Pelvic Floor: The Forgotten Muscles

If your a mom, chances are you're afraid to jump on a trampoline. You might also have tendency to cross you legs to sneeze and avoid high impact activities like the plaque. Most women understand having a baby changes things down there. We can emphasise with each other. Pushing out a baby puts a lot of stress on pelvic muscles. And since many other moms also experience leaking, then it must be normal right?

Not quite. Even though leaking is common, that doesn't mean it's normal.

Our bodies have an amazing system built to withstand trauma (such as that of childbirth!). The problem is certain muscles become damaged during traumatic events and need to be retrained to function normally again. With childbirth, these are the pelvic floor muscles.

Most of us know we have pelvic floor muscles and many women are told doing kegels is the key to strengthen them. But there is a bit more to it than that.

The pelvic floor is a group of muscles that sit inside of the pelvis. Like any muscle in our body, we need our pelvic floor to perform many day-to-day activities. The job duties of these muscles include more than just preventing incontinence. Here is a list of the pelvic floor functions:

1`. The pelvic floor muscles constrict the urethra, vagina and anal canal.

In other words, When you pelvic floor muscles are working optimally, you pee when you wanna pee, there are no surprises.

2. They provide support for all the internal organs.

The pelvic floor muscles keep our organs where they should be. When the pelvic floor isn't working optimally the organs may shift, causing prolapse.

3. The are stabilizers.

Many people have heard of the importance of a strong core in injury prevention but what most don't know is the pelvic floor is part of the core. Our pelvic floor works alongside other core stabilizers to produce smooth and efficient movement.

4. They respond to breathing and changes in intrabdominal pressure.

When you have the unexpected urge to sneeze your pelvic floor muscles will contract to prevent leaking. When your pelvic floor is weak, it doesn't efficiently contract during high pressure activities which causes pressure to be unevenly distributed often resulting in leakage.

5. They are affected by emotion.

When we are stressed, not only do we tend to tense our shoulders but our pelvic floor also tenses up. This can lead to pain and discomfort.

Our pelvic floor has many different functions. Using a canister as an analogy helps us visualize how the pelvic floor works with our other core muscles.:

-The top of the canister is the diaphragm,

-The back of the canister is our spinal muscles,

-The front and sides is our abdominal muscles

-The bottom is our pelvic floor.

When we inhale, the diaphragm is going to expand and descend. As the diaphragm descends, the pelvic floor mimics this action. The muscles and connective tissues lengthen, stretch and create a slightly downward movement. The pelvic floor becomes loaded, like the stretch of a spring. On the exhale breath, there is going to be a recoiling action of the pelvic floor muscles and tissues with gained tension, as the diaphragm also moves back upwards to resting position.

While it can be hard to feel a pelvic floor contraction is, it helps to realize the action of the pelvic floor is similar to the actions of any other muscles. Our biceps are constantly being used throughout the day but it's typically so minor we don't realize it. We never go a day without both relaxing and contracting our biceps. How much you activate the bicep is dependent on the activity. The amount of muscles fibers you use to pick up a pen is going to be different than to pick up a toddler. This concept is similar with the pelvic floor. While we need it to be able to contract while performing daily activities, the intensity of that contraction should vary depending on your activity.

So how do we teach the pelvic floor to work as it should?

Most of us have heard we need to be doing kegels to strengthen our pelvic floor muscles. While kegels are a great start, many don't perform them effectively. Research suggests that some women may be performing kegel exercises in a way that could actually lead to worsening symptoms. One study cited that 25 percent of the women in their sample performed Kegel exercises in such a way that could promote incontinence. Just like when you're training your biceps, you need to be able to contract and relax the pelvic floor muscles. When we are constantly holding kegels it can led to a pelvic floor that is over-recruited. This is called “hypertonic”, which means that the pelvic floor is spending more time in an overly-contracted state, instead of dynamically moving through its range of motion (a functional pelvic floor is just like any other muscle system: it should move and not just statically hold!)

In the video below, I'm showing how to perform a kegel in a way that allows it to go through it's full range of motion. The key to "kegels" is to integrate the pelvic floor contraction with our deeper abdominal muscles and our breath. Hence why the exercise is called the connection breath.

The connection breath is a great exercise that brings awareness to how the pelvic floor functions. But if you have any pelvic floor dysfunction symptoms (such as leaking, pelvic pain, pain with sex...), it's also a good idea to receive guidance from a pelvic health physical therapist.. This is a physical therapist that is trained in treating symptoms associated with the muscles of the pelvic floor. They can identify the body’s current capabilities, teach strategies that promote full-body functioning, emphasize healing of the pelvic floor, and implement exercise that takes into consideration each woman’s stage of healing. The goal of any pelvic health physical therapist is to give you the tools to strengthen and recover efficiently and effectively so that you can return to the activities you love in daily life and in fitness. Every woman's body is different, while doing more kegels may be ideal for some women, many others require a different approach. This is why is it important to work with a professional that can evaluate and treat the cause of any dysfunction.

Often times as moms, we tend to put ourselves on the bottom of the list. Taking care of everyone else's needs before our own. But prioritizing your own health is just as important as taking care of those dependent on you. Taking the time to heal and strengthen the pelvic floor is one of the ways can practice self-care that'll benefit you for years to come. The pelvic floor is a muscle that is used all throughout our day. By focusing on good posture, the connection breath, and full-body movements that utilize our stabilizing muscles, we can teach the pelvic floor to handle all that life throws at us.

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