfect position to give your pelvic floor muscles a rest. 

When we’re sitting, standing or moving around, gravity means that our pelvic floor muscles are working hard to support the weight of our organs above them. They’re also contracting and relaxing to facilitate how we move and to manage any additional pressure our activities (like running, jumping, lifting, laughing or coughing) might place on our internal organs.

When we lie down, the weight on our pelvic floor muscles is reduced and these muscles can rest.

Rest is vitally important when we are dealing with an injury or a weakness because:

rest is what allows muscles to heal

When we actively work our muscles, like when we exercise, they develop micro tears.

These tears cause our muscles to feel sore when they’re tired. When we rest, our cells repair and rebuild tired and torn muscles by laying down extra fibres which make our muscles stronger.

This is why lifting weights or exercising until the muscle feels tired makes the muscle grow.

For most of us, our pelvic floor muscles are working pretty hard, most of the time. Given their many roles like helping hold us up, supporting our pelvic organs, and helping us wee and poo, there’s not much opportunity for them to take a break and that is why it can be helpful to find some time to rest - even for short periods - throughout the day.

This is especially important when you are trying to build up your pelvic floor muscle tone. 

There are lots of reasons lying down can benefit your pelvic floor health including:

1. Lying down takes the pressure off. In a lying down position, there is less weight on the pelvic floor muscles so they don’t have to work as hard as they do in standing or sitting.  
2. Rest rebuilds muscle. Giving our pelvic floor muscles the opportunity to rest allows our bodies to lay down extra fibres to repair any microtears and make the muscles stronger.
3. Lying down promotes relaxation. Given that the pelvic floor muscles contract in direct response to mental and physical stress (pelvic stress reflex response), any opportunity to relax and relieve some stress is a positive. Lying down promotes muscle relaxation, stress-relief and a slower heartbeat.
4. It encourages good alignment. Lying down takes the pressure off your spine and allows the body to find a healthy posture.
5. It’s the perfect position to learn pelvic floor squeezes. When you are learning to do your pelvic floor squeezes, or training them because you are symptomatic, it is best to start with a lying down position. This is because there is the least weight on the pelvic floor in this position. From there, you can build up to doing them when sitting, standing or moving around. 

Good Lying Down Positions for Resting the Pelvic Floor

 Back Lying

Place a pillow under your head and your knees to support the natural curves of your spine. You could also use a rolled up towel under your knees and neck.

Back Lying - Legs Elevated

Another option would be to support your head with a pillow and rest your lower legs on a chair or the bed while you lie on the floor so that the hips and knees are both at 90 degrees. This may benefit fluid return, as well as being quite a restful position. 

Fluid return is important for those that experience some forms of nocturia (waking to wee at night). Spending a few minutes during the day in this position will encourage fluid to return to the system earlier - reducing the need for weeing at night.

 Side Lying

Place a pillow between your knees - knees at 90º to promote a neutral position of the pelvis, ankles together, hips stacked one of top of the other.

Having the knees at 90 degrees provides a wider base which is easier to balance on so you can release the muscles more effectively. 

Secondly, a pillow between knees helps keep the upper most leg at the height of the upper most aspect of the pelvis. This can take a load off the glutes (bum muscles) of the upper most leg. 

 Front Lying

Use your hands as a pillow and rest the head on its side. Keep your toes touching and allow your ankles to roll out to the side. This allows the pelvic floor muscles to release and relax.

This is best done on a harder surface (like the floor) to keep the pelvis in neutral. 

When you are lying down, it's the perfect opportunity to practise some belly breathing and consciously release your pelvic floor muscles. 

Lying down for rest (not sleep) is most beneficial for up to around 30-40 minutes but even 5 minutes will benefit your body and mind. After around half an hour, your metabolism slows down and you might want to sleep. Sleep is important too but that’s another conversation.

When you’ve finished your rest, you need to be mindful of how you move from lying down to standing again. From a lying position, roll on to your side, bend your knees and use your arms to push you up into a sitting position. From there, you can move to standing. 

Incorporating brief rest periods in a lying down position during your day will help your pelvic floor muscles to rest and heal. It will also help you reduce stress and encourage you to practise your pelvic floor exercises. 

For more accessible, practical content like this, follow us on Instagram (@sheela.ie) and YouTube (@sheelawomen). 

Lastly, if there is a woman out there you think might need to hear any of this, please share. Pelvic floor issues are incredibly common but not normal and that means there are ways to prevent, manage and treat pelvic floor issues at any age.