Pelvic Floor Rehab-Energetic Connections

An aspect of my approach to bodywork is looking at emotional stressors or energetics and how that contributes to someone’s pain patterns. I always say, there are a lot of crooked people out there, but not all of them are in pain.

The root chakra and sacral chakra come into play with the pelvic floor. The root chakra can close off with anything that involves fear. I think all of us can agree that we’ve felt some amount of this over 2020-21. Any history of abuse or trauma, at any point in life, can contribute to issues in the root. Fear usually involves the breath to tighten, and as we’ve discussed, the breath mirrors into the pelvic floor. If the root gets closed off, it shuts off connection to the feet. I often feel that a lot of knee/foot issues are not just about the pelvic floor in terms of mechanics, but also this holding from current or past fear patterns.

The root is also all about stability. So any type of lack-of-safety feelings would play into dysfunction here as well. This could be financial, physical or emotional.

The sacral chakra obviously involves sexuality, but also creativity and sensuality. If you don’t feel safe, how can you feel like you have the energy or bandwidth the be creative or truly yourself?

You can bring more opening and awareness to these areas by visualizing the sphincters of the pelvic floor opening up like a valve and that water is coming down the legs. If color is your thing, the corresponding colors are red for the root and orange for the sacral.

Take this for a walk and you can visualize those colors going down one leg, back up and over to the other leg like a light up yo-yo. Check in with your body and see as you put those colors in your mind’s eye, are they vibrant? If they start off more dusky or dark, let the old stuff drop out of your feet and into the ground. Then as the light comes back up the leg, can it be a bit brighter? If you continue to do this, the colors will become clearer and you’ll feel better—promise.

This is my favorite book on energetic systems. The author connections modern psychology with the chakra system. It’s a great balance of ‘woo woo’ and philosophy.

Pelvic Floor Rehab-Release Pelvic Floor Muscles & How to Activate the Pelvic Floor

We’re finally into the meat! In this video we go over how to release SUPER common problem spots for pelvic pain and lower back pain—the pesky pectineus, iliacus and obterators.

You can use just your hands to get some relaxation in these areas and they do *wonders* for relieving pain all over the body, including the neck and shoulders.

To release the pectineus, you’ll want to pin the pocket of the groin, and then you can use the weight of your leg to act as a stretch. In massage it’s called a ‘pin and stretch’. I go over the details in this video—promise you’ll feel like your leg not only gets longer, but more relaxed afterward.

The iliacus lines the ilia of the pelvis and can be a major core compensation muscle. This muscle can be tight if you also have digestive issues or hold tension in your ‘guts’. Releasing this before attempting core work may help you get more abdominal engagement.

Lastly, we go into the obterators, which are super deep at the base of the pelvis. These get tight from sitting as well as from breath-holding. Many of us also ‘pinch pennies’ down there when we’re stressed, which makes this area chronically tight. Think about the pelvis like a butterfly with its wings spread. Pinching the bottom of the wings together pulls the upper wings apart. Thus, releasing that tether on the bottom wings, relaxes the upper portions. Doing this can be a huge help in lower back pain.

I would not suggest using something like a Theragun on this area—you aren’t trying to pummel your pelvic muscles. This massager has some helpful attachments that help to hook onto bones and it has a vibrational/percussive element instead of just percussive. Also, if you gently try to push those upper edges of the butterfly wings (the ilia) together and that feels relaxing to your body, you may want to invest in a pelvic floor belt. There’s a lot of variety here and you want to find the right thickness for you as if you buy one that has too much depth, it will ride up as you bend over. Here’s the one I’ve heard the best feedback on from clients. You can find my favorite book on the pelvic floor with helpful exercises here.

Again, massaging these spots will help you relax all over and will make it easier to breathe. Please comment or reach out if you have any questions and thanks for watching!

Pelvic Floor Rehab-Jaw and Diaphragm

In this episode we hop over the pelvic floor and work superior to the pelvic floor—the head, jaw and diaphragm.

