BY AMY DIXON

Owner of Inner Strength Pilates & Polestar Pilates Educator

Unless you’ve had trouble with it, you likely don’t think of it: your pelvic floor! What exactly is that, you ask? Well, here’s all you ever wanted to know, (and then some) about your pelvic floor! There are so many commercials for incontinence products and so many items on the store shelves for constipation. It IS a big deal that no one wants to talk about. So, let’s go there, and maybe shed some light…

Your pelvic floor is the base of…. well, your pelvis! It is often likened to a hammock that runs from the pubic bone to the tailbone, and is made up of layers of muscles, ligaments, and fascia. The pelvic floor is the base of our core and works with other muscles to aid in respiration and spinal stabilization.

It’s a dome-shaped unit that has the complex job of holding everything inside the pelvic cavity and providing support to the base of the spine. It allows us to hold onto our delicate faculties during coughing or sneezing fits, yet it also releases in coordination with the sphincters of the bladder and colon to allow for the passage of waste. And, let’s not forget its role in sexual function, pregnancy, and childbirth!

Many of us know the Kegel, (named in the 1940s after the doctor of the same name), as the exercise we use to stop urine flow, prescribed in response to the post-baby dribbles. The Kegel has served us well over the years! However, we know so much more about biomechanics and anatomy than we did way back in the day! After all, the big exercise trend in the 1940s was….um, well, nothing! Scientists thought that women who exercised were causing damage to their reproductive systems.

So why the dysfunctions? Alignment actually has a lot to do with it!  As with all muscles, these tissues respond to the position of the bones they are connected to. For example: when your hamstring group is too tight, it causes the back of the pelvis to shift downward, which in turn pulls on the lower back, typically causing it to hang out in a lengthened position where it will weaken. Often, the result here is back pain and an inability to properly use the pelvic floor and ‘tush’ muscles.

According to the Mayo Clinic, half of all women over age 50 experience pelvic floor weakening. Weak pelvic floor issues can range from prolapse of the bladder, uterus, or rectum, urinary or fecal incontinence, stress/urge incontinence, and diminished sensation during intimacy.

The opposite situation is too tight or “non-relaxing pelvic floor dysfunction,” symptoms can present as spasms, painful bowel movements, painful intercourse, pelvic pain, radiating pain to the thigh or groin, or SI [sacroiliac] joint dysfunction.

Both of these scenarios can often be related to the position of the pelvis. Too much tilt in either direction affects the muscles in and surrounding the pelvis. It is vital to get the pelvis balanced back into a neutral position, so the muscles are in a balanced relationship to each other. Having the neutral position restored then allows the mobility of the structures to move and strengthen.

Our pelvic floor works in conjunction with the diaphragm in breathing. Or, at least, it should. When inhaling, the diaphragm and pelvic floor lowers to create the vacuum effect for air to fill the lungs. Then, during exhalation, both the pelvic floor and diaphragm lift. If we simply focus on the breath, many times the pelvic floor functions better as a result.

However, breathing can go awry, and the nervous system can get mixed signals. Fear, anxiety, stress, trauma, and surgery can all affect the natural breathing rhythm. Then the body is in a traffic jam, so to speak. Developing trust in the body to calm the nervous system is one way Pilates can help. The good news, according to the International Urogynecology Journal, is that researchers found that a 12-week Pilates program can effectively improve pelvic floor muscular strength!

There are certainly exceptions, and when the pelvic floor gets wonky, there are specialized physical therapists to help! We’ve worked with PT specialists at Novant, Baptist, and Cone to assist in the rehab process.

As a Polestar Pilates Education Center, know that we are IN the know on the latest in Pilates research! At Inner Strength, you will learn the proper functioning, and exercises that will effectively both strengthen and stretch the pelvic floor.