So, you’ve been doing research on the internet and have diagnosed yourself with an “overactive” or “hypertonic” or “tight pelvic floor” – now what? How do you get those muscles to chill out and relax?
As we inhale, our diaphragm (breathing muscle) moves downward to enlarge our chest cavity to allow for air to be pulled into our lungs. As a result of this diaphragm movement, the pressure in our abdomen (intra-abdominal pressure) increases. Ideally, we want our pelvic floor to move reciprocally with the diaphragm and move downwards too to accept this increased pressure. The pelvic floor should move up and down like a trampoline as our intra-abdominal pressure changes in relation to our breathing and activities that we are doing for optimal functioning (i.e keeping us continent and pain-free). See the picture below for a visual of that movement – as we breathe in the pelvic floor moves down (a more relaxed position), as we breathe out the pelvic floor moves up (a more contracted position).
We want to utilize this relationship to positively influence the pelvic floor. To focus on relaxing and lengthening the muscles we want to use our inhale to help with this movement. Let’s try this right now – lie down on your back in a comfortable position. Place your hands on the side of your ribcage. As you breathe in, I want you to breathe into your hands, into your belly and into your back. Think of this as 360 breathing. Then let your exhale come naturally and gently, you should not have to force it out. Perform another 360-inhale breath and think about relaxing the pelvic floor muscles (the opposite of a kegel contraction) as they move into a downward position (as if someone was jumping on the trampoline and it is moving down).
Doing your pelvic floor lengthening or relaxation exercises periodically throughout the day is most beneficial. Diaphragmatic breathing that is long and slow is also a great stress reliever as it slows down your heart rate and activates the Vagus Nerve which is responsible for our parasympathetic nervous system which aids with “rest and digest” (the opposite of “fight and flight!”). Taking several diaphragmatic breaths while relaxing the pelvic floor can be done while sitting in your work chair, while sitting on the toilet after completely voiding or in a stretched position such as child’s pose, happy baby, or in an adductor or pigeon pose stretch depending on what your needs are and what feels most comfortable and relaxing to you. So, the next time your Apple Watch tells you “It’s time to stand” – use that as a cue to change positions, do some breathing and let the pelvic floor relax so that you are not playing catch up at the end of the day.
This breathing exercise and the “reverse kegel” or pelvic floor lengthening technique is important but not where treatment ends! We want to figure out WHY these muscles are tight and address the underlying cause too! Some other things we may look at to determine the root cause of your symptoms is hip and low back mobility and strength, abdominal bracing strategies, stress-related provocations as well as potentially looking all the way up the chain (upper back) and down the chain (knee and ankle) so that we are taking a holistic approach to managing your symptoms! Think about that trampoline analogy again – if the pelvic floor muscles are the net of the trampoline, and our low back and hips and all the structures that make up the support of it are the springs and base of the trampoline, they all play a role in how springing or non-springy that trampoline is going to be. They ALL play a role.
If you want the most optimal functioning “trampoline” (aka pelvic floor), call us at Up and Running PT to find out more about the services we offer and how we can get you back to loving life!
This blog was written by our very own Pelvic/Women’s Specialist, Dr. Sam Greig.