Written by Naura Ben-Hassen, Pelvic Health Specialist, Kinesiologist, Osteopath, and Fitness and Movement Expert
Naura Photo by Felicie Photographie
Illustration by Anastasiia – stock.adobe.com
PART ONE of a six-part series helping you regain your body and move freely without pain, incontinence, and discomfort in your core.
When you hear “pelvic floor,” it’s easy to draw a line straight to prenatal or postnatal concerns, but the pelvic floor is involved with so much more throughout our lives, and can easily affect our lifestyle and well-being.
The pelvic floor muscles are super important for women. They are of capital importance in the stability of the body, stability of the spine, balance, proprioception, and are an integral part of the abdominal strap (CORE). I like to imagine the CORE as a cane, the top is the diaphragm (breathing muscle), the bottom is the pelvic floor muscles, in front we find the abdominal group, the rectus abdominis, external obliques, internal oblique, transverse, and at the back we have the multifidus, the spinal erectors, and the back musculature.
The pelvic floor consists of several muscles and ligaments which are located between the legs; at the bottom of the pelvis, they are diamond-shaped. They start from the pubic bone to the coccyx, passing by the 2 ischial tuberosity and forming a “hammock.” Traditionally women have been told to do kegels to strengthen those pelvic muscles, but it’s much more than Kegels. A bit of background: around 1950, a gynecologist named Arnold Kegels recommended doing pelvic floor contractions. This is where the name Kegels comes from. A pelvic contraction and a Kegel are the same thing.
How To Do Kegels Correctly
The contraction of the pelvic floor muscles is just as important as the relaxation.
• Contract the pelvic floor, you should feel a narrowing of the vaginal opening.
• Lift the pelvic muscles. The image I often present is the jellyfish.
• Relax the pelvic floor completely before doing another contraction.
Fact:
1 in 3 women do not contract their pelvic floor well. Do not contract the buttocks, jaw, neck, or any other part, when doing a pelvic contraction—the movement must be done by the pelvic muscles only.
Additionally, it is important to understand that just because we have symptoms of pelvic dysfunction does not mean our pelvic floor is weak. A pelvic floor that is too strong (hypertonic) creates the same symptoms as a pelvic floor that is too weak (hypotonic): stress incontinence, heaviness in the lower abdomen, back pain, SI joint pain, hip joint pain, deep backside pain, etc.
How Do We Know if Our Pelvic Floor Is Hypertonic (Too Strong) or Hypotonic (Not Strong Enough)?
Easy, do the test (below). The pelvic muscles are a blend of slow twitch and fast twitch muscles, enduring muscles (maintain pelvic contraction for 10 seconds) and reactive, therefore being able to contract quickly and release quickly.
Ask Yourself:
1. Are you able to maintain a good contraction for 10 seconds?
2. Are you able to quickly contract and release your pelvic floor (10 cycles)? If you are not capable, your pelvic floor is more hypotonic and like any muscle, it would benefit from strengthening. On the other hand, if you pass this test, Kegels will not be a good option for you and could make your symptoms even worse. An overly toned pelvic floor is more common than we think. Lots of things influence the pelvis and therefore the pelvic floor. Everything that happens in the pelvis affects the pelvic floor and vice versa. In the body, everything is connected and when you work the body as a whole, that’s when you get the most results.
Things That Influence the Pelvic Floor
The pelvic floor itself: is it hypertonic or hypotonic?
Posture. Posture has an impact on the pelvic floor, because poor posture creates pressure on the pelvic floor. In addition, an inadequate posture reduces the effectiveness of the abdominals and therefore the pelvic floor.
Breathing. Breathing has a direct correlation on the pelvic floor, the two work in synergy and together. When we inhale, the lungs fill with air and descend, they put pressure on the internal organs and these put pressure on the pelvic floor which must absorb the pressure. And when exhaling, the pelvic floor rises, the organs rise, the diaphragm rises, and the air is expelled from the lungs. Having good breathing is essential for the efficiency of the pelvic floor in addition to improving posture and relieving chronic pain. By breathing better, we reduce tension between the shoulder blades, the back, and even the neck. The thorax is the part of the body with the most joints—the ribs attach to the sternum and spine, as well as the collarbones. You have to learn to move them well. When you inhale, the ribs should open and when you exhale they return inwards and towards the center; this is called 360 breathing.
Synergy. The synergy of the abdominal muscles have an effect on the pelvic floor.
Position. The position of the pelvis and the strength of the muscles which stabilize the pelvis such as the glutes and adductors.
Ground Support. The feet, the plantar arch, and support on the ground. All of these things influence the proper functioning of the pelvic floor, which explains that it’s rarely just one muscle that’s the problem.
Try it: Inhale slowly through your nose, inflating the rib cage and allowing the movement of expansion of the lower part of the rib cage in all planes of space, in front, behind, and on the sides. The upper part of the thorax should be relatively still, as well as your shoulders and head. Exhale freely through your mouth, without muscular efforts. Repeat the exercise 5 to 10 times.
In the next issue, we’ll address posture and thoracic mobility for the optimization of your pelvic floor.
