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The Pelvic Floor: What Is It, Why Isn’t It Working, and How Can Massage & Movement Help?

The pelvic floor is the group of muscles that span across the inside of your pelvis. With 2 or 3 holes for the urethra, rectum, and vagina, the muscles form a supportive “floor” for the abdomen. The muscles generally run from the inside of the sacrum and tailbone to the pubic bone and other parts of the pelvis.

Image from Atlas of Human Anatomy, Frank H. Netter, M.D.

When the pelvic floor isn’t working optimally, you can experience symptoms like incontinence, pelvic organ prolapse, pelvic pain, pain during sex, constipation, or back or hip pain. Many people, including doctors, will tell you that pelvic floor dysfunction (PFD) is caused by childbirth, high intensity exercise, or constipation. However, none of those actually cause PFD on their own. Rather, PF muscles often become weak and tight over a long period of time, so that eventually a situation arises that overtaxes them in a way they can no longer handle.

What Really Causes Pelvic Floor Issues?

Habitual movement patterns that chronically shorten the pelvic floor will weaken the muscles to the point where they can no longer do their jobs. Such habits include copious sitting, wearing shoes, postural habits that increase tension around the pelvis, walking habits that tighten the hip flexors, and a deficiency in glute muscle use (such as not squatting). All of these movement habits, done frequently over a long time, will shorten the space between the sacrum and the pubic bone. With less space within which to exist, the pelvic floor will physically shorten, decreasing the amount it can contract.

People often think that because the pelvic floor is weak it needs to be tightened. However, what is often the case is that the pelvic floor is so tight that it cannot tighten any more, and therefore is weak. For example, tighten your hand into a fist as hard as you can. Now, what if I asked you to squeeze even harder and you couldn't do it? In a similar way, the PF muscles can't squeeze any more because they have run out of room. Real muscle strength means having the ability to both contract and relax. A muscle can’t do its job while being able to do only one of these.

How Can You Resolve Pelvic Floor Issues?

Massage can help provide balance to pelvic musculature, including many of the pelvic floor muscles themselves without working internally. If you are seeking to improve your posture or movement habits, massage can help speed the process and encourage tension patterns to change for the better.

If you are seeking long lasting change and a truly strong and responsive pelvic floor, you need to work on improving the way you move. I can work with you to guide you in

· transitioning to minimal footwear

· sitting on your ischial tuberosities (sitz bones) rather than your sacrum

· restoring you ability to squat well

· learning to walk using a posterior push-off

· reducing core tension patterns that put excess pressure on the PF

· improving whole body alignment because your PF is connected to everything else

I offer one-on-one sessions and group classes at the Bellingham Yoga Collective where you can start the path towards being able to trust the ability of your pelvic floor muscles again.

Below are many resources I highly recommend reading for more information about the pelvic floor and how you can start resolving PFD today.


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