The body is a series of diaphragms, or suspension bridges. The brain rests in a diaphragm and the jaw is a diaphragm. We then have the breath diaphragm, then the pelvic floor and even the archway of the feet are diaphragms. All of these archways coordinate with one another in movement, so when there’s tension in one, it will reflect and reverberate to another one.

Since this course focuses on the pelvic floor, we get into releasing the head and breath diaphragms before going more deeply into the pelvic floor in the next episode. There’s a yummy head and jaw massage in this video. Then we combine that with releasing the diaphragm using a ball or towel combined with optional breath holds.

As the format of the course goes, we release then re-engage. In this case, this means being more aware of how our pelvic diaphragm and breath diaphragms work in conjunction in respiration. For a shorter version of that, you can watch here. Breathing correctly helps with a whole host of issues, as we know. When we inhale, the diaphragm flattens, pushing our organs into the pelvic bowl. In order for this to happen fully, our pelvic muscles have to be sufficiently relaxed. Then, on exhalation, the pelvic floor ascends and pushes our organs back up into the chest cavity like an elevator. The breath and these diaphragms are massaging our guts, as it were, aiding in digestion. Personally, I find this difficult to fully feel when I’m sitting (even as I type this on my couch) in a lounge-fashion. So try standing up, or properly situated as I explain in this video.

Warm wishes your way and thanks for watching (or just reading)!

Pelvic Floor Rehab-Abductors & Adductors

As we travel up from the feet and ankles towards the pelvic floor, we hit the adductors and abductors (inner & outer thighs). These are the balance muscles of your legs, the I’m-falling-and-I-can’t-get-up muscles. The inner thighs run contiguous to the pelvic floor and core muscles. AND pretty much everyone is weak in these groups.

Massage

Par for the course of this Pelvic Floor Rehab series, we release, then re-engage. You have a few options for that here. The most cost effective is to purchase a foam roller. I always advocate buying a 36” roller as they are more versatile for things like core work in addition to release work. You have the standard density option (which can be pretty intense for certain areas of the body) or a less dense, softer version. Amazon has everyone beat that I ever see in terms of price, a link to purchase here. And here’s a link to a previous video on how to use a foam roller on the inner thighs as well as a trigger point release for the pubic bone.

You can also use a theragun or other self-massager. Two of my favorite options are here for a more affordable version and here for a more versatile version, particularly for when we get into the pelvic floor releases in a couple episodes. There are attachments to the latter massager that make it easier to access smaller muscles and yield a more pinpointed release.

Lastly, I love cupping the outer thighs/IT band. It’s an easy thing to do as you watch TV and is not rocket science. Here’s a link to the cupping set I’ve used for years. Alternatively, you can foam roll your IT band, link on tips for that here.

So, massage/roll/cup the inner and outer thighs. We also do some work on the Quadratus Lumborum (QL) in this video. This muscle causes a lot of issues for a lot of people and is often tightened up on just one side, lending someone to be crooked. I find that it becomes that way, in part, because of weakness in the muscles targeted in this video.

Stretch

You can easily stretch your IT band/abductors by putting a towel around your foot and pulling your leg across your body. Alternatively, you can put one foot on a surface like a chair or couch and then twist your body over that extended leg. Try to drop the targeted butt cheek towards the floor as you stretch.

For the inner thighs/groin, here is a shortened version of my favorite stretch that is also in this video.

To stretch the QL, stand inside of a doorway, bring your inside leg forward and grab onto the doorframe—you’re bending over the direction of whichever leg is forward. So, right foot in front, you’re bending to the right to grab onto the doorframe. You can gradually add a twist of your chest towards the doorframe and you may feel this stretch go all the way down your back.

Activate

My preferred way to activate the abductors is a simple side leg lift, a la Jane Fonda. I find that this isolates them better than doing a side squat walk with a band around the thighs. In a squat walk, I feel like people load more into the quads. Here’s a link to a shorter version of what I’m talking about.

For the inner thighs, you can adduct the legs (bring them together) with them up on a wall or in the air. Here’s a version in the air, which works the core more. If your hamstrings are super tight, the wall might be better. You can also start with a more gentle version like this with the knees bent.

