What is your pelvic floor and why does it matter? The pelvic floor is a sling of muscles that runs inside the pelvis. It works dynamically with the diaphragm and abdominals to dictate pressure during breaths. The pelvic floor also has intimate connections to the sphincters of your urogenital structures. These structures are important for 3 vital human functions: peeing, pooping and sex.
Yea, I said it. The stuff that no one wants to talk about.
Some men and women experience incontinence or urinary urgency but think that is “just something that happens” with age or high level activity. This simply is not true. Others may have pelvic floor dysfunction symptoms including low back/hip pain, constipation, painful sex or feelings of incomplete voiding.
Every time you breathe, your pelvic floor is moving and contracting. The way in which you stand and move has a direct effect on the ability of the pelvic floor or contract and work in synergy with the rest of the deep core. What if you could change a few daily habits and have decreased pelvic symptoms? Check out these 7 common habits and see what applies to you:
1. Ab gripping- Whether it is to make your tummy look flatter, for stabilization during everyday movements or due to overtraining abs at the gym, ab gripping is adding constant and unbalanced pressure to your pelvic floor. When you are simply moving throughout your daily activities, your belly should be relaxed! I give you permission to fight the social stigma of a less-then-flat abdomen and give your pelvic floor a break. Let the belly go!
2. Preventive peeing- Many people have the habit of trying to urinate when their body is not signaling that they need to void, usually right before leaving the house or on a scheduled break at school/work. This “peeing just in case” can also lead to pelvic floor dysfunction or worsen existing issues. Your bladder will now have a different set point of when it thinks it’s full! Now the pelvic floor muscles never have to be coordinated to control a full bladder and fight the urge for 30 minutes before you get home.
3. Hovering- Believe me, I’ve been at music festivals and used a porta-potty that was so gnarly I didn’t want to touch the handle! What I am about to say does not apply to that situation--I would not recommend that you ever sit in that. However, when using the restroom in public, many women will hover over the toilet while urinating. This is not doing your pelvic floor any favors. Remember, the hip musculature and pelvic floor have connections so while you are holding an isometric air squat, do you think your pelvic floor is relaxed? Hell no, it’s holding on for dear life. Take your time when peeing and try to sit whenever possible. Most bathrooms these days have those little paper covers for the toilet seat. Use that! And take your time, giving your pelvic floor time to relax and the bladder to completely empty.
4. Breath-holding- As I mentioned before, the diaphragm and the pelvic floor work together. So breath holding will also increase pressure on the pelvic floor and increase the likelihood of leaks. Those who use breath holding as a strategy while moving light object or bending over, usually do so to avoid a leak or feeling of urgency. However, this increased pressure increases the likelihood of a leak! I understand that there are times breath holding is essential- lifting heavy weights. There are alternate strategies to avoid leaks in these situations—outside the depth of this post!
5. Butt clenching- This goes right along with ab gripping- relax! Deep hip muscles have fascial connections with the pelvic floor, so a tight booty = a tight pelvic floor. But tight means strong, right? No, in this sense I mean tight as in over-recruited. Your pelvic floor is on high guard all day from increased pressures and over-recruitment. Then you expect it to hold on tighter with a violent sneeze or a couple dozen box jumps? It is tired! The pelvic floor function and intimate relationship is more about timing and synergy than strength. Ladies- be careful when are trying to look sassy in those heels on Saturday nights. High heels can also cause women to unconsciously hold their pelvis in a tucked position or butt clench.
6. Poor posture- So I have said a lot about pressure, particularly imbalances and increased amounts. However, posture is often the prequel to the alternate recruitment strategies discussed above. If your diaphragm and pelvic floor are not stacked on top of each other, then they are at a disadvantage for working together. In appropriate synergy = pelvic floor dysfunction. The best way to check this is to look at your posture in the mirror or have a friend take a picture. You want your rib cage and your pelvis in line. Poor posture indicators are your lower ribs poking forward, nipple trajectory pointing upward rather than straight, hip bones much further forward than your lower ribs.
7. Sitting all day- Sitting is just bad for you, plain and simple. But it has particular effects on the pelvic floor from both a myofascial and alignment standpoint. The glutes and your pelvic floor are buddies, they like to work together. When you sit on your glutes all day, the fascial layers become compressed and unable to slide as easily. As far as alignment, who can actually sit with good posture for 8 hours? Not me. I don’t think I would trust someone that could- they are probably an alien. Those deeper hip muscles that have connections to the pelvic floor can become tensioned and tight which could lead to a tighter pelvic floor- remember tight doesn’t equal strong! That being said, as you sit slumped over a computer, your alignment of ribs over hips is likely disrupted. Then we are back at the beginning with an imbalance of pressure. Don’t you see, it is a never-ending cycle?!
** Allergies/coughing/sneezing- Ok, so this isn’t a habit per se but worth noting on this subject! Women and men with persistent allergies causing frequent cough and sneeze episodes may also see increased pelvic floor dysfunction due to the frequent pressure changes. If this sounds like you, be sure to find some medicine that works for you or talk to a physician about possible allergies. If the coughing is from smoking, well that is absolutely a habit that you can direct effect!
I think it’s safe to say everyone could find at least one habit that applies to them. Take some time to be more aware of your posture and how you are holding your muscles when they should be relaxing! Stress urinary incontinence and urgency is not normal but it is common. You never know, a few simple habit fixes may resolve your symptoms. If not, reach out to us at Athletes’ Potential, we would love to help!
Dr. Jackie Varnum PT, DPT
Dr. Danny and staff's views on performance improvement, injury prevention, and sometimes other random thoughts.