Pelvic Floor Rehab-Glutes and Hamstrings

Continuing on in all-the-things-connected to the pelvic floor journey, we arrive at the derrière and hamstrings. Since this sit cradled in a chair for days and years, it’s incredibly common that adults have underachieve and weak muscles in these areas. The pathway I’m recommending to get them back on…

Massage

In short, foam roll just about everything. Hit up your calves, hamstrings, quads, glutes and back first. Tight adductors (groin) is a super common reason the glutes don’t fire correctly, we covered them in the last episode. Here’s a link to a shorter version of how to foam roll those.

Another crazy connection I’ve seen over the years is the opposite shoulder blade being an issue in glute/hamstring recruitment. The body balances itself on diagonals. Think about your footprints in sand, they’re not in a tightrope-like line, they zig zag. In proper gait (how you walk), the upper body should rotate over the forward leg. When working with clients, this element is often off, leading to a kind of waddle instead of a swagger. These folks are often in my studio because of back pain, knee pain and neck tension. All of it can connect to this diagonal element being lost in their walk and instead they pogo stick side-to-side. So, massaging the shoulder blade is critical as well before we get into trying to activate the rear end.

Stretch

The video details a couple approaches to stretching the hamstrings to start—we stretch the muscle as well as the fascial chain. What’s the difference? Stretching the muscle means working the joint in its full range of motion, versus the fascial chain is more like stretching the skin. Someone who taught a training I once attended likened it to if you were wearing jeans or a wetsuit—if there’s greater pull on the fabric, that’s more like a fascial stretch.

The action of the hamstrings is to bend the knee. Therefore, stretching the hamstring muscle would mean actively pulling open the knee like a clamshell. We have 3 hamstrings muscles, so stretching at different angles means we can target each one.

When most of us think about stretching the hamstrings, we think about a pike stretch or putting a leg out and leaning over it. This is our fascial stretch. Something easy like putting your foot up on a chair and leaning over it, while waving your leg side-to-side to pick up those 3 hamstrings will do the trick.

For the glute and the deeper hip rotational muscles, pigeon pose is a straightforward and good bang for your buck in terms of what it hit and the time you’re in the stretch. There’s a few options in this video to add the active stretch element to pigeon as well as some different fascial components.

Activate

We then move into a couple of simple activations you could even do pre-walk or run. To activate the glute max, gently press your foot into a wall. Make sure your thighs are parallel or have the active thigh slightly behind the standing leg. Feel your rear tone up as you press.

The hamstrings bend the knee, so have the same thigh orientation as above and then pull your heel to your bum. Taking the leg and foot at different angles will help to activate the different hamstring muscles. This is all explained in the video and you can fast forward to 20:23 for details. You can do the same exercise lying on your stomach and it will automatically keep your thighs in that parallel position, making it harder to cheat in the motion.

Lastly, we do a simple hip rotation activation of internal rotation and then external. It’s a gentle exercise, yet deceptively difficult. Another option is the clam series, which you can find here.

I always say my primary concern when doing this work is aging well and not necessarily the biceps and bikini-body. That said, I’m all for a butt-tastic body if it motivates you for some post-Covid fun as well as keeping your hips strong. 🍒

Stretches to Relieve Lower Back Pain

Lower back pain can have many different causes. Muscle weakness, poor posture, disc/spinal issues, leg length differential or an old injury can all factor into back pain. That said, this chronic pain can be helped by stretching certain areas and building hip strength.

From a fascial (connective tissue) line perspective, the tension you feel in the lower back could be coming from anywhere along that posterior side of your body. So a tight foot or calf on that side could also be a tight sacrum. Below is a simple foot fascia stretch you could do while watching tv or before a walk/run. If you know you have tight calves, this is my favorite stretch to release the muscles as well as the fascial line.

For a more active approach, anyone with a tight lower back has tight quad muscles (front of thighs). This version integrates a yoga pose with some turbo options for stretching. Your front leg doesn't need to be crossed in front of the opposite thigh, you can just tuck that knee underneath you. You can also place a pillow underneath the glute that is stretching. Just being here may be intense enough. If so, breathe and visualize new space in your hips. You may also feel this more in your butt than in your quad. Try to bend the elongated leg for the thigh stretch. If your hamstring cramps, scroll up and do the calf stretch first. If you can bend the knee, this stretch is a great twofer for the thigh and rear.

