A recent study determined that both low-intensity exercises such as Pilates and high-intensity exercise such as aerobics may help to reduce the intensity of period pain compared to no exercise.
The review looked at women under 25 with moderate to severe period pain who exercised 45-60 minutes, three times a week. More trails and research are necessary; however, this is interesting and may offer sufferers of painful periods a way to manage their symptoms.
As someone who suffers from painful periods: usually I spend my period curled up in a foetal position clutching a hot water bottle, I wanted to look at exercises and techniques that would help to relax and unwind the body from being in such a held, tense position.
This is almost like a mini class. It runs through breathing exercises, stretching, mobility, and then some final relaxation. You can pick and choose what you do or do all of it!
Breathing
The diaphragm and the pelvic floor, along with other stabilising muscles, work together to facilitate breathing and maintain intra-abdominal pressure – as the diaphragm drops when you inhale, the pelvic floor also drops, when you exhale the diaphragm returns to its start position as the pelvic floor lifts up.
The routine starts with a few minutes of diaphragm breathing. This will connect you to your breathig, allow engagement and relaxation of the pelvic floor, and lower stress.
Diaphragm Breathing
01) Find a comfortable laying position on your back, place a rolled towel or pillow under your knees if front of the hips feel tight. Relax your shoulders and neck and place hands on your stomach or down by your side, whichever position is better for you.
02) Breath in slowly through your nose. Send the air down into the belly, imagining the air filling your belly and allow the belly to dome if it wants to. The chest and ribcage should stay relaxed.
03) Breathe out slowly through the mouth and just let everything relax. If the belly doomed let it relax back to its normal position.
04) The chest remains still as you breathe in and out. You can place one hand on your stomach and one on your chest to feel how the breath falls
05) Stay here and breathe for as long as you would like.
Breathing with Pelvic Floor Engagement
01) Bend the knees, place the feet on the floor about hip distance apart.
02) Breath in slowly through your nose as you imagine your hip bones being drawn ever so gently together and then softly draw the pelvic floor up and close. Hold that feeling for 3 seconds.
Pelvis should not move and your bum, shoulders and neck should stay relaxed.
03) Breathe out slowly through the mouth, relaxing the body. Allow the hip bones to return and the pelvic floor to release. Rest for 5 seconds.
04) Repeat 10 times. Do not worry if you cannot connect into pelvic floor, it can be very tricky.
Stretching
Muscles contract after being held in position for a long time or as a reaction to pain which can increase discomfort and restrict movement. When experiencing period pain the front of the body such as hip flexors, chest, abdominals and adductor muscles can become tight.
These exercises will help to stretch these muscles out.
Butterfly
01) Place a pillow, a bolster cushion or towel under your lower back as support as you lay down. Relax the neck, chest and shoulders.
02) Place the soles of the feet together and allow the knees to fall open. You can place your hands on your stomach or down by your sides, whatever is most comfortable for.
03) Take a few minutes just to breathe in this position. Allow the body to sink down into the mat with every exhale.
04) Very gently bring the knees together, placing the feet flat on the floor.
4 Sign/Piriformis Stretch
01) Lay on your back with your knees bent, feet on the floor around hip distance apart. Place the arms by the sides with the body relaxed.
02) Take the left ankle and place it across the right thigh, allowing the left knee to fall open. You are creating a triangle with your legs or a 4 sign.
03) Breathe into this stretch.
04) If you wish to increase the stretch you can bring the right leg off the floor, reach behind the right thigh with the hands and gently pull the legs towards the chest.
Hip Flexor Stretch
01) This is like a kneeling lunge; it starts in a high kneel meaning that your bum is off your heels and there is a straight line from shoulder to knee. Take one leg forward, place the foot on the mat and keep the ankle and knee at 90 degrees. The hips are stacked over the back knee.
If none of this makes sense have a search for kneeling hip flexor stretch and you will find some videos or images that I can’t use.
