Pelvic Floor Health

When Lucca was about 2 I picked him up one day and felt something in my abdominal wall give. Just above my tummy button there was a very small hardening - I worried it was a hernia, or the beginning of one. Until this point I’d also been struggling with haemorrhoids.

Despite having a great deal of knowledge in pelvic floor education, postnatal and pregnancy care I realised I wasn’t practicing what I preached. I hadn’t been putting myself first and it was beginning to show.

Haemorrhoids, hernias and pelvic floor disfunction are all connected and have so many different factors to consider. Here’s what I know so far:

The diaphragm and pelvic floor have a powerful and intimate relationship. They work in coordination as part of your core support system, that includes:

• Top: Diaphragm

• Bottom: Pelvic floor

• Front/sides: Deep abdominal muscles (especially the transversus abdominis)

• Back: Deep spinal muscles

Stability and Core Function

• The diaphragm and pelvic floor help regulate intra-abdominal pressure during activities like lifting, sneezing, or exercising.

• If this system is imbalanced (e.g., holding the breath during exertion or having an overly tight pelvic floor we may experiencen

  • Back pain

  • Hernias

  • Pelvic organ prolapse

  • Incontinence

Coordination is Key

• These two muscles must communicate efficiently. If one isn't functioning properly (e.g., a shallow breather or tight pelvic floor), the other may compensate, often leading to dysfunction or fatigue resulting in leakage.

• For example:

  • Chronic stress can cause chest breathing, bypassing the diaphragm, leading to a tight pelvic floor that never relaxes.

  • Pregnancy alters pressure dynamics, often weakening both diaphragm mobility and pelvic floor tone.

How to Support This Relationship:

• 360 Breathing: Place your hands on your lowe ribs and breathe into the sides. Come into childs pose and breathe into the back body. Can you breathe up to your collar bones and inbetween your shoulder blades? “Belly Breathing” may not be a helpful term - or diaphragm doesn’t sit in our belly and this may actually lead to greater intraabdominal pressure. Can you take full breaths as well as full exhalations?

• Postural awareness: noticing things like rib flare or an over arched/curled pelvis. Our posture isn’t rigid - we want to be able to move in lots of different ways! But noticing what our habitual patterns are can really help. Even how we walk and stand in the ground come into it.

• Core-focused movement (e.g., Pilates, yoga): Helps train the entire pressure system to work together efficiently.

• Stress awareness and relief Greater body awareness of where we hold onto tension - not just our hips, pelvic floor but also our jaw, shoulders. All of these can impact our pelvic floor.

• With a great coach work on using load (i.e. weights) to load your tissues and add strength. Great coaches know how to work with bracing to help intraabdominal pressure.

Key Takeaways

There is SO much going on with the pelvic floor and abdominals. Diet, stress, posture, breath and lifestyle all come into this.

If in doubt - go and see a professional. A women’s pelvic health physiotherapist may be able to help. Don’t suffer with symptoms - we don’t have to live them!

I went to see Emily Elgar at Woman Kind Physio in Sheffield and she was great. I also got back into the gym and worked with brilliant coaches who coached me on my form and how to brace. I also got back into my yoga and relaxation practices. Finally - and this is something I’m still working on - I am dealing with the stress of being a new mother in this crazy world and recognising the toll that sometimes takes on my body. I’m getting better at asking for help and dealing with things when they arise.

Any questions please do reach out nd if you’d like to work with me 1-to-1 to help with any of the above please do get in touch.