One of the reasons I love having this blog is to be able to give a platform to experts in all of the fields of holistic health. This week I asked the wonderful Dr Sarah Duvall to explain the importance of a strong pelvic floor for everybody, not just mamas and mamas to be! Sarah holds both Masters and Doctorate degrees in Physical Therapy and has over fifteen years experience as a Personal Trainer - I am delighted for her to share her expertise with you. Pelvic floor strength is extremely important even outside the pre- and postpartum time period. Sure, being pregnant and giving birth does have an impact on your pelvic floor. It would be silly for us not to admit that! BUT, I’ve seen numerous clients that have weak pelvic floor muscles but have never had kids. Crazy, right? And what about all the men having pelvic floor weakness? They have certainly not had babies. So, it’s a topic worth a closer look no matter where you are in life.
Your pelvic floor affects and is affected by your kinetic chain. Just like I can fix a patient's neck pain by turning off their hip flexors and activating their glutes, we can activate or deactivate the pelvic floor through muscle firing. I’ve seen some crazy cases. Take, for example, an old ankle injury that turned into a hip compensation pattern that then shut down this runner's pelvic floor.
Or Sam (not the client's real name), the runner with a chronic hamstring strain and pelvic floor weakness that had a dysfunctional diaphragm. She could take a deep breath at rest just fine, but when I added in exercise her system fell apart, hence the chronic nature of the injury. Sometimes a system looks great at rest, but then falls into compensation patterns when you up the intensity. Being able to keep great muscle firing patterns allows an athlete to remain injury free over the long haul.
If you are suffering from anything chronic, you better believe there is more involved than just the site of injury. (Probably why just foam rolling your IT band is not fixing your IT band problem.) In order to fix the issue, you have to look at what’s going wrong in the entire kinetic chain and fix that.
We should all focus a little more on the pelvic floor because it’s a great indicator of your pelvis as a whole. Is your pelvis in correct alignment? Are all the muscles firing like they should? Your pelvic floor will often tell you.
I’ve had several women that came in thinking they were going crazy because they had trouble making it to the bathroom, but the feeling would come and go, sometimes weeks apart. I thought it had to do with pelvic alignment. Alignment puts muscles in advantageous angles to work. Ready for the catch? Muscles determine alignment! Yep, we just got on the proverbial wheel. I often hear the complaint that “I got adjusted but it doesn’t hold,” and that’s because it’s how your muscles are firing that caused the misalignment in the first place. So, if you realign without changing the firing, then you will go right back. This can be very frustrating!
Let’s take a second to talk optimal pelvic floor alignment. The pelvic floor is the base of your pelvis and spine. It’s a sling of muscles that helps hold up internal organs and keep proper alignment. Because your pelvic floor sits in the middle, it helps stabilize against lateral forces to the sacrum and pelvis. A lateral force can simply be your body weight when stepping off a curve. Ever step funny and feel like you tweaked something?
So, what in the kinetic chain helps the pelvic floor stay strong? The diaphragm is a clear driver of pelvic floor strength. It acts like a piston, when you take a deep breath in the diaphragm expands down, pushing pressure down into your pelvic floor. Then, on the exhale, your diaphragm recoils back up and so does your pelvic floor. Well, at least it’s supposed to! This system often gets mixed up. The pelvic floor will go down when you exhale due to diaphragm dysfunction. This is bad for building and maintaining proper pelvic floor strength and firing.
One of my favorite exercises for getting diaphragm expansion is a full squat. This is such a great exercise for getting your paraspinals to release, which allows for back body diaphragm expansion. Plus, it gets you ready for glute activation! This PRI squat really promotes diaphragm expansion and pelvic floor response:
Squat down, feet close together. Balance weight between balls of feet and heels. Really try and sink into your glutes. Hold on low but keep your arms straight and relaxed. It may take a little playing around to find the perfect distance from what you are holding on to.
Inhale: pelvic floor relaxes down, should feel a great stretch across your midback
Exhale: pelvic floor naturally comes up, try and relax on the exhale and just let it happen.
The other common kinetic chain issue for the pelvic floor is hip rotational strength. Part of the pelvic floor is made up by the hip rotational muscles. Now that’s pretty cool in my book! I love it when systems in the body overlap. When I watch clients exercise, I will often see a hip collapse or knee cave in -- think running, step ups or single leg squats. This tells me that their hip external rotators and lateral stabilizers are weak. This is a glute medius and pelvic floor weakness issue. My favorite glute med exercise is as follows (this is also a great exercise for the VMO and creating a healthy knee):
If you are in the Boston area and would like more information on the importance of Pelvic Floor Health, Dr Sarah is running some FREE workshops over the next couple of weeks, for more details and to book click HERE.
About the Author: Dr. Sarah Ellis Duvall, PT, DPT, CPT, CNC
A wife, mom and adventure sports athlete, Sarah takes functional training to a whole new level. In her unique approach to treating patients, she believes in teaching. Fully understand every aspect of the body is a necessity to complete healing. To learn more about her approach to the Pelvic Floor, check out her Pelvic Floor Video Series today. When she is not hanging off the side of a mountain, Sarah enjoys writing and presenting at http://www.CoreExerciseSolutions.comand figuring out how her patients can continue to pursue their dreams and lead a strong, adventurous life.