The QL is the ‘hip hiker’ muscle. If you stand on an elevated surface like a curb or even a yoga block, you would pull the hip up directly to your ear on that respective side. You’ll know which side is your weaker if that motion feels completely foreign to your brain.

Having good stability in these muscles is a critical piece to balance and therefore aging well. This means aging well for all genders. Some of my male clients talk about these machines in the gym and refer to them as the ‘chick machines’. Balance is for everyone, so don’t forget to target these just as much as squats and lunges in your workouts—stability in these muscles will make things like lunges easier. And, these are the struts to the pelvic bowl, so inner outer thigh strength is pelvic floor strength. Channel your inner Jane Fonda, y’all.

FREE Pelvic Floor Rehab Course

What is the pelvic floor?

I define the pelvic floor as more than just the elimination muscles—I see it as anything that touches brief underwear lines. If you think about it, those are in contact with a chair for hours a day (for the average person), so they atrophy over time. Then as we age we’re dumbfounded as to why it can be challenging to do day-to-day tasks like squatting down, lifting things off of the floor, getting up off of the floor or even balancing.

I don’t see stand up desks as a cure all for this. I’ve worked on many people with pelvic floor issues who use standing desks. Chances are you were sitting for years professionally or in school before you started using one. So, those imbalances can already be there.

Why is pelvic health important?

These are your falling-and-I-can’t-get-up muscles! They’re critical for aging well and having solid balance and stability. And, they’re often small muscles, so just because you work out, doesn’t necessarily mean that they’re one and strong.

It’s also critical to have good strength here for proper elimination long-term and to head off pelvic organ prolapse and prostate issues.

The pelvic floor also plays a critical role with the breath. Belly breathing is great for relaxation and yogic techniques, but the bandas have to relax and expand for true health in the pelvis. So, I find that a LOT of people need to work on expanding the pelvic floor, yes even moms, because their pelvic floors are tight from improper breathing. For this reason, pelvic floor health and strength isn’t just a postpartum or post-hysterectomy issue, it’s for men and women.

Structure and format of this course

This is not a course on Kegels! I find Kegels to be a constipation view of pelvic floor health and not encouraging dynamic strength that we need there to do things like lifting and balancing.

We’ll start distal (away) from the pelvis and work our way in. We’ll look at common, faulty neuromuscular pathways I’ve seen over the last decade and try to correct those patterns. The modules will have a release then stretch then re-engage format and then I’ll also include some basic as well as intermediate exercise sequences. At that point, you’re free to go about your way in a regular exercise class, hopefully with these areas more engaged.

Why I’m passionate about this content

You can find out more about this in my bio. Long story short, I had an intense and painful bout of piriformis syndrome for about a year and a half after my dad unexpectedly passed away. Thing is, it never got diagnosed as such. I was super active and 28 at the time. MRI came back negative for disc issues and every doctor kept wanting to label it as sciatica, which it wasn’t. After thousands spent on physical therapy/massage/chiropractic/acupuncture, I started studying anatomy and biomechanics and figured out it was the piriformis. I looked up ‘piriformis problems’ and the web said it was common for people who ran a lot and who sat at a desk for a living. That was me to a T!

Thing is, the pain didn’t get better with just the biomechanics. The holistic folks kept saying it was my internalized grief. I was crying all the time, so I didn’t see anything internalized about it. That said, the more I dug into the deeper feelings about how my dad died, the pain started to change. This is why I bring this approach into my work with clients. If something has stuck around for months or years, there’s a good chance you’re holding some deeper stress and emotions around it. I’ll bring in some of the things I’ve researched over the years re:emotions and the pelvis into this course as well.

Another reason why pelvic health is so important to me…my grandmother has had chronic UTIs for 25 years. At this point, she’s pretty much immune to all antibiotics. I can’t help but think if she started doing things like this in her 50s and 60s she wouldn’t have suffered so much and have this risk in her 80s.

Internal pelvic floor physical therapists in Austin

This course is not meant to be a substitute for proper, internal physical therapy. In Texas, you typically need a doctor referral. Here are some of my favorite folks in Austin.

Erin Arnold

Relate Center

Swapnali Chaudhary