Pelvic Health and Alignment

The muscles of the pelvic floor are pretty amazing. They have many different roles including bladder and bowel control, supporting the pelvic organs, sexual function and core stability. During pregnancy and childbirth, these muscles take on the additional task of supporting the weight of your baby and then allowing the baby to pass through for delivery. These diagrams depict the pelvic floor muscles as they are normally and then during childbirth.  Pelvic Floor Muscles at rest Pelvic Floor Muscles when the baby is crowning Remember that this is what your body and these muscles are made to do. However, perineal tearing (tearing of the skin and muscles between the vagina and the anus) is unfortunately quite common and can occur when the muscles are not able to yield appropriately. This can lead to bladder and bowel incontinence and numerous other conditions related to pelvic floor dysfunction. For the muscles to undergo this amount of stretch and decrea...

Erin, Leah and myself working hard at the clinic This week I went to a yoga class for the first time in a long while. It was awesome! And very challenging.  In Grade 9 or 10 at school, I was getting disheartened by being one of the slower swimmers in my training squad. I told my Dad I didn't want to go anymore because I was the slowest and he said 'Well how are you going to get any better if you don't go'. I figured this made pretty good sense, so I kept at it, set some PBs, and his words have stuck with me ever since.  So for those who say they 'just aren't flexible' and 'never have been', how are you going to get any more flexible if you never do anything about it. Yoga isn't about being better than any one else in the class. It is simply a guided practice that you do for yourself. Pelvic floor dysfunction is often related to the lack of pelvic movement in our daily repertoire of positions (sitting in chairs, standing, walking a...

(The primary cause of my tailbone pain) Coccydynia is the fancy term for a sore tailbone. It can be caused by several different things but is often prolonged by pelvic floor muscle dysfunction. What is it? Coccydynia is essentially pain in the tailbone ( Coccyx = Tailbone, Dynia = Pain ) This can present as an achy/dull pain or sometimes more intense/sharp pain particularly with movement (eg. rising from sitting) or sitting for a long time. What causes it? Tailbone pain or coccydynia can be caused by a direct injury to the tailbone, however, t his does not necessarily mean that there is a fracture or dislocation of the bone or joint. Some related causes can include: Direct impact or a fall directly onto the tailbone, eg. while snowboarding or from a height Damage to the tailbone during childbirth (vaginal delivery)  Strain of the pelvic floor muscles from pregnancy Prolonged sitting with your weight on your sacrum and tailbone eg. flights/long car rides  (see...

I love travelling and feel very fortunate to have the opportunity to do so. However, one of the downsides about moving to the other side of the world is that you do spend a lot of time in transit just to get home for a visit. Over the last month and a bit, I have done a ridiculous amount of flying (for educational courses, home visits and fun), spending about 45hrs in the air (between Calgary, Vancouver, Seattle, Los Angeles, Brisbane, Sydney, Dallas and Austin) and a whole bunch more time in and around airports, taxis, buses and trains. All of this added up to a very sore tail bone and tight pelvic floor muscles and a lot of time to think about how travelling can affect your pelvic health.  Here are some of my travel-related observations to keep in mind that you can also apply to your everyday life! Sitting The most obvious downside to travelling is the looong amounts of time spent sitting and particularly the way that you sit. I have a tendency to curl up in my sea...

Today's post is slightly different to most of the others. I've never written a book review before (outside of primary school), however I just had to share this particular one with you. Recently I was lucky enough to get my own copy of... Alignment Matters by Katy Bowman! My first impression was: Oh my gosh this woman is smart! If you've never heard of her, Katy Bowman is a biomechanist from the USA and teaches thousands of people easy ways to look after their body and keep it functioning the way that it should. I love this book from a Physio perspective as there is a huge focus on prevention of injury and maintaing (or gaining) whole body wellness. The information throughout the book is very well researched but also easy to read for people with lots or little health education. The book is a collection of the first five years of her blog, organised into relevant categories and body parts with each gem of knowledge presented in short chapters. Great if you don...

See Pelvic Organ Prolapse: Part 1 for information on what a prolapse is and some of the causing factors.  What can be done about it? !!Prevention!!:  As the support of the muscles underneath the pelvic organs decreases, the strain on the ligaments holding them increases and they eventually stretch beyond the point of no return. Ensuring good body alignment and m aintaining pelvic health and function of the muscles is key at any stage of life, but essential  during your pregnancy and leading up to delivery. Restoring optimal function of the core abdominal muscles and learning how to properly relax the pelvic floor muscles for bowel movements can help to decrease the overall pushing and strain required. Preparing your body for pregnancy to increase the space in the pelvic outlet (obstetrical conjugate) and yield of the pelvic floor muscles can help to decrease the amount of force required to get the baby out ( read less Valsava-ing ), as well as prevent perineal tea...

