Can't Feel Your Pelvic Floor Relaxing? These Two Mental Cues Actually Work

One of the most common challenges in pelvic floor physical therapy — particularly for patients working on releasing an overactive floor — is the difficulty of translating anatomical instruction into felt, embodied experience. Being told to "relax your pelvic floor" is straightforward enough as a directive. Actually feeling what that means, in a part of the body that most people have minimal conscious awareness of, is a different matter entirely.

This is where therapeutic cuing — the use of specific mental images and physical anchors to guide internal awareness — becomes one of the most important clinical tools in pelvic floor rehabilitation. Two particular cues have proven consistently effective across a wide range of patients.

The Morning Glory Visualization

The first cue uses the image of a morning glory flower — a bloom that opens wide at its peak and gently closes again in a rhythmic pattern.

The instruction begins with positioning: seated comfortably or lying down, with the focus shifted inward to the pelvic region. The patient is guided to inhale slowly through the nose, allowing the abdomen to rise rather than the chest, feeling the lower ribs expand laterally. As the breath fills the lower abdomen, they are asked to imagine the vaginal canal as a morning glory — lengthening downward and gently opening, as a flower opens toward light.

At the peak of the inhalation, the image is one of full, unhurried opening. Not straining or forcing — simply allowing.

On the exhale, the image reverses: the flower closes softly and the petals draw gently upward — not a forceful contraction, but a natural, effortless return. The emphasis is on the quality of the movement: soft, coordinated, and completely free of muscular straining.

For patients with significant overactivity and pain, the exhalation component — the closing and lifting — may be removed initially. The therapeutic focus is entirely on the inhalation and opening. Even just breathing in and allowing the floor to feel as though it is lengthening downward represents a significant departure from the chronic holding pattern these patients live in. That departure, practiced consistently, begins to shift the resting tone of the floor over time.

The Sit Bones Cue

For patients who find anatomical visualization challenging — who can't connect to the internal imagery of the vaginal canal — the sit bone cue provides a more externally anchored alternative.

The sit bones, formally called the ischial tuberosities, are the two bony prominences at the base of the pelvis that contact a firm chair when you sit down. Most people can easily locate them — they're the bones colloquially called the "butt bones," where the hamstrings attach.

The instruction: inhale slowly through the nose, allow the abdomen to fill with air, feel the lower ribs expand — and simultaneously imagine the two sit bones separating apart from each other, moving outward as the breath fills the pelvis. This lateral spreading sensation corresponds to the actual movement of the pelvic floor as it descends and widens on inhalation.

On the exhale, the sit bones draw back together and gently lift upward toward the throat — a subtle, internal sense of convergence and elevation that corresponds to the pelvic floor's natural recoil as abdominal pressure decreases.

The sit bone cue works particularly well for patients who are more kinesthetically oriented — who respond better to physical sensation and movement than to visual imagery. The fact that the sit bones are palpable, locatable reference points makes the instruction more concrete and the sensation more accessible.

A Note on Progression

Both cues are starting points, not endpoints. For patients in significant pain or with high levels of overactivity, the early sessions may focus entirely on the inhalation and opening — practicing the release without any exhalation contraction component. As the floor begins to normalize its resting tone and pain levels decrease, the full cycle — open on inhalation, close and lift on exhalation — can be integrated.

The goal is a pelvic floor that moves freely and reflexively with breathing: descending on inhalation without conscious direction, lifting on exhalation without straining. A floor that participates automatically in the body's pressure management system rather than fighting it.

When this coordination is restored, the downstream improvements in pain, continence, sexual function, and comfort tend to follow.

📞 Call 314-252-0345 to schedule an in-home pelvic floor PT assessment.