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Pelvic Floor Health, the What's, Why's and How's of it

Updated: Mar 28, 2023

MY INTRODUCTION INTO HEALTH, YOGA AND THE SCIENCE OF MOVEMENT.

Here we are, seated on a comfortable chair, or cushion. Or maybe, on the bed. Maybe you're standing or seated on the toilet seat. Have you ever wondered what you're actually sitting ON? Have you ever felt the bones at your bottom when you sit on a hard surface?

Well, I'm here to tell you all about... just THAT! For a long time, I was unaware of everything down there, and I mean everything... As a young teenager, it was taboo in my Tamilian household to talk about bodies, their functions, or even natural cycles for that matter. It was not until I began reading about the body as a hobby in college that I was introduced to the way it moves, breathes, flows, discharges, and consumes. I realized.. I KNOW NOTHING ABOUT MY BODY.

10 Years later here I am diving deep into anatomy books, learning from amazing teachers and in absolute awe of the human body. This topic of Pelvic floor health especially hits home for me. I never understood why conversations about the body and its functions were often discussed in a 'hush-hush' tone or considered 'Adult' topics. In my humble opinion, children can be introduced to the wonders of their bodies through many fun, appropriate activities.


The Pelvis, What is it?

FOR THOSE INTERESTED IN WHAT THE PELVIS IS.. SOME TECHNICAL INFORMATION

The Pelvis is at the bottom of your torso. It is a combination of bones, ligaments, tendons, nerves, joints, muscle and fascia. The skeletal structure is made of the Ilium, Ischium, Sacrum, coccyx and pubis. It has many ligamentous attachments — sacroiliac (Sacrum-Ilium) ligament, Sacro tuberous (Sacrum-Ischium) ligament , Sacro spinose (Sacrum-Ischium) ligament and The Inguinal (Iliac-Pubis) Ligament. Okay.. Okay.. that's a lot of really big words, I know!

Why am I saying all of this about the structure? Only, so you (the reader) know the terms used to describe these parts of your body, and.. also for you to familiarize yourself with them incase you hear it being used in a class.

Structure of the pelvis- Images from Visible Body app



What is the Pelvic Floor?

A SHORT INTRODUCTION TO THE PELVIC FLOOR

The pelvic floor is a group of muscles at the base of your Pelvis. They offer support for the organs in your abdomen.


The Pelvic Floor muscles are there to hold things (organs, fluids) IN, expel others (waste, gas, fluids) OUT, expand and condense with the breath, it provides stability for the surrounding muscles and joints, support and assistance in childbirth and aids in sexual function. The pelvic floor muscles have a far reaching effect up the chain (everything above the pelvis) and down the chain(everything below the pelvis). For example, tightness in the hamstrings could be an effect of some dysfunction in these muscles, a held or short breath could also affect the pelvic floor muscles.


Pelvic Floor Dysfunctions

IT AFFECTS US ALL!

This is important to note, not only because dysfunction in this area will create compensations in movement patterns, and affect your posture, but also because this will have an effect in your day-to-day activities. Incontinence, leaking, pelvic organ prolapse, are some of the outcomes of a pelvic floor issue.

(See :https://www.medicalnewstoday.com/articles/327511#symptoms for more information on common pelvic floor dysfunctions)


Why should I worry about Pelvic floor dysfunction?

WHAT AFFECTS MY PELVIC FLOOR HEALTH?

Pelvic floor health is important to discuss in the context of movement and lifestyle. Certain foods, stress (chronic) and lack of movement can be contributors to a pelvic floor dysfunction. Now, I am not a Pelvic floor PT, and I would strongly urge anyone reading this to fact check this for themselves. What I have learnt from my teachers and through my own research is that movement is imperative to maintain a healthy pelvic floor. What type of movement you may ask? Anything that gets you to move the body in many ways (different planes, changing demands on the core and limbs) , engaging your core and holding a neutral posture is beneficial to maintaining a healthy pelvic floor (Levator ani). These muscles are buoyant, they are neither too stiff nor too lax. They are flexible and adapt their reflexivity as the demands change.

Levator Ani- Images from Visible Body app


What is a sign of a healthy Pelvic floor?