Another area that can pull on the lower back is the groin. Most of us never think to stretch here yet it can really compound tension in the lumbar spine. This is a pretty intense stretch, so here is a more gentle stretch.

When you're out of the pain or as a preventative measure, you want to build hip strength. If you've recently had pain, doing this may not feel good, so listen to your body. If you feel a sharp pain, this is not for you right now. You may need more individualized help, so gimme a call! Or, reach out to your trusted chiropractor, massage therapist or physical therapist.

I find that lower back pain perhaps more than any other chronic pain area always has an emotional or stress-holding connection. I already wrote about how lower back pain connects with breath holding here. Some things to explore for the emotional connection would be: When did this pain start? What else was going on in your life around that time? Does the pain tend to get worse during certain times of the day? If it's in the morning, are you happy in your work/relationship? In the evening, are you feeling burdened by your responsibilities? Does it hurt more when you speak to a certain person? Are you holding or internalizing anger, frustration or another emotion with regard to that person?

Noticing your personal patterns can help you start to process some of these underlying aspects that are keeping this pain chronic. I believe this is a big reason why a massage or even a stretching routine doesn't keep the pain from coming back. If some of this resonates for you, visualize these emotions/memories leaving your body via your breath. Let it go!

Core Strength: More Than the Abs

How strong is your core? Did you just suffer a flashback of sit-ups combined with an internal sigh of how you should do more of them? I have great news for you....you don't need to do crunches to strengthen your core! There is an overemphasis in popular culture that a strong core=strong abs, but this is an outdated view.

What is the core?

I see the core as much more than abs--it's all of the muscles that keep us upright. As we're typically seated, hunched over a screen or steering wheel in the 21st century, the back muscles, pelvic floor (including the butt muscles) and diaphragm are aspects of the core we need to focus on. These other areas help support our spine, encourage good posture as well as give us full breath.

A fascial approach to the core.

When I'm assessing what areas need attention in a client's body, I'm always thinking about fascial, or connective tissue, lines. This means that an area where you feel tension could actually be originating from another spot in the body on a particular fascial line. So it's not always about muscle strength or weakness, but rather, what areas of the body are locked short and which areas are locked long. In other words, what areas need more length and which need more tone? If we take this global apporach to posture, most adults are locked short in the front from being hunched over and locked long, fascially, in the back. So why would we do a ton of sit-ups or flexion-based exercises thinking we're strengthening our core?!

Pilates and the core.

I love Pilates, otherwise I wouldn't have been certified to teach it, yet I feel like the method overemphasizes working the core in spinal flexion (the spine is bent over in a "C" shape). Moreover, much of Pilates is done while laying down, which is great for feeling core connections, yet there needs to be a functional application since we don't go about our day lying down. Joseph Pilates created his method several generations ago when our day-to-day lives were very different. I think an updated approach to his program means building back strength first, which passively stretches that front fascial line, making us straighter. Then, we can look at an abdominal or front-body approach to the core once those muscle tissues are not locked short and scrunched.

A unique approach to core strength.

I have my clients do a lot of work that hones in on the diaphragm and pelvic floor as a part of building their core. We also do a lot with the upper back muscles to pull the shoulders out of kyphosis (being rounded forward). I do this with some unique props that force you to balance while working your core and a piece of equipment that incorporates standing movmements so you're learning how your core supports you while upright and walking. This approach is not only more functional, it's more fun!

For the month of January I'm offering a special package for new clients. If you know you need to build core strength but don't know how or want to experience something new, you can learn more here.

Why I Hate Kegels

Pilates squats on the reformer for lower body alignment and pelvic floor strength.

Just about every woman out there has had her doctor prescribe Kegel exercises--hold your urine flow for a few seconds to strengthen your pelvic floor. I see Kegels as a constipation view to strengthening the pelvic floor because they encourage bracing and holding in an area that is often too tight. Plus, Kegels are more often emphasized for women over men when we all need strong and flexible pelvic muscles. More about that here. If we all think pelvic floor health=Kegels, we lose the sense of how these muscles are connected to other movement in everyday life. To me, the pelvic floor is more than just your elimination muscles, it includes all the muscles of your pelvis that support your torso and posture--this includes your rear.

