Pelvic Floor

PT Corner with Friends

To Kegel or Not to Kegel

By Guest Author

Sep 1, 2022

By Dr. Ashley Newton, PT, DPT

 

Intra-abdominal pressure is the pressure within the abdominal cavity created by the interaction between the abdominal wall and organs. This pressure changes with breathing and the resistance from the abdominal wall. When you are lifting an object or even lifting a limb, you increase intra-abdominal pressure. 

 

The coordination of the diaphragm, abdominals, and pelvic floor musculature works to support the pelvic contents during changes in intra-abdominal pressure. However, if the synergy between these muscles is compromised, they are unable to optimally support the abdominal organs. This results in excessive pressure placed on the back, pelvic organs, and pelvic floor. Problematic issues that could arise include urinary incontinence, pelvic organ prolapse, back pain, and diastasis recti. 

 

So how do you know if your body is handling pressure well? How do you avoid putting undue pressure on your abdominal organs and pelvic floor? 

 

It all begins with breathing. Our abdominal cavity is capped at the top by the thoracic diaphragm and capped at the bottom by the pelvic floor musculature. This creates what is referred to as the “core canister.” When we breathe, the pelvic floor and thoracic diaphragm move down and up together like a piston. If this movement is restricted by fascial tightness, weakened, and/or moves in the opposite direction, the pelvic floor and thoracic diaphragm are compromised in their ability to support the abdominal contents. 

 

Here’s a breathing exercise that can help you check in on your coordination:

 

  1. Begin in a seated position. Align your skull, scapula, and sacrum.
  2. Make sure you are sitting evenly on your SIT bones.
  3. Bring your tongue to the back of your top teeth and imagine you are pressing a small raspberry against the top of your mouth.
  4. Place your hands on the sides of your ribs.
  5. Inhale through your nose and think about widening the ribs into your hands. Imagine an umbrella opening, expanding your chest gently.
  6. Exhale slowly through your mouth and imagine “fogging glass” as you exhale.
  7. Keep your belly soft as you exhale. Squeezing the belly can create excess pressure on the pelvic floor and abdominal organs.
  8. Repeat the exercise 5 times.

 

Breathing works your core muscles and it is the foundation of managing your intra-abdominal pressure. Whenever lifting objects, you do not hold your breath! This creates increased pressure on the abdominal contents, pelvic floor, and heart, which can be dangerous. Always keep breathing while you are lifting in order to prevent an unhealthy increase in pressure on your musculature and organs. 

 

Good lifting mechanics and upright posture help optimize the functioning of your core canister. These techniques can also enhance your ability to manage changes in pressure in your body. With a strong core and healthy breathing habits, your body is able to stabilize your spine and better protect you from injuries.

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