The impact of a tight or hypertonic pelvic floor isn't limited to the pelvis area.
Whist a tight pelvic floor can cause symptoms such as incontinence, painful sex and pelvic pain, the effects can be more far reaching.
The pelvic floor is the floor of your core; tightness here will impact other elements of the core system, such as the diaphragm. If the diaphragm becomes tense, this will impact on how optimally the chest expands and contracts with breathing.
Our bodies are linked via a support system called fascia. This is connective tissue that runs throughout the body. Because fascia links diffrent areas of the body together, tension in one place can lead to tension in another. For this reason it is not uncommon to experience jaw tension alongside a tight pelvic floor.
A tight (hypertonic) pelvic floor can often go undiagnosed because it can present similarly to other pelvic floor problems. Common symptoms include back pain, stress incontinence, urge issues and constipation. These symptoms such as will not improve until the tightness of the muscles is dealt with. For this reason it’s so important to get assessed by a women’s health physio
It can be frustrating when recovery doesn’t go quite to plan. Almost every woman I’ve treated has had at least one blip along the way. Whether it’s increased pain from a c-section, worsening prolapse symptoms or leaking when you have a bad cold, it can be really disheartening. But the thing is, we are not robots! Lack of sleep, nutrition, stress and a change in activity can all cause a flare up of symptoms. But that doesn’t mean all is lost. Keep going on your treatment plan and you will find progress does resume! Sometimes you may find you need to take your rehab level back down a step before increasing it again once your flare up settles.
The NICE guidelines recommend a three month physiotherapy exercise programme for prolapse, because research has found that we need to play the long game! Whilst commitment is required, most women find that a course of physiotherapy is effective to manage their prolapse.
astasis recti is a defined as the partial or complete separation of the "six pack" muscle. This muscle is connected down the midline of the stomach by the linea alba (connective tissue).
Diastasis is common in pregnancy - a gap in the six pack muscles occurs to make room for the growing uterus. In most cases the gap naturally close within about 6-8 weeks after pregnancy, but for some women the gap fails to close spontaneously.
Diastasis doesn't just occur in women and pregnancy. it can also affect men, sometimes from doing excessive or incorrect abdominal exercises.
Abdominal separation affects your "core cylinder" muscles, and therefore often occurs alongside other core issues such as pelvic floor weaknes,, incontinence, back pain, constipation and prolapse.
The most common symptom is the classic "mummy pooch" or feeling like you continue to look pregnant, months or years after birth. You may also notice a doming or bulging down the midline of your belly when doing activities that engage the abdominals.
Healing a diastasis requires a holistic approach looking at nutrition, posture, soft tissue release and core exercises.
The core should always be rehabilitated as a whole and so effective diastasis treatment will involve exercises that engage the pelvic floor and the deep abdominals simultaneously.
You can start reconnecting to your core by first finding your pelvic floor:
1)Lie on your back with your knees bent
2)Inhale, breathing from the base of your ribs. As you exhale, close and lift your pelvic floor (imagine you are trying to hold in wee and wind at the same time). Try and start the contraction at your back passage first.
3) At the end of the exhale, let go of the contraction.
Once you can achieve a pelvic floor contraction you need to add load to strengthen your entire core cylinder, which will rebuild tension across the midlne of your abdominals. A physiotherapist can direct you to make sure you are doing the right level of exercises.
You can get a referral via the NHS to a women's health physio, or contact us for an assessment and treatment. Our online pelvic floor foundation course is also perfect to start healing your diastasis. Find out more here.
Claire is a women's health and sports Physiotherapist. She is the owner of Spring Physio and is based in East Sussex.