Are clinically recommended pelvic floor muscle relaxation positions really efficient for muscle relaxation?

Introduction and hypothesis Various positions for pelvic floor muscle (PFM) relaxation are recommended during PFM training in physiotherapy clinics. To our knowledge, there is no study addressing the most effective position for PFM and abdominal muscle relaxation. Therefore, the current study aimed to investigate the effect of different relaxation positions on PFM and abdominal muscle functions in women with urinary incontinence (UI). Methods Sixty-seven women diagnosed with UI were enrolled in the study. The type, frequency, and amount of UI were assessed with the International Incontinence Questionnaire-Short Form and bladder diary. Superficial electromyography was used to assess PFM and abdominal muscle functions during three relaxation positions: modified butterfly pose (P1), modified child pose (P2), and modified deep squat with block (P3). Friedman variance analyses and Wilcoxon signed rank test with Bonferroni corrections were used to evaluate the difference between positions. Results The most efficient position for PFM relaxation was P1 and followed by P3 and P2, respectively. The order was also the same for abdominal muscles ( p < 0.001), P1 > P3 > P2. The rectus abdominis (RA) was the most affected muscle during PFM relaxation. The extent of relaxation of RA muscle increased as the extent of PFM relaxation increased (r = 0.298, p = 0.016). No difference was found between different types of UI during the same position in terms of PFM relaxation extents ( p > 0.05). Conclusions Efficient PFM relaxation is maintained during positions recommended in physiotherapy clinics. The extent of PFM and abdominal muscle relaxation varies according to the positions.