The Pelvic Floor & Core connection
The Pelvic Floor Buzz, Kegel Chairs, and Social Media Algorithms
Ahhhh, the pelvic floor. It’s all the buzz these days. You can hardly scroll Instagram or Facebook without someone out there in the fitness world claiming they have all of the answers to your pelvic floor woes if you follow their 12-week online program. And if you’re not being targeted by fitness professionals, then at some point you’ve probably been targeted by an algorithm on Amazon trying to sell you some kind of product to tighten or strengthen your pelvic floor. (And please, don’t get me started on your local MedSpa trying to get you to sit on the crazy expensive kegel chair!)
The truth is, no specific set of exercises, no product, and certainly no magical kegel chair is going to solve all of your pelvic floor problems. To claim that any of these things will resolve your symptoms simply undermines the complexity of the role of the pelvic floor muscles within the movement system as a whole.
The internet is a confusing place, and with all of the excitement and talk around the pelvic floor, I want to provide some clarity that will hopefully save you time (& money!) when it comes to sifting through what really works when you’re dealing with pelvic floor dysfunction.
the pelvic floor as part of the deep core
The pelvic floor muscles, though they sit in the bottom of the pelvis, are an integral part of our anticipatory core. Simply put, they’re part of a really, really important group of muscles that create stability within our trunk and prepare our bodies for movement. If you saw someone across the room from you about to throw something heavy at you, your pelvic floor, along with your diaphragm, transverse abdominis (deep abdominal muscle), and lumbar multifidus (deep lower back muscles) will fire to brace you and keep you from falling over as you prepare to catch whatever is being thrown at you. In fact, if you activate your deep abdominals, you might appreciate that you feel yourself doing a kegel (pelvic floor contraction) without even thinking about it. Vice versa, if you do a kegel, you should be able to appreciate your deep core muscles also firing at the same time. When the system is firing on all cylinders, the pelvic floor should be firing proactively, subconsciously, and synergistically with all of it’s best friends. Thus, pelvic floor dysfunction occurs when there’s disruption somewhere in this intricate connection.
tips for success when getting to the bottom of your pelvic floor issues
Start by actually having your pelvic floor muscles assessed.
Would you ever expect a physician to start you on high blood pressure medication without ever assessing your blood pressure to know if it’s even high? I would hope not. The pelvic floor can be doing all kinds of things. Maybe it’s truly weak. Maybe it’s weak and also tight. Maybe it’s strong but just lacks coordination. Or maybe it fatigues really quickly. The treatment and recommendations for each of these situations should look completely different. Thus, no one should be telling you what to do for your pelvic floor issues without actually assessing them first. Only have issues when you’re upright or standing? See a practitioner that assesses how they function in standing! An assessment laying on your back does not equate to what’s going on with your muscles when you’re upright.
Get evaluated by someone who takes a look at the entire movement system.
As previously discussed, the pelvic floor should be playing nice with all of it’s neighbors—Your diaphragm, your deep abdominals, and your deep lower back muscles. If you have a history of respiratory issues, abdominal surgeries, lower back issues, pregnancies, hypermobility spectrum disorders, or really, anything that impacts any of these other areas, your pelvic floor can get involved (for better or for worse). This is why kegels alone, kegel chairs, online programs, and fancy contraptions you see on Amazon will likely never fully resolve your symptoms. I can’t tell you how often the driver of a patient’s pelvic floor dysfunction lies outside of their pelvis.
(Stay tuned for an entire blog post about the relationship of the hip joint to the pelvic floor—I’ve not even touched on that, yet.)
Be patient with yourself and trust the process.
It’s Muscle Physiology 101 that any changes you notice in improved strength or coordination in a muscle within the first 6 weeks of training are related to nervous system changes (i.e. nerves are communicating more efficiently to that area of your body). It has nothing to do with your body actually laying down more muscle fibres. Beyond that 6 week mark, with the right frequency, consistency, and training, your body will begin to lay down muscle tissue and strengthen. Give yourself at least 3 months of consistent dedication to working toward improving your symptoms before you decide whether or not something is or isn’t working for you. When training muscles for automaticity (i.e. pelvic floor activating for a sneeze so you don’t pee your pants), this can take high repetitions, very consistently, over a considerable amount of time before it’s really ingrained in your nervous system wiring.
healing your pelvic floor isn’t rocket science if you know what you’re working with
When it comes to getting your pelvic floor dysfunction under control, seeing a pelvic floor physical therapist who takes a whole body approach is unmatched. Our physical therapists at Paradigm Pelvic Health & Wellness specialize in head-to-toe assessment of the movement system, including the pelvic floor, so that we can develop a unique treatment plan, individualized to your very specific needs. You might be shocked at just how quickly your symptoms can improve when you’re doing the right things. Give us a call at (240)-267-2924 to start your healing journey today, or contact us here.
