Pressure: Friend or Foe to the Pelvic Floor?

Pressure. Probably one of the most frequent words spoken in my clinic. But is pressure a bad thing? Keep reading to find out.

Oftentimes if you are experiencing stress incontinence (leaking with coughing, laughing, sneezing, jumping) or feeling heaviness in your pelvic floor due to potential prolapse, pressure imbalance is a strong culprit. Now, please do not read this as pressure imbalance is the only reason for your symptoms, if you’ve read any of my other blogs previously, I hope you are starting to see that pelvic floor and core challenges are multi-faceted.

Our body is a very complex system that needs to absorb but also use pressure to function properly and tolerate everyday tasks. Let’s break it down throughout the core canister which is the space between the rib cage/diaphragm to the pelvic floor and from the abdominals to the back extensors.

Starting at the top. The rib cage/diaphragm. Here is where we start to see the anatomical asymmetries begin. The diaphragm is not completely symmetrical side to side. The right hemidiaphragm is slightly larger, slightly thicker, and slightly stronger than the left hemidiaphragm. It is believed that this is caused by where our organs are positioned. On the right side of our body, the liver, which is a very large organ, sits off to the right side just under the diaphragm. Conversely, on the left side, the heart sits above the diaphragm. Additionally, the right lung is also larger with 3 lobes to the lung compared to only 2 on the left.

These anatomical asymmetries that we all have then create a domino effect. These changes can then impact the abdominal wall that attaches from the rib cage to the pelvis itself. Oftentimes, we find that the left abdominal wall is in a more lengthened position than the right, causing an increase challenge to fire as strongly compared to the right side.

Further following down the chain, we know that oftentimes the right side of the pelvis is typically sitting further back, tucked in, and and rotated towards the center while the left side is sitting more forward, open, and rotated outwards. The position of the pelvis itself than impacts how the pelvic floor is sitting. (For a reminder, feel free to check this previous post out).

Heading to the back extensors, it is very common to find tightness and shortening in the back muscles which also attach to both the rib cage and the pelvis impacting how both of these are sitting.

So if you are having leakage with activities or heaviness in your pelvic floor, we have to discover where your body could do better at absorbing pressure and then train the body to also use pressure for stability.

One of the first areas to start addressing to help increase pressure absorption higher up the chain, is working on getting lengthening and expansion into the back and the right side as needed. This can be done together or separately, pending on how your pattern presents. As the lengthening and expansion into the back gets further incorporated, this allows easier and more efficient activation of the abdominal muscles.

Then, moving into the pelvis and working on getting the pelvis itself to have more mobility. The more mobile the pelvic bones are, the more mobile the pelvic floor muscles can be. The more mobility the pelvic floor has, the better it can absorb pressure versus being too rigid from tension that the muscles’ ability to absorb pressure is just not there.

When the body is able to absorb pressure throughout all of these areas, we can then shift focus on training your body to use this pressure for stability! I love having clients work on blowing up balloons in various positions. What this does is it helps train the body to manage an increase in pressure throughout the core canister and increase stability throughout the body.

Translating this over to day to day tasks, our body needs pressure for stability especially as we increase the demand/effort to the body. Functionally put, this could range from anything from an extra aggressive cough from an illness to wanting to back squat a new personal record. The body utilizes the pressure throughout the core canister to provide stability throughout the increased effort.

A great visualization I heard from Sarah DuVall at a conference last year is imagine a crumpled up plastic water bottle. You can do your best to pull the top and bottom of the bottle apart and try to manipulate the sides of the bottle to reshape it back into it’s original form, but until you blow air into the bottle to build up internal pressure, the bottle will likely not get enough stability to reshape back to original shape.

Pressure is quite the buzzword in the pelvic floor community. I’m guilty of using if often but it’s not something you should be afraid of. Our bodies are created to absorb and utilize pressure to function efficiently. If you are having symptoms, what will be the most helpful to you is to learn how to balance this pressure.

If you found this post helpful, please comment and share with others as I love educating the community!

Keep following along for tips, trick, and pelvic floor tidbits.