You and every other human have a group of muscles at the bottom of the pelvis that you use for the most basic everyday functions鈥攖o walk, lift things, exercise, pee, poop, have sex, and, for some, bring life into the world. Those are pretty critical functions for a part of the body you rarely concern yourself with鈥ntil you encounter pelvic floor dysfunction.
This could look like occasional incontinence (urinary leakage with jumping jacks, anyone?) to uncontrolled and ill-timed gas (like an 鈥渙ops鈥 during at a yoga class). Recent research suggests that at least and will experience at least one pelvic floor health issue during their lifetime, and that鈥檚 based only on subjects who reported their dysfunction. Many of us don鈥檛 realize that some of the issues they experience can actually be traced back to their pelvic floor muscles.
Although many issues are unique to those of us who are born female due to stress on the pelvic floor muscles brought on by pregnancy, childbirth, and the hormonal changes that accompany getting older, many pelvic floor issues are exacerbated by stealthily subversive habits that almost all of us unknowingly engage in at least once in a while.
The Anatomy of the Pelvic Floor
The pelvic floor contains 14 to 16 different muscles woven together in three layers. Like any other muscle in the body, the pelvic floor muscles can also become weak, tight, and/or fatigued, causing pelvic floor dysfunction.
Pelvic floor dysfunction can manifest as an array of symptoms:
- Sensing an overwhelming urgency to pee or needing to pee all the time
- Constipation or straining with bowel movement
- Leaking pee or poop of any amount (urinary or fecal incontinence)
- Difficulty urinating
- Difficulty controlling gas
- Experiencing pain during sex
- Experiencing pain in the lower back, hips, and/or tailbone
- Feeling heaviness in your pelvis (pelvic organ prolapse)
- Feeling pain during a gynecological exam or when you insert a tampon
6 Habits That Contribute to Pelvic Floor Dysfunction
If the following actions occur once in a while, there are typically no consequences to the well-being of your pelvic floor. However, if they become habits, they can contribute to issues.
1. Taking 鈥淛ust-in-Case鈥 Pees
Forcing yourself to pee before bed (or before a movie, or at a rest stop on a road trip, or ahead of a workout class…) may seem like a thought-out plan. But while taking a 鈥渏ust in case鈥 restroom break tends to be an ingrained practice dating back to early childhood (thank you, parents), it鈥檚 not great bladder hygiene for adults.
The bladder and brain constantly communicate with one another and fall into routines based on your habits. Going 鈥渏ust in case鈥 creates and reinforces neural pathways that indicate your bladder needs to be emptied, even if you go just a few drops. Rest assured, your bladder can hold up to 500 milliliters聽of fluid. That鈥檚 the equivalent of a 16-ounce bottle of water and then some.
2. Hovering Over a Public Toilet
There are also times when you actually do have to pee but find yourself in a less-than-pristine public restroom situation, so you decide to squat over a toilet without sitting down.
The mechanics of evacuation include releasing the pelvic floor muscles with no pushing or straining necessary. But hovering or squatting over a public toilet activates your core and pelvic floor muscles rather than relaxes them. This position makes emptying your bowels or bladder more difficult by requiring effort to initiate evacuation. This causes unnecessary strain.
It鈥檚 best to sit your bum down. Use whatever form of protection gives you peace of mind, such as seat covers, toilet paper, or an eco-friendly sanitizer spray.
3. Sucking in Your Stomach
Contrary to the unfortunate and outdated programming that some of us experienced as children around false beauty standards and fitness fads, a does no one any favors.
To clarify, engaging your core and sucking in your stomach are two entirely different actions. Engaging the core begins with the contraction of the lower abdominal muscles, as if you were pulling on a pair of tight pants. It鈥檚 followed by the rib cage pressing downward and inward, as if it was protecting your internal organs. Engaging your core in this manner provides stability.
Sucking in your abdomen is more of an illusion. When you draw in your tummy, your mid abdomen sucks inward, the ribcage presses outward and upward, and the pelvic floor pushes down. This destabilizes your body by creating rigidity and tension rather than strength.
Your abdominal cavity has its own natural pressure system that interacts with the abdominal wall and visceral organs. The pressure oscillates throughout the day based on internal movement (e.g., breathing and digesting) and external movement (e.g., exercise).
Imagine squeezing the middle of a balloon. Cinching it in this fashion sends the pressure up (toward the ribs) and down (toward the pelvis). This is what sucking in your stomach does to your abdominal cavity. Over time, increased pressure on the pelvic floor can lead to tension, weakness, and a lack of coordination in your pressure system.
4. Holding Your Breath During Your Workout
Have you ever found yourself doing something hard, whether physical or mental, and realized you鈥檇 been holding your breath? Consider your plank. It鈥檚 a challenging hold that, when practiced properly, works your entire core and engages muscles from head to toe. With such intensity, holding your breath is a common tendency.
Returning to the balloon image, holding your breath during physical intensity is like pushing on the balloon from the top. The pressure responds by moving outward, restricting core activation, and downward, restricting the natural movement of the pelvic floor muscles.
A habit of holding your breath in a plank or any challenging pose or workout inhibits the natural deep core and pelvic floor connection, which allows you to hold intense shapes and build strength.
5. Overtucking Your Tailbone
There鈥檚 a lot of controversy around the common yoga instruction to 鈥.鈥 As a pelvic floor therapist, I, too, have an opinion on this, although the cue isn鈥檛 what I have an issue with鈥攊t鈥檚 how it’s interpreted.
Many people hear this cue and find an extreme shape, flattening their spines and scooping their pelvis under. Overtucking the tailbone results in the clenching of glute muscles and the overactivation of the pelvic floor muscles. This can create pelvic floor tension, hip pain, lower back issues, pain with intercourse, as well as urinary and bowel concerns.
There is no such thing as 鈥減erfect posture.鈥 We need to learn the beautiful nuances of our bodies and understand that our spine position changes when we walk, sit, sleep, and roll.
6. Wearing Tight Clothes
High-waisted yoga pants and sports bras that are too tight inhibit abdominal expansion (think back to the balloon) and block the rib cage from moving fully and organically. Prolonged exposure to restrictive clothing, including ill-fitting bras and pants, can create abdominal tension and disrupt the usual pressure management within the core canister. This can also result in difficulty breathing and, yes, pelvic floor dysfunction.
This is especially true for clothing worn specifically for movement and exercise. Yoga pants and sports bras that fit well will not only feel better but also improve your ability to breathe and allow for greater core activation.
In addition, improperly fitting underwear (e.g., constriction around the legs) does not allow normal blood flow into the lower half of the body. Consider this permission to purchase clothes based on fit rather than size! And if you lounge in your yoga pants, you may want to consider a more relaxed fit.
It鈥檚 the little things that can make all the difference in preventing and managing pelvic floor issues.