A VISUALIZATION PRACTICE TO FEEL INTO THE CORE

Visualize your abdomen, chest and pelvis as a Cylindrical container, this is your CORE. Now visualize this space expanding and contracting. Expanding to the sides and up and contracting inwards. There is a pressure system involved in this process. There is an exchange of gases. Imagine, a downward pressure into your pelvis and pelvic floor area. Bear down with the breath to really feel it. What does that feel like? What happens at your chest and your throat? What is the quality of this space when the breath is pushed down?

In most situations, with bearing down, there's an automatic closure of the glottis (throat). And, this increased downward pressure will push the organs down, increasing the pressure on the muscles of the pelvic floor.

Now, visualize an expansive breath, in the lungs, around the ribs and along the back rim of the ribs. Imagine the Diaphragm (Mushroom shaped muscle at the bottom of the ribs, above the stomach), expanding along the lateral line of the ribs as you INHALE and condensing upward away from the stomach on the exhale. Bring the awareness to the sit bones (what you sit on essentially, at the base of the pelvis), imagine the pelvic floor muscles expanding between these two points laterally and along the sacrum and pubis from front to back of your pelvis. Visualize this as a hammock, this hammock responds to each breath. I don't want to tell you how it 'Should' move, instead I invite you to explore this for yourself.


Diaphragm- Images from Visible Body app


A DAY IN THE LIFE OF A HEALTHY PELVIC FLOOR

On a day-to-day basis, voiding (expelling solids and fluids) completely, being able to hold urine in until you reach a toilet, no pain with intercourse, no local pains in the musculature or joints that surround the pelvis are all indications of a healthy pelvic floor. A well functioning pelvic floor lends its support to a regulated nervous system. An overstimulated Nervous System could lead to excessive holding in the pelvis and in our breath.


Source: https://northwestwellnessgroup.com/the-pelvic-floor/


Is pelvic floor dysfunction different for men and women?

WE ARE ALL MADE OF THE SAME STUFF!

All people have a pelvic floor..

This means that dysfunctions of the pelvic floor affect us all. the only difference is that in men there are two fewer muscles than in women. In women, a history of sexual abuse, trauma, stress, pregnancy, surgeries, lifestyle (long sitting, carrying heavy loads), are some of the common risk factors. In men, abuse, stress, injury, heavy lifting (with suboptimal breathing mechanics), surgery are popularly known. There are commonalities and differences between all genders but it is safe to assume that we all need the knowledge of our pelvic floor.


WHAT CAN I DO TO SUPPORT MY PELVIC FLOOR HEALTH?

All of us lead unique lives. Our circumstances are all different. A blanket response is never the answer. Long periods of sitting affects pelvic health, carrying heavy loads with a ton of downward pressure affects pelvic health too. Adapting movement styles to your lifestyle can be a simple intervention. Working with a professional will grant you access to specific interventions needed for YOU. If you are someone who has issues with voiding (getting everything out), constipation or holding, speaking with a pelvic floor PT/ Specialist can help immensely. Passing urine and stools is an important function of the pelvic floor muscles, if this is a problem area for you, speak with a nutritionist to get a better idea of what your diet is lacking. Deterred sexual functions are also addressed by a pelvic floor PT.

Keeping a regular schedule of movement through Yoga, Bodyweight training, Weight Lifting, running, dancing will assist in maintaining the health of your Pelvic floor, Posture, Breath and overall wellness.


How a Yoga practice can benefit your Pelvic Health

YOGA HAS THE POTENTIAL TO IMPROVE OUR CONNECTION TO OUR BODIES.

In a Yoga class, breath is a focus of the class, aligning your breath with movement plays an integral role in bringing awareness to the body, as it is. Each pose has us exploring the many planes of motion we move in — Sagittal, Frontal and Transverse. We are consistently contracting and lengthening the muscles of the pelvic floor. In a yoga class we have the ability to move mindfully, with awareness, building a practice of becoming conscious of our internal signals. This is important. This open line of communication with our bodies and the sensations that come up in movement informs our nervous system. It helps us explore our innate ability to communicate with our bodies through mindful movement and breathing practices.

