Pelvic Floor Activation- The First Steps

Pelvic Floor Activation- The First Steps 
Guest Blog by: Carolyn Wojtusiak DC, Chiropractor, Women's health and Fitness

One of the most beautiful experiences to go through as a person is the miracle of childbirth- bringing new life to this world. It is the most rewarding and uplifting experience, but it also comes with side effects that we, as parents, are not expecting. Throughout the first few weeks of post-partum, the transformation into parenthood is in full swing and it is a time where one is learning to live their new “normal.” While learning to be the best parent possible for your little one is paramount, adjusting and healing from delivery is a close second. Challenges that people experience throughout healing are often caused by or cause pelvic floor weakness. Finding the connection to our pelvic floor so it can heal can be very challenging and my answer is always to return to the basics. 

The pelvic floor (PF), in and of itself, serves as the hammock to our pelvis. It is composed of muscles which are responsible for two major functions in our body. It’s first job is to support the organs within the pelvis- the bladder, vagina, uterus, and rectum, while its second purpose is to serve as the floor of our core musculature. During pregnancy the PF undergoes a great deal of stress while the baby is growing and the body is preparing for delivery. Throughout labor and delivery, the PF relaxes and opens, allowing the baby to enter our world. If one experiences difficulty while attempting to relax and open, complications can occur. Tearing, hemorrhage, and prolapse are all possibilities throughout this journey and it is important for mom to receive the care necessary to heal appropriately. 

Healing begins with increasing the connection from our mind to this region of our body. The best way to find this connection is to re-introduce the PF’s purpose into our body- to support the reproductive organs and bladder while stabilizing our pelvis in relation to our torso. To engage the pelvic floor, it is important to understand that the pelvic floor is also known as the pelvic diaphragm, which serves as the foundation of our core musculature. The core is the trunk of our entire body and is essential to the stability of the human frame. The breath diaphragm and pelvic diaphragm serve as the top and bottom of our core and our breath cycle ties them together. When the diaphragm drops upon inhale, our pelvic floor relaxes, allowing the belly and pelvis to fill with air. As we exhale our pelvic floor engages, rising into the abdomen and pushing our diaphragm back into our rib cage. 

In the beginning it is often easiest to re-establish this flow while lying on your back with a pillow tucked under your pelvis to give it a gentle lift. This takes the gravitational pull from our pelvic and abdominal organs out of the equation- especially if you are experiencing prolapse! People often think that to engage the pelvic floor, one must simply kegel. There is a little more to it than just this. While the kegel is an important component to the engagement of our pelvic floor, it leaves out other regions that deserve just as much attention. I like to imagine my pelvic floor in halves, an anterior and a posterior. Each half contains openings- the rectum is in the posterior, while the vagina and urethra are in the anterior half. Each one of these openings is surrounded by their own sphincter, which are all part of the pelvic floor. Activation of the PF will also engage these sphincters. 

In the recommended position, place one hand onto your chest and the other on your belly. The goal throughout the first phase of these exercises is to engage our pelvic floor musculature individually, according to our region break down. I personally like to begin with the posterior region, surrounding the 

rectum and work my way forward. The cue that I recommend to patients is to think of it as you are holding in gas. For the anterior half, surrounding the vagina and urethra, I like to encourage women to think they are pulling their pubic bone to their sacrum. Once you find each isolation, begin to incorporate each half into your breath cycle. If you find that you are experiencing difficulty engaging either of these regions, do not feel rushed to master their activation quickly. Everyone is different and each will find their connection at their own pace. It is important to spend as much time as you need with each region to feel comfortable before moving on! 

Once you have identified and found comfort in your breath cycle with each of these regions, bringing them together to contract as a whole during exhalation is the next step. This should be a slow and sustained breath cycle with a full activation of the PF. I want to stress this because it is important to be able to activate the PF in both a quick and slow, rhythmic manner. Our muscles are composed of two types of fibers- slow and fast twitch fibers. Slow twitch fibers are important for sustained activation of a muscle. The breath cycle described above represents a long and steady contraction from slow twitch fibers in our pelvic floor musculature. This is required for supporting all of the structures in our pelvis. Quick activation, fast twitch, is important to mimic for situations that require a fast response of our muscles- similar to jumping, sneezing, coughing, or running. The final phase of this breathing exercise is to challenge the pelvic floor in a way necessary to recruit your fast twitch fibers. While exhaling during your breath cycle, I challenge you to quickly pulsate your pelvic floor up to ten times! Being able to do so increases the pelvic floor's ability to respond quickly to internal and external stresses.

When the pelvic floor is engaged properly with our breath cycle, we promote a balance of support and stability in our body- a very important piece to the puzzle while healing during our first few weeks post-partum. Establishing a well connected core and pelvic floor begins with breathing but many variables can be contributing factors to an individual’s progression. It important to utilize the guidance of a midwife, chiropractor, physical therapist, or any healthcare professional who is well versed in pelvic floor therapy to ensure that your individual symptoms are being addressed appropriately. The journey of parenthood is full of many challenges and blessings; I encourage each of you to take each step with patience and appreciation. Honor your body for all that it has done and continues to do for you and your family. 

To contact Dr. Carolyn Wojtusiak see her website: https://evolvehealthandwellness.com/