The pelvic floor is an underrated group of muscles that deserve MUCH more attention than they’re currently getting. They’re such a taboo topic that most people are too scared/embarrassed to talk about issues that they experience, so they just call them normal and deal with them! whaaaaatttt…?? BUT this is an area that can have dysfunction and symptoms that affect nearly every part of your life (ie. working out, sneezing/coughing, sexual function and relationships, etc.). It’s SO common that 1 in 3 women will experience some sort of dysfunction because of these muscles.
So let’s break the cycle and talk about the pelvic floor!
First and foremost, let’s ensure that we are on the same page regarding the pelvic floor! The pelvic floor comprises a group of muscles that form the bowl shape of your pelvis. These muscles play a vital role in various bodily functions. Some of their main functions include assisting with bowel and bladder control, having sphincters that aid in bowel and urine release, supporting the pelvic organs and the weight of the uterus and baby (if applicable), and playing a significant role in the core system. They also contribute to stability, allowing you to withstand increased pressure within your abdomen when lifting, moving, or running.
Now that we understand more clearly what the pelvic floor is…
Here are 5 things that you NEED to know about it:
1. The pelvic floor is part of your core.
The “core” is more of a system of muscles that we refer to as a “core canister” and there are 4 main areas. The top is made up of your diaphragm and the bottom is your pelvic floor. They have a reciprocal relationship meaning while one is contracting, the other should be relaxing and vice versa. The front is made up of the transverse abdominis and the back is made up of the paraspinals and multifidi, which all aid in stability. All of these muscles maintain pressure within the abdomen. This means that training the stability of your core can directly improve the integrity of your pelvic floor. Learn The Truth About Core Stability here!
2. Dysfunction is NOT just leaking.
It can present as…
Pain – This pain could be present in the front and/or back of the pelvis, which is known as pelvic girdle pain. It could also be in the lower back, hip, and even present as nerve pain.
Leakage – This is NOT just in women. This could be urine, bowel, or even gas. It could be during a max lift, a sneeze or cough, run, or jump. Anything leaving the body unintentionally is considered leakage or incontinence – even a couple dribbles.
Prolapse – These are symptoms like fullness, pressure, heaviness, bulging or a feeling that something is going to fall out of your body.
Diastasis Recti/Hernias – This could affect women, men, and even babies! This bulging of the abdominal pressure through the abdominal wall usually demonstrates a weakness in your “core canister”.
If you’re dealing with dysfunction, we can help identify the cause and get you back on the right track!
3. Incontinence/Leaking can be due to a weak OR tight pelvic floor.
Often, when incontinence occurs, we assume it happens because the muscles are too weak to withstand the pressure placed upon them. However, this isn’t always true…especially in athletes.
TIGHTNESS in these muscles can also lead to incontinence.
For example, take a look at the spring analogy infographic. “A tightly coiled spring is unable to absorb shock or impact.” If your pelvic floor is too tight, it can’t absorb the impact and this can lead to leakage. “The pelvic floor should have enough give to absorb shock [and impact]”.
To evaluate the TRUE cause of your incontinence AND come up with a plan on how to treat it, Book an Evaluation!
4. Leaking is NOT normal – whether you’ve had babies or not.
Yes, it’s common for women to have dysfunction after having babies, but it’s NOT normal and they don’t have to live with it! There are actually many women that have dysfunction that haven’t even been pregnant before!
There are various types of incontinence, but the main one we see is Stress Urinary Incontinence – meaning the athlete is leaking with increased intra-abdominal pressure. This means there is a pressure management issue in the core canister and something isn’t working properly so you’re losing control. This usually has to do with how the athlete is breathing and/or bracing during lifts and CAN be improved. This is Why you NEED a CrossFit Physical Therapist that knows the ins and outs of your sport!
5. The answer is NOT always kegels!
We work with a very athletic population, so our athlete’s usually demonstrate tight and tense muscles. That’s why the infamous kegel exercises (strengthening of your pelvic floor) can’t and shouldn’t be the end all be all. That’s the last thing you’d want to give an athlete with overactivity of these muscles.
For these scenarios, you may need stretching/relaxation exercises, you may need to alter your breathing/bracing strategies, and/or you may need movement retraining. Our fellowship trained therapists will be able to help identify what combination of these treatment approaches will best serve you.
The bottom line is that pelvic floor dysfunction can have a variety of presentations and is not the same across the board. This means that the cause, the exercises, and the education can not and should not be the same either. Whatever the symptoms, they’re likely not normal and CAN be addressed. You don’t have to live in pain or live with incontinence. Let’s tackle this once and for all!
If you’re in the Charlotte area, come see us! We’re much different than your traditional idea of physical therapy. If you’re not local, we also offer virtual visits! Contact us to book an evaluation.
Thanks for reading,
Aerial B.