One of my favorite pelvic floor exercises is a squat because it works the pelvic floor in a large range-of-motion. This way, you're getting stretching on the way down and strengthening on the way up. Think of squats as coming from the bones of your pelvis to kick these muscles into gear. 

Don't feel like you need to go all the way down into a full squat if it doesn't feel good in your body. Many folks can't because of knee or hip pain. Try holding onto something, or putting something underneath your heels, and you may find you can get lower to the floor. As you descend, these muscles are stretching and opening like an umbrella. When you stand up, they contract and come closer together like the closing of an umbrella.

If you think about it, we squat every time we sit down. With a bit of mindfulness and maybe some props, you can reconnect with your pelvic floor and use it to sit down and stand up. No more plopping on the couch!

Pilates is a great modality to strengthen the pelvis for everyday movement. This includes strengthening your inner and outer thighs, which are critical for balance.  I love working with clients to rehab their pelvic floors because it's an area of much importance, and for many of us, an area of much trauma. If you've had any abuse in your past, sexual or otherwise, regardless of gender...it may be difficult for you to feel these muscles (read more about this here). This is why I love working one-on-one with clients. In a private session, you're in an environment where it is safe to go here, to connect and to heal, bringing a true sense of self. It brings me to tears when I get to witness this transformation and see my clients discover how much power they have. Love the pelvic floor!!!!

Loosen Your Pelvic Floor, Open Your Root Chakra!

When we hear "pelvic floor" it's usually with regard to women who have had children and how their pelvic floors become weak or distended. Years go by and then there's a new wave of pelvic floor awareness with prostate issues or pelvic organ prolapse. Based on my work with clients, I find tight pelvic floors to be super common due to stress and prolonged hours of sitting which contribute to lower back and hip pain/tightness.

What is the pelvic floor, exactly?

I see it as more than just our elimination muscles. If you were wearing brief underwear as in the photo, your pelvic muscles are in contact with fabric. So, there's three main sections:

• Front-lower abs, the little triangle between your hip sockets and pubic bone
• Undercarriage-elimination muscles and connective tissue
• Back-hip rotational muscles, gluteals

How does the pelvic floor tighten?

Sitting, feeling stressed and holding our breath. I wrote more about this in detail here. If you're prone to sucking in your stomach or have suffered from digestive issues, these muscles would also become chronically tense.

In addition to stress-holding, we can also have some unresolved emotional issues that can cause these muscles to restrict and hold.

What the heck is a 'root chakra'?

You can look at chakras as being areas of the body that emotionally (energetically) represent certain things we all face in life. In the case of the root chakra, it correlates to things that are foundational to our being--safety, security (including financial), family/clan identity and physical health. Issues here can come from not just our personal experience, but from the experiences of our family members. SO, pretty much everyone has crap to work through in this chakra.

Fear is a big factor in holding patterns here including, pelvic floor tightness. If we're constantly bracing for something to happen or afraid that there won't be enough, the muscles of the pelvis respond to that emotional outlook. Origins of that fear can include:

• Abuse, including abandonment or neglect
• Poverty, war
• Major personal illness or in your family
• Not having good personal boundaries so we're constantly at the whim of others' actions
• Inherited trauama and issues from our families

How can you shift these patterns?

Physically, you can practice relaxing these muscles.

In my one-on-one sessions with clients we discover where you're holding physically and emotionally and then intentionally create space there. I construct a series of exercise sequences to reinforce a new pattern in your body that doesn't involve bracing or restriction. With repetition, your body generates a new neurological pattern via flow instead of holding. To reconnect with your root chakra and maintain a relaxed pelvic floor day-to-day, try these tips.

• Breathe and feel the breath connect down to your pelvic floor. I wrote more about that here.
• Do things that honor your body and its health.
• Celebrate what you already have in your life--these things may not be material or tangible.
• Find and connect with a community to feel a sense of belonging.
• Go outside and put your bare feet in the ground. Feel how you are a living being!