The risk of Pelvic Organ Prolapse can increase with pregnancy and vaginal delivery, however may occur even without any pregnancies and can even happen to men! What is it?  'Prolapse' comes from the latin word prolabi which means "to fall out". Pelvic Organ Prolapse (POP) involves the descent of the pelvic organs; the bladder, bowel or uterus, into the vaginal space.  The degree of prolapse is measured on a scale of 0-4, determined by how much the organs have moved toward the opening of the vagina or if they are protruding outside the body. This may be observed by your family doctor, OB/GYN, birth professional or pelvic health physiotherapist by asking you to cough or hold your breath and bear down for 8 seconds to determine the extent of the prolapse.  The female pelvic anatomy (larger pelvic outlet and open space of the vagina) combined with our upright posture makes women particularly vulnerable to this condition. However, men can also experience similar ...

Vaginismus can be another cause of pain with intercourse and can sometimes prevent any kind of penetrative sex. What is it? Vaginismus is the involuntary reflexive contraction of the pelvic floor muscles (in particular those around the vaginal opening) in response to attempted penetration, whether it be from a tampon, speculum or penis. You may or may not experience any pain with this. The muscular response can vary from a slight contraction but still allow for penetration (albeit usually uncomfortable or painful) or completely close the vagina to not allow any penetration at all. For the partner, it can feel like 'running into a brick wall' when the muscles are so firmly contracted. Vaginismus may or may not be experienced in combination with Vestibulodynia . What causes it? There is not always a obvious cause of vaginismus. In a lot of cases it is a learned response of the muscles due to a painful experience with penetration or after an event such as childbirth...

The female body is pretty amazing to be able to carry a baby for nine months, deliver a child through a usually very narrow space and then return back to its previous state. This is what the muscles and tissues are specifically designed to do. Having said that, pregnancy and childbirth is often one of the most physically challenging events we can ask of our bodies. It is no wonder then, that the pelvic floor muscles require some specific training and preparation leading up to delivery, as well as rehabilitation post-natally to return to their optimal function.  The following diagrams show the muscles of the pelvic floor and also gives you an idea of how much these muscles need to stretch to allow for a baby's head to pass through.  Female Pelvic Floor Muscles   Pelvic Floor Muscles when baby's head is crowning during a vaginal delivery I see a lot of women pre and post-natal for pelvic floor problems and prevention. Here are some areas that Pelvic Hea...

When you think of pelvic floor issues, pregnancy and having babies usually comes to mind. Good news, it is possible to optimise your post-natal pelvic health before and while you are pregnant to prevent future problems! The last thing I want to do is to frighten anyone about the negative things that can happen with pregnancy and giving birth. I think pregnancy is a beautiful experience and I am personally excited about that one day when I might be lucky enough to have my own children. However, I do feel very strongly about the importance of knowing about these conditions in advance for prevention purposes! Please take the time to educate yourself and get to know your body in order to optimise your delivery and post-natal function.  Carrying a baby inside your tummy and (practically on top of) your pelvic floor for 9 months can put these muscles under significant stress, regardless of the type of delivery that you have. This alone can cause weakness and spasm of the musc...

This diagram depicts the numerous muscles of the pelvic floor. I drew it myself. A lot of pelvic health problems arise because, just like any other muscle in the body, they can become weak or tight and even have painful trigger points and areas of spasm.  This view is of a person lying on their back and looking from the feet up. All of the coloured parts are different muscles and they all work very closely together. As you can see, the muscles around the anus are a lot bigger than the ones at the front which is one reason that urinary incontinence is so common.  These muscles attach to all sides of the pelvis, therefore contributing to the stability of the joints, SIJ included. If a person has increased laxity in any of the pelvic joints, this can cause the muscles to work overtime and subsequently become tight/spasmed, creating more pain. They also attach to the coccyx and can cause tailbone pain (coccydynia) if the muscles are very tight and constantly pulling on the joi...

I can't take credit for drawing this one but I did label it! This shows the bony features of the female pelvis and where the pelvis floor muscles are located. 

Get to know your own body!  I drew you a picture! This diagram shows the external anatomy of the female genitalia.  The  mons pubis  or pubic mound provides cushioning over the pubic bone during intercourse The  Clitoral glans  is the only external part of the clitoris. Most of this organ is underneath the surface and much larger than you realise. It is also the only organ in the female or male body that is purely dedicated to sexual pleasure. Yay for us! The  Urethral opening  is the opening for urine to empty from the bladder The  Labia Majora  are the external (outer) lips of the vulva The  Labia Minora  are the inner and smaller flaps and look very different for every woman The  Vestibule  is the area within the inner lips of the labia minora but outside of the vagina The  Introitus  is the opening of the vagina The  Vagina  cannot be seen from the outside, this refers to...

The main point when it comes to vulvar skin care applies to the rest of your body and your life too: Chemical free is best ! ( For more ways on how to make your life chemical free, check out this awesome blog by the gals at  BaoBag ! ) Clothing and Laundry Wear all-white cotton underwear Remove wet bathing suits and exercise clothing as soon as possible Avoid scented or harsh laundry detergents and using fabric softener on undergarments Hygeine Use soft, white, unscented toilet paper Avoid getting shampoo on the vulvar area Do not use bubble bath, feminine hygeine products, perfumed creams or soaps Wash vulva with cool to lukewarm water only Do not douche or flush the vagina with water or any other liquids (generally makes things worse rather than better) Use only unscented menstrual products and 100% cotton if possible. Another alternative is a menstrual cup (eg. Diva cup) which also helps to reduce waste and save the environment. Prevent constipation and stra...