02) Tuck the tailbone under to create length through the front of the thigh and open the hips. If that is enough then stay here and take several breaths. Keep the torso upright as you do this.
03) If you want to you can press the body forwards slightly: torso stays upright, the front knee moves forward as you lengthen the back thigh.
04) Repeat on both sides.
Cat
01) Move into four-point kneeling – you want your wrists under your shoulders, soft elbows, knees under your hips, back in a comfortable position and your neck long, looking just in front of your fingertips.
02) The weight should be evenly distributed between the hands and the legs. If this position is uncomfortable on your wrists you can use yoga blocks or go onto your forearms.
03) On the exhale tuck the pelvis under as if you were a sacred dog with its tail between its legs. Allow the movement to continue into the lower spine then lifting through the ribcage and relaxing the neck.
Avoid rounding the shoulders or lifting the ribcage first.
04) Breath in and return to the start position. Take it slow really focus on that lengthening through the spine and tucking of the pelvis to create length through the front of the thighs.
05) Aim for 10 repetitions, or as many as feels comfortable to you.
Child’s Pose
01) From the four-point kneeling position take the bum towards the heels, lowering the chest towards the mat. You may or may not have much movement here, do not worry if the bum isn’t near the heels.
02) Take the arms out in front of you, palms on the mat. Keep the shoulder and back relaxed.
03) Breathe into the stretch allowing the body to relax with each exhale. Spend a few minutes here just breathing.
04) When you are ready, on the next exhale walk the hands over to one side of the mat taking the body with it. Hips are staying down; you are aiming for a crescent moon like curve along the outside of the body.
05) Breathe in as you return to the start position then exhale as you take the body in the other direction. Go slowly and stop at any point if you feel twinges or the body starts to tense.
06) Repeat 2 more times to each side then spend a few more minutes breathing in child’s pose.
Adductor Stretch against a Wall
01) Lay with your legs together resting against a wall, your bum should be close to the wall so that the entire leg can rest against it. If you would prefer not to stick your legs up a wall this can be done without the wall though I would recommend using a yoga strap to help you control the movement.
02) Keep the upper body relaxed; arms can be by your side or on your stomach. Take a breath in; on the exhale slowly start to take the legs apart keeping them in contact with the wall. Go as far as is comfortable then back off the stretch slightly by bringing the legs a little closer together. This will stretch the adductor muscles (inner thighs).
Make sure the pelvis stays still and try to take the legs equal distance apart; you may notice that one leg wants to go further than the other and that is fine.
03) Breathe in at the end of the stretch then exhale to draw the legs back together.
04) If you wish to intensify the stretch, place your hands on the inner thighs at the end of the stretch and let the weight of your hands encourage the legs further open if it is comfortable.
05) Aim for 10, or go for as many as you like. You can also hang out in the stretch and just breath if that is comfortable.
Mobilisation
Mobility exercises are slow, controlled movements that can decrease muscle tension and improve blood flow around the body.
Hip Rolls
01) Scoot away from the wall and lay on your back with your knees bent and feet and knees together. Place the arms by the side.
02) Take a breath in then on the exhale take the knees to one side, rolling onto the outside of the foot. We are starting with small movements before going into the full hip roll so aim for more of a gentle rock on the low back than a full roll.
03) Breathe in to return the knees to centre then exhale to take the knees to the other side. Ribcage and chest stay relaxed.
04) Aim for 10 to each side, if this is as much as you want to do then do a few more otherwise go into the full hip roll.
05) On the exhale you take the knees to one side, rolling onto the outside of the foot, and take the knees as far over as is comfortable you can control the movement. Waist and ribcage can lift with this movement but shoulders should remain relaxed.
06) Inhale to return to centre then exhale to take the legs to the other side.
07) Aim for 6 of these to each side, or as many or as few as you like.
Hug a Tree
01) Keep the knees bent, feet on the floor. You can keep the legs together or take them apart, whatever works for you.
