For Women: Pelvic Organ Prolapse-Health of the Pelvis
In my study of yoga and the Core Confidence Specialist training that I took in 2018, I learned about the importance of the pelvic floor muscles and their close association with breathing and with the core body.
The pelvic floor is a collection of muscles, nerves, tendons, blood vessels, ligaments and connective tissue that are interlaced within the pelvis and make up the pelvic floor.
The muscles of the pelvic floor connect to the pubic bone in front, to the coccyx in the back and to the sitting bones. These muscles provide stability to our spine and pelvis, help keep the pelvic organs in place, and help maintain continence. They must be strong to work together for long periods of time and be able to contract quickly and sturdily at various times during the day when we laugh, cough, or sneeze.
Pelvic Organ Prolapse
Some women of childbearing age might get a pelvic organ prolapse after they give birth. This condition shows few symptoms at first, which leads some women to miss noticing it.
One of the roles of the pelvic floor is to help keep the pelvic organs in place. The position of the bladder, uterus and rectum depends to some degree on the strength and position of the pelvic floor.
A weakened pelvic floor can no longer support and lift, which stops the organs from preserving their anatomical position. The organs will start to drop down, and in severe cases will start to stick out through the vagina.
5 Roles of the Pelvic Floor
- Stabilize and control the spine and the pelvis.
- Support the internal organs.
- Act like a sphincter to maintain continence.
- Sexual role.
- Sump-Pump action through breathing.
Pelvic Floor Dysfunction
- Inability to contract fully
- Inability to release fully
- Inappropriate timing of the contraction
Types of Dysfunction
- Urinary incontinence
- Pelvic Organ Prolapse
- Painful Intercourse
- Pelvic girdle pain
Movements Recommended for Pelvic Floor
Pelvic floor movements strengthen the muscles in the lower part of the pelvis. They are suitable for women who have mild bladder leakage and feelings of pressure in their abdomen.
You actively squeeze the muscles in the pelvic floor. This involves short exercises that can be done in everyday life, three times a day. It is best to learn the exercises from a physiotherapist so that they are right for your specific symptoms.
But, before you start doing yoga or exercising your pelvic muscles, you must retrain your core muscles, which are really formed of four muscles: the diaphragm, the pelvic floor, the transversus abdominus, and the multifidus.
This group of four muscles prepare us for action before we act. Rehabilitating this group of muscles means doing exercises that focus on identifying and co-activating them.
There are rehabilitating programs that help women learn optimal posture, breathing and exercise to help these muscles relearn the support strategies that has been lost.
It is a hindrance if you train your core when these muscles are dysfunctional.
The Transversus Abdominis (TVA)
The TVA is the deepest abdominal muscle. It wraps around us like a corset and inserts on both sides of our spine. We use it all day when we breathe, cough, or sneeze, and should use it when we lift something.
This muscle can become stretched and weak by inactivity, pregnancy, posture changes, overweight and even from constantly doing forward flexion abdominal exercises such as sit-ups.
The TVA, like the pelvic floor muscles, must maintain some degree of tone during the day to help support the spine and the internal organs. A high degree of tone can create downward pressure on the pelvic floor. A low degree of tone can mean a lack of support for the spine and abdominal contents such as the stomach, small and large intestines, pancreas, liver, and gallbladder.
The risk of organ prolapse can be increased due to:
- Chronic bowel straining.
- Chronic coughing.
- Chronic heavy lifting.
- Excessive kyphosis of the back.
- Physiotherapy with a specialized pelvic floor physiotherapist.
- Massage Therapy.
- Walking, swimming, training on the elliptical and the bike.
- Avoid heavy lifting for some time.
- Learn good deep core strategies to use both in daily activities and when we exercise.
Walk, swim, and bike.
- When we want to lift something as part of our exercise routine, we should try different positions for lifting, from sitting, side-lying or supine positions.
In extreme cases, some women with pelvic organ prolapse may never be able to return to high impact activities such as cross-training, running, or knee-highs because the ligaments support lost its anatomical integrity.
Breathing is very important because the diaphragm and the pelvic floor are intertwined. When we inhale, your diaphragm and our abdominal organs are pushed down, which makes the pelvic floor stretch out and sink down. When we exhale, our diaphragm rises again, our pelvic floor muscles contract, and the pelvic floor rises again.
Breathing and the movement of the diaphragm must be coordinated so that the pelvic floor muscles contract and relax in an optimal way.
Tips for Daily Life
Avoid putting excessive straining on your pelvic floor muscles in daily life.
Standing up from a supine position
If you are lying down and get up while keeping your upper body straight, your stomach muscles tense and this pushes your pelvic floor down. You can reduce the pressure by rolling onto your side first, supporting yourself with your arms, and then getting up.
If your back is not straight, there is less tension in your pelvic floor and the organs in your abdomen are squashed together, so they push down on the pelvic floor. Keep your back straight when you sit or walk.
When you lift objects, there is less strain on your pelvic floor if you bend your knees first and come back up with a straight back, using the strength of your leg muscles, instead of keeping your legs straight and bending forward. It is helpful to hold the object close to your body and tense your pelvic floor muscles.
If you hold your breath when lifting heavy objects, the muscles in your back, stomach and pelvic floor cannot work together as well as they could. The muscles work better together if you continue breathing.
Coughing and sneezing
Coughing or sneezing means a quick pressure increase in your abdomen. This can put strain on your pelvic floor if your upper body is bent forward. Lessen the strain by looking up or over your shoulder when you cough or sneeze.
Abdominal exercises like sit-ups put a lot of pressure on your abdomen. This can be a problem for women who have a weak bladder, are pregnant, or had a baby in the last few months. If any of those apply to you, talk to your doctor who might suggest avoiding abdominal exercises for a while, or doing lighter exercises instead. When exercising, find movements that are pain free and work to become able to move past the limits.
According to Leslie Howard, yoga teacher and yoga therapist specializing in pelvic floor health, pain in the hip socket or in the groin, clenching or grinding the jaws (TMJ), and sciatica pain are linked to an imbalance in the pelvic floor.
This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.