Many people think leaking while coughing, running, lifting or through other physical exertion is caused by a weak pelvic floor and they need to do more Kegels to strengthen it. Although a weak pelvic floor can cause stress incontinence and strengthening exercises are no doubt important, there are other causes to consider such as a tight and stiff pelvic floor, lack of core dynamic stability and alignment, restricted movement through the core and last but not least shallow breathing.
The pelvic floor is one part of the muscle system that makes up your 'deep core'. Think of the pelvic floor as the bottom of a canister that provides stability and support for your internal organs. It also affects your ability to control your bladder and have a bowel movement. The top of the canister is your diaphragm, and around the sides are your abdominal muscles. These systemically connected structures maintain co-dependant dynamic stability in a healthy body.
The core therefore consists of the pelvic floor, deep abdominal muscles, spinal stabilisers and diaphragm. With every breath, our pelvic floor and diaphragm are meant to work together, creating and regulating pressure. On an inhale, the diaphragm lowers, exerting pressure out into abdominal wall and down on the pelvic floor; on the exhale, the diaphragm rises as the abdominal wall moves in and the pelvic floor lifts.
When we exhale under normal conditions, this process happens without any effort or conscious attention. But when demand for oxygen is high (e.g during physical exertion), a forceful exhale causes deeper abdominal contraction and pelvic floor contraction.
As you see in the picture above, the pressure is then all going down and out during inhalation, creating excessive force on the pelvic floor and decreasing our core stability.
Why shallow breathing isn't good for you
In a shallow breathing pattern, we use accessory muscles in our neck and chest that weren’t designed to direct our breathing. These accessory muscles are meant for emergencies (e.g for 'fight or flight' response). If we breathe in shallow pattern, our shoulders rise and we use the upper body to get air in; when the diaphragm goes up on the inhale, then it has to come down on the exhale, putting more pressure on the pelvic floor. What goes up must come down!!
Our body is designed to allow for deep breathing. In other words, the ribs should expand and contract equally in all directions. This allows for deep breath and full movement of the diaphragm. This healthy range of motion is important because it helps absorb impact and manage pressure – two key things while you run, exercise or carry heavy loads.
Watch yourself breathe in the the mirror. What do you notice? Is your neck tense? Are your shoulders rising? OR is all the air going out through your belly? Do your ribs move out to the side and the back? Or do your ribs not expand and contract at all?
Observe and Restore
I can help you with the observation of the alignment, quality and fluid relationships between your different diaphragmatic core structures. It can be a very useful tool to identify restrictions, pelvic dysfunction and grow stability, alignment and free fluid movement. Observing the wave of movement through the core and being curious about where motion is initiated from, or where it travels through, gives us a lot of information about the presence or lack of core integration. With Bowen Therapy and myofascial exercises I can help you restore a healthier deep core.
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