The correct way to activate pelvic floor muscles - Review

 Noa Ben Ami¹, Rachel Kafri²

Abstract
Background: The main function of the pelvic floor muscles (PFM) is to support the pelvic organs. The anatomical and intimate location of the PFM, makes it difficult to assess their correct activation in the general population.

Objectives: To review the different training methods and approaches for PFM activation and to find the most effective instructional method.

Methods: An online search of PubMed, Google Scholar and Cochrane was performed. The review included trials that examined different verbal instructions and training Methods to activate PFM.

Results: There are a number of approaches for the activation the PFM, but the literature evidence shows that direct and isolated activation of the PFM is significantly more effective than using the abdominal muscles or breathing techniques, as in Yoga and Pilate's, or indirectly, as in the Paula Method and the Abdominal Hypopressive Technique.

Conclusions: The studies demonstrated that only direct and isolated activation of PFM was effective.  Assessing  their correct activation should be done by a physiotherapist who is trained and skilled in pelvic floor rehabilitation. 

Keywords: Pelvic floor muscles training, verbal instructions, imaging, assessment