02) Take the arms over the chest; finger tips touching and bent elbows. Imagine you are hugging a rather large, round tree, give it a proper bear hug and get that nice circular shape between your arms and body.
03) Breathe in then on the exhale; keep the shoulders relaxed as you open the arms leading with the elbows which should remain soft throughout this exercise.
04) Take the arms as open as comfortable. You may reach the floor, you may not. Take a breath in to return to centre with fingertips touching.
05) Aim for 10 of these.
Bridge
01) Same start position, however you want the legs about hip distance apart and not too close to the bum.
02) Take a breath in then on the exhale tuck the tailbone aiming the hipbones towards the naval, letting the spine rest on the mat, then start to peel the spine off the mat bone by bone by bone.
03) Take a breath in at the top, add in some bum engagement to help stabilise the pelvis then think of sending the knees forward to create length through the front of the thighs.
04) Exhale to release down. Release from the top of the back first and imagine gentle laying each vertebra down one after the other.
05) Aim for 10 of these and focus on curling through the spine.
Open like a Book
01) Lay on one side with shoulders stacked, hips stacked, and ankles stacked. If you have a mat line yourself up with the back of the mat to ensure your body is straight. Bend your knees and have the heels in line with the bum.
02) Place a block or cushion under your head to support it.
03) Have your arms in front of you with the elbows bent, palms together.
04) Take a breath in, on the exhale start to move the top arm, following the movement with your head and neck. The hips stay stacked the movement is spinal rotation. Go as far as is comfortable.
05) Return to centre on the inhale.
06) Aim for 10 of these to each side.
Clams
01) Staying in the position, though you can move your arms into a more comfortable position.
02) On an exhale you are going to lift the top knee away from the bottom leg without rolling backwards. It doesn’t matter how far the leg goes.
03) Close on the inhale. You are imagining your legs form the top and bottom of a clam and the clam is opening and closing.
04) Aim for 10 of these to each leg.
Progressive Muscle Relaxation
This technique alternates between tensing and relaxing muscle groups and has been used to improve sleep, decrease sleep, and reduce symptoms of pain.
01) Find a comfortable laying position on your back, place a rolled towel or pillow under your knees if front of the hips feel tight. Relax your shoulders and neck and place hands down by your side
02) Take several deep breaths, try to go back to that diaphragm breathing at the beginning, or just breathe.
03) On the next inhale squeeze the muscles in the feet and count down from 5
04) Exhale and actively think about the feet relaxing and all of that tension leaving the body.
05) Repeat 2 more times
06) Work your way up the body repeating this process: calves, thighs, bum, abdomen, hips, back, shoulders, arms, hands, neck and then face.
References
Armour M, Ee CC, Naidoo D, Ayati Z, Chalmers KJ, Steel KA, de Manincor MJ, Delshad E. Exercise for dysmenorrhoea. Cochrane Database of Systematic Reviews 2019, Issue 9. Art. No.: CD004142. DOI: 10.1002/14651858.CD004142.pub4
Bull, J.R., Rowland, S.P., Scherwitzl, E.B. et al. Real-world menstrual cycle characteristics of more than 600,000 menstrual cycles. npj Digit. Med. 2, 83 (2019)
İlknur Gökşin, Sultan Ayaz-Alkaya, The Effectiveness of Progressive Muscle Relaxation on the Postpartum Quality of Life: A Randomized Controlled Trial, Asian Nursing Research, Volume 12, Issue 2, Pages 86-90, 2018
Jasuja V, Purohit G, Mendpara S, Palan B.Evaluation of Psychological Symptoms in Premenstrual Syndrome using PMR Technique, Volume 8, Issue 4, 2014
Thirupathi Shanthi, Effectiveness of progressive muscle relaxation therapy in reducing the affective symptoms in pre- menstrual syndrome among the young adult girls, Indian Journal of Continuing Nursing Education, Volume 18, Issue 2, Pages 92-96, 2017
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