PELVIC FLOOR AND THE CORE

The pelvic floor is essentially the floor of the core. When we work on our Core Container, we are working on keeping the buoyancy of the pelvic floor. The health of the hips, activation of the glutes, activation of the deep core muscles, position of the pelvis, position of the ribs and head are all related to this. The body always works as a synergistic whole, and never in isolation.

BREATH AND THE PELVIC FLOOR

The pelvic floor diaphragm is connected to the breath. There is a reciprocal effect of the breath in the thoracic into the pelvic floor. This is to say that dysfunctions in breath due to closed off ribs, rib flare, short breath, rounded shoulders etc. will affect the adaptability of the pelvic floor to respond optimally. Calming pranayama practices like Alternate Nostril Breathing (Nadi Shodhana), Bhramari (Humming bee), and a simple breath focus can be incorporated into a daily practice. Other breathing practices recommended are deep breaths through the nostrils, in a 1:2 ratio, where 1 is the length of the INHALATION and 2 is double that length for the EXHALATION. An awareness of the diaphragm, and its natural movement is beneficial to calm the nervous system down, reverting it to a parasympathetic or restful state.

When working on improving the functions of the pelvic floor, a combination of movements and breathing is recommended.


YOGA POSES FOR THE PELVIC FLOOR

A SHORT MAT SEQUENCE

1. Supine-Knees to chest

1. Start by laying down on a comfortable mat.

2. Lengthen the back, locate these 3 points, skull-scapula-sacrum (3S) on the mat.

3. Bring the knees to chest and hold both knees with interlaced fingers.

4. Hold knees to chest and breathe into the base of your body, in between your sit bones.

5. Stay there for 2-3 breaths or for as long as you need.

6. Next, drop one foot down , bring the palms to the front ribs, keep the opposite knee in to chest.

7. Hold the knee in, engage the glute of the foot on the ground

8. Hold and Breathe into the chest and ribs for 1-2 breaths

9. Extend the bent leg out, hold, then bend the knee back in for 4-5 rounds

10. Repeat on the other side. Notice the differences between both sides.


Tip: Explore the connection of breath and movement while mobilizing the hip.


2. Supine-Hip Internal and External Rotation
  1. In a supine position, with the feet flat and knees bent, bring the palms to the ribs. Hold and breathe into the palms.

  2. Explore Internal and external rotation of your hips in this position.

  3. Start by sliding the foot out and allowing the knee to cave in.

  4. Follow it by sliding the foot back in and letting the knee fall out.

  5. Control this movement at the hip (where the thigh bone meets the pelvis). Go slow..

  6. Practice 10-12 rotations on each side.

Tip: Good hip mobility transfers to good pelvic floor health


3. Supine-Pelvic tilts
  1. In a supine position, with the feet flat and knees bent, bring the fingertips into the hip crease (as demonstrated in the gif above).

  2. Direct the fingertips downward, away from the ribs, tilting the pelvis anteriorly. Exhale as you do this.

  3. Inhale and tilt the pelvis posteriorly, drawing the fingertips up toward the ribs.

  4. Move slowly. Repeat 6-7 rounds of anterior and posterior pelvic tilts.

Tip: Low back mobility is interconnected with Pelvic floor health.


4. Quadruped- Cat-Cow/ Marjariasana with variations
  1. Begin in a Quadruped position. Place the palms under the shoulders and knees under the hips.

  2. Bring the pelvis to a neutral position. Ears are above the shoulders. Spine is long.

  3. Hold this position for 3 full breaths in the ribs.

  4. Begin to lower the sternum down, opening the top of the chest, Inhale.

  5. Exhale and lift the sternum up, expanding the back ribs.

  6. Practice 3-6 rounds of this.

  7. Explore Cat-Cow with a variation in the position of the knees and feet. Explore,

- Knees-IN , Feet- OUT,

- and Knees- Out, Feet-IN

8. Ending the practice in AdhoMukha Svanasana or Downward Facing Dog (DD). Hold for 3-6 breaths.

9. In DD, breathe into the back ribs, and feel the lift of the back body up into the pelvis.



Want to know more?

Write to us as aiswhwarya@embodiedyoga.co.in, or visit the website, www.embodiedyoga.co.in


Embodied Yoga hosts classes through the week, click here to know more. If you're looking for 1:1 classes, find details below.












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