By Allison Oswald, Plumb Line Studio
When women think of the pelvic floor, they most often think kegels. But it’s time for women to know there is so much more to the pelvic floor than just that.
The pelvic floor is a key component to the core system. Giving support to the contents of the abdominal cavity, maintaining sphincter control to the bodily systems and providing sexual function and pleasure, it goes well beyond simply contracting.
Connecting to the pelvic floor is empowering, grounding and strengthening. A healthy pelvic floor functions all day, everyday, without too much recognition. Most women are not in tune to how it works until a problem or dysfunction arises. But if women could understand its function prior to that, they would be more prepared to mediate an issue, possibly prevent a dysfunction and be able to heal or recover more efficiently from an injury or childbirth.
The pelvic floor is a sling of muscles at the base of the pelvis that connect from the tailbone to the pubic bone. They contract in anticipation of movement to stabilize the pelvis, as well as lengthen to accommodate any increased pressure, such as with a cough or a sneeze. These muscles work in conjunction with the diaphragm, our major breathing muscle, which is why breath is so crucial in connecting to the pelvic floor. These two components also work together with the deepest abdominal muscles and back muscles. Together these four parts are the “core” or “stabilizing system”.
Keeping these parts aligned properly also contributes to proper function. Alignment is unique to each individual, but in general it is advised to keep a neutral posture, meaning that the pelvis is neither tipped forward or backwards, and the rib cage/diaphragm is stacked directly on top of the pelvis, so that the upper chest is neither puffed up or rounded down. With this alignment and diaphragmatic breathing, the core system is set up to work as efficiently as possible.
Thinking about becoming pregnant, experiencing pregnancy and recovering from pregnancy are all phases of life where women become more attuned and aware of their bodies. This is especially so as it relates to the external appearance of the mother’s growing belly, changing posture and overall weight gain. But this is also a pivotal time for women to connect deeper to their pelvic floor, as it relates back to those physical changes as well as the emotional changes.
Here are some things women should know about their pelvic floor before, during and after pregnancy:
Let it go
Women hold a lot of tension in their bodies, specifically in the pelvic floor, without consciously thinking about it. In order to conceive, good circulation in the pelvis is crucial , which can be restricted with muscle tightness. One way to resolve this is to begin by making sure you are not standing or sitting with your butt tucked under you throughout the day. This position shortens the pelvic floor muscles and can cause unnecessary tightness.
Begin a breathing practice to coordinate the diaphragm and pelvic floor system. Sit comfortably in good alignment (slight curve in the lower back). Inhale through your nose as the ribcage expands laterally and feel the pelvic floor lengthen down/relax. Then exhale through your mouth as the rib cage comes back in and the pelvic floor recoils back up and in. Getting your body in tune with this connection and movement will allow you to carry it over into your everyday life, exercise and movement practice so that it becomes more natural.
Maintain alignment as best as possible
As the physical changes occur during pregnancy, it can be easy to allow your body to fall into a less supported position where you hang out in the front of your hips while standing or slouch down while sitting. This will prevent your entire core system (including the pelvic floor) from functioning as best as it can, which could lead to low back pain, hip pain or incontinence.
Exhale with any exertion
Blowing out through your mouth as you lift anything somewhat heavy, or get up from a low position, etc...will automatically contract the pelvic floor to give you more support. Whereas holding your breath during these activities can lead to issues such as low back pain, incontinence, diastasis recti (abdominal wall separation) and hemorrhoids due to the pressure put down on the pelvic floor.
Deep squat to stretch the pelvic floor
Near the end of pregnancy, it is important to allow yourself to stretch the pelvic floor to prepare for labor and be able to breath in and out as these muscles stretch further. This is the only time you would exhale as you lengthen these muscles intentionally versus letting them naturally recoil up and in. Take a deep squat with support and breath as you visualize the pelvic floor lengthening and opening up.
Leaking is not "normal"
Just because you’ve had a baby (vaginal or c-section) does not make urinary incontinence ok. And doing kegels is not typically the fix. Seek out a pelvic floor physical therapist to be properly evaluated and set up with a treatment plan specific to your needs.
Sex should not be painful
Painful sex, or dyspareunia, is persistent genital or pelvic pain, before, during or after sex. And it can be caused by a multitude of factors postpartum, some of which include pelvic tension, scar tissue, hormone levels and more. Working with a pelvic floor physical therapist is to determine the cause and set up a treatment plan is crucial.
A true visionary in the realm of women’s health, Allison Oswald, PT, DPT, WCS, CPT works with women by focusing on the core as a pivotal point for well-being. While attending school to become a board certified physical therapist, Allison recognized a major gap in existing treatment, specifically related to women and women’s health issues. An area of the body that is often overlooked, the pelvis is the central anatomy from which virtually all other facets of our health operate. In 2011, Allison set up her private clinic, Plumb Line Studios in Santa Monica, CA. As a mother herself, Allison finds her passion in working with women who are in their childbearing years and postnatally, as she knows first hand, this area of health can be challenging without the proper support.