TVA Exercise
The Pelvic Pyramid consists of the transversus abdominis (TVA) muscles, the pelvic floor muscles, and the multifidus muscles.
The first thing you should learn is how to isolate and contract the muscles of the Pelvic Pyramid™ without relying on other muscles to do the work and without holding your breath.
You will learn to sustain the contraction for extended periods of time and during other stabilization exercises.
You’ll also learn how to contract the TVA, multifidus, and pelvic floor muscles as a unit, in different positions. We say “Engage your Pelvic Pyramid™” almost like a mantra. Engage your Pelvic Pyramid™ when you lift, sit, stand up, walk, or hold your baby; all are opportunities to exercise. Why? Because by being strong and stable in this core, you can make your symptoms of incontinence go away or prevent them from happening in the first place.
The TVA is the deepest abdominal muscle. It helps to hold your spine and pelvis stable. It works with the other Pelvic Pyramid™ muscles to support the organs of the pelvis. And (BONUS!) having strong TVA muscles can also give you a flat tummy.
The objective is to contract the TVA muscles without engaging the help of other muscles. Muscle isolation is the key to exercise efficacy.
It’s important to learn the right way to work your TVA muscles, which is with conscious breathing and your spine held in a neutral position. (LINKS.) Lie on your back with your knees bent and your feet on floor. Assume a neutral spine and keep your buttocks and thighs relaxed.
Using your index and middle fingers, locate your hip bones, or the anterior superior iliac spine (ASIS).
Find the TVA muscles by moving the flat fingertips two to three inches toward the center of your body and two to three inches down toward the pubic bone. We are in the neighborhood of a low-rise bikini.
The feeling of a good contraction is gentle, a slight tensing of the muscle fibers under your fingertips. Your pelvis should be still and your buttocks and thighs relaxed. This is not a forceful or big movement, but a slight tensing, as if the muscles were pulling away from your fingers. It’s subtle. You should not feel a bulge.
Hint: Imagine drawing in the navel to zip up tight, low-rise jeans, or imagine a birthday candle held over your navel and try pulling your navel just slightly away.
Set your shoulder blades and inhale. Then slowly exhale and contract. Do six to eight repetitions, with a deep breath into your rib cage for each contraction.
Now try to hold it and breathe. Don’t be impatient. Sometimes it takes the TVA muscles 10 to 20 seconds to respond. The goal, ultimately, is to feel the engagement right away and to hold it for 10 seconds or more. The feeling should be like that of a corset tightening around your lower belly.
Inhale and prepare, then exhale and contract: Feel for that subtle tension. Hold the contraction for 10 to 20 seconds, breathing, breathing, and breathing. Go for two to three repetitions.
Breathe normally. Be patient. If your TVA muscles are twitching, keep your fingers still. Some people can do this exercise right away, but most of us need days or even weeks before it starts to come easily. Keeping your fingers on your TVA muscles is the key to this exercise. Always do it.
Common mistakes to watch out for: creasing at the waist (which gets the rectus abdominus muscles more involved than the TVA muscles), breathing into the upper chest instead of into the rib cage, excessive rib depression, fitting the pelvis under, tensing your glutes, pressing your navel or spine to the floor, or pressing out your abdomen. (It’s very easy not to get this right.)
These exercises are a two-minute commitment every day—and the key to success is just that, to do them every day. Do eight to ten reps with a 10-second hold once a day, with rib cage breathing throughout.