Your Pelvis Needs More Than Just a Floor

Many women who have had children experience what we tend to refer to as “pelvic floor issues”. You know what I’m talking about – when laughing, coughing and heaven forbid sneezing in public becomes an exercise in how to subtly hold it together when you know there’s nothing subtle about it.

As a result, many moms go for pelvic floor physiotherapy to retrain the musculature that helps retention amongst other things. Unfortunately I often see women many years later who still have retention issues despite having had treatment of the pelvic floor early in the post-partum period. They will often tell me that the treatment helped but the issue still remains problematic.

A Little Physics Abracadabra

Why is this? To answer that question we have to get into a little bit of physics. I know, it sounds painful but I promise to make it understandable. Your bony pelvis is like a bowl without a bottom. Picture your standard stainless steel mixing bowl with the bottom removed. That’s what your pelvis is like with all of the muscles removed. What forms the bottom of the bowl are the pelvic floor muscles. Essentially they sling like a hammock from your pubic bone to your tailbone and fill in the space in the bottom of the bowl.

Naturally these muscles take a bit of a beating during pregnancy (that’s a lot of work holding up that heavy baby) and during childbirth (don’t think that one requires explanation). So why isn’t just treating this hammock of muscles enough? It’s because of everything sitting on top of it. Remember, the pelvic floor is at the very bottom of the barrel (literally) of your trunk. Sitting on top of it are all of your organs, and then your entire chest cavity with all its important stuff inside.

Between your chest cavity with its heart and lungs, and your abdominal cavity with its vital organs, is the diaphragm. It is a huge dome of muscle that completely divides the two cavities into separate chambers. When we breathe in the diaphragm descends and increases the pressure in the abdominal cavity. When we breathe out the diaphragm goes back up to where it was and decreases the pressure in the abdomen. Some describe this like a piston in a cylinder, but unless you are a genius with combustion engines, most people don’t really get what the means. So instead, let’s picture a crowded room with a dividing wall down the middle. The wall is moveable though, so as people on one side push on it, the people on the other side get more squished together (i.e. pressure). Then if those people push back, the pressure shifts to the other side.

Your Amazing Travelling Organs

Your diaphragm does this a minimium of 20 thousand times a day, much more if you are active. This means that tens of thousands of times a day everything in both chambers has to shift around under changing pressures. Wow. Every time I think about that it still impresses me. As an example, your liver, which sits tucked right up under the diaphragm, moves down and then back up again several centimetres with every breath. Over the course of a day then, your liver travels a minimum of about two kilometers!

All of this means that what’s happening way down at the bottom of the barrel in your pelvic floor is dependent upon everything that is happening above. If something above isn’t quite right in terms of alignment and mobility, then it will change the alignment and pressure throughout the barrel and will have consequences on the pelvic floor.

Hey, Where did my Support Go?

During pregnancy everything in the chest and abdominal cavities gets pushed aside to make room for your baby. Then when you finally get to meet your little bundle of joy, there is suddenly a big void left in the abdomen and all of the organs are in disarray having lost what they have been leaning up against for months. Does it makes sense that sometimes something can get stuck or out of alignment?

It seems clear then, that “pelvic floor issues” aren’t just about the pelvic floor. Rather, they are about your entire trunk and how everything inside of it is moving in relation to every other part, and how this is affecting pressure in the two chambers. If you are experiencing retention issues long after your children are out of diapers, then you likely have some alignment and mobility issue that is affecting your bottom line (pardon the pun but I couldn’t resist that one). If this is the case, get help from someone who will look at your body as a whole and can get to the root of the problem. There are many skilled practitioners out there, but not many who look at the big picture. Find yourself one, and then go forth and sneeze freely.