The pelvic floor and how you move
Article published in Northampton Living
(February 2021)
EXPERT CONTRIBUTOR
PATRICIA YOUNG
Pelvic Health and Orthopedics
Therapy and Wellness Center
+1 413 387 0722
office.restorept@gmail.com
restorewell.com
There are numerous factors that contribute to the variety of diagnoses that a pelvic floor physical therapist evaluates and treats. Let’s address one piece of the puzzle to explain just some of the considerations to be made when teasing out the source pelvic floor dysfunction. The pelvic floor requires balanced integration of your abs, gluteals, and back muscles, as well as upright posture and balanced walking. All of these elements have to be properly integrated for functional PF muscle strength and tone.
Let’s consider how you walk. For example, if you have very flexible ankles that roll frequently, your feet will hit the ground with a certain impact, which feeds back to the pelvis. If there is too much flexibility down at the ground, your pelvis may compensate by increasing its muscle tone as it “holds on” to stabilize you. If you have weak gluteal muscles (your buttocks), you may sway side to side rather than pushing forward from your glutes. This will also adversely affect the PF as it again compensates for the way you are distributing your weight when you walk. Correcting these orthopedic issues has to be part of the PF treatment plan if they are present.
People who are very flexible (hypermobile) have increased movement in their joints. Often times they are capable of amazing movement patterns (think dancers, gymnasts, ice skaters). They have incredible agility but it is not uncommon for them to experience very high, painful tone in the pelvic floor. Essentially, they stabilize their movement by using pelvic floor muscles. Teaching a flexible person how to engage their global pelvic muscles alleviates the tension in the PF as well as the pain that accompanies this movement dysfunction. This can be initiated by starting with isometrics (contraction of the muscle without lengthening it) and breathing techniques to relax down through the pelvic floor. The challenge is to increase strength without increasing tone (tightness).
Those who engage in certain exercise routines that increase strain on the pelvic floor often have complaints of hemorrhoids or prolapse. The classic sit up is often used with the belief that it is a component of core stability. Essentially, when a sit up is performed, there is increased pressure on the pelvic floor as you repeatedly compress your organs downward. More effective are balance and chain activities (such as “planks” which can be modified for different levels of fitness) to engage your center in a functional manner. You don’t want to increase abdominal pressure, as the pelvic floor has to support it!
Resolving pelvic floor dysfunction requires an integrative and team approach for best outcomes. Evaluating movement, strength, posture, and walking is essential. Other factors such as nutrition, sleep, stress, and exercise in addition to past medical history all provide information to help find your way to feeling great again.
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