by ashley newton, pt, dpt
The pelvic floor is known to hold onto stress. The body has nerves that go to the pelvic floor that are intimately connected with our sense of fight or flight. This area of our body is responsible for supporting our organs, so it makes sense that when the body and brain are stressed, we tighten these muscles as a method of protection. However, this guarding can become maladaptive when the brain and body get stuck in fight or flight mode. In pelvic PT, we refer to this state as ‘up-regulated’, a state where the nervous system is in an excitatory state and our body is focused on survival. In survival mode, the pelvic floor’s adaptability can become compromised and result in some of the following issues:
- Pelvic pain: the pelvic floor muscles contract and guard in response to pain but sometimes they get stuck in guarding mode. When the muscles undergo stretch such as with sexual activity, the experience can be painful!
- Changes in voiding: if the pelvic floor gets stuck in ‘on’ mode, it can have trouble relaxing when it is time to void. With both urination and defecation, the pelvic floor needs to relax and lengthen in order to completely void. If the muscles are having trouble lengthening because they are gripping/contracting, voids may feel incomplete or difficult to pass.
- Leakage: if the pelvic floor muscles are gripping, guarding, and staying in fight or flight mode, they can have trouble doing their job of closing around the urethra and rectum to maintain continence.
- Weakness: if the pelvic floor is constantly tightening, it becomes weak. Thus, we are not able to recruit these muscles as readily to do their job of stabilizing the pelvis when we move. As a result, other tissues may become overloaded trying to do the job of the pelvic floor.
Ways to Get Out of Fight or Flight!
To get the body and brain unstuck and move into a more relaxed, down-regulated state, try the following exercises:
- Legs up the Wall: Place a pillow under the pelvis and bring the legs to a wall so they are supported. Allow the legs to relax and practice diaphragmatic breathing.
- Child’s pose: Begin on hands and knees and sit the pelvis back to the heels with the knees apart. Begin breathing into the back and direct the breath down to the SIT bones, sensing that they move apart as you inhale and draw back toward your midline as you exhale
- Mindful Walking: Get out in nature and practice relaxing the arms and unclenching the jaw as you walk.