This blog is designed to convince you of the importance of focusing on a “one step at a time” approach to regaining control of your pelvic floor. The muscles that make up your pelvic basket are often unknown muscles. Quite simply, many of you know you have biceps and quadriceps, but have you heard of your obturator or your puborectalis, or even your gluteus medius (which is a different muscle than your gluteus maximus!)? Rehabilitating the pelvic floor begins first with discovering many of these smaller muscles and then training yourself to contract or engage these muscles through slow, subtle, controlled movements. The minute these movements become too big or too fast, our bodies automatically recruit our bigger muscles that like to take over. The problem is that these bigger muscles offer movement but not stability. This type of strengthening has its place but not in pelvic floor rehab.
Let me give you an example to clarify this point. Your multifidi are small muscles that lie deep under your back extensors and attach to individual segments of your spine. The Prone Multifidi Extension exercise that I coach you through in the 1st workout on the Hab It: DVD, requires very subtle movements designed to recruit and isolate these small multifidi muscles. This small rotation of your pelvis achieves segmental extension of your lumbar spine and, more importantly, your sacrum. The minute these extensions become too big, creating movement beyond your pelvis, you automatically recruit your big back extensors and glutes which like to take over. This allows a good percentage of your multifidi muscles to take a break, which results in us losing our muscle isolation and our segmental extension goal.
It is with this in mind that we need to slow down, isolate, control our deepest stabilizers, and get these pelvic basket muscles firing efficiently. Remember, I have talked in depth about the “root of our core,” the deepest three stabilizers of our body in previous blogs. http://hab-it.com/blog/?p=257 It is important that we regain control of these stabilizers before working bigger movements that will allow us to return to our normal recreational activities. So I caution any of you rushing through your pelvic floor/pelvic basket strengthening. You will continue to have symptoms UNLESS you learn to recruit your deep stabilizers first. This is why it is important to allow your body 4-6 weeks of training with the Hab It DVD, which will help you find and engage all the muscles of your pelvic basket, before rushing back to running, hiking or any other recreational activity.
Once you have developed good control of your pelvic basket, your work is not yet over. It is now your job to maintain this strength and stability for years to come. Just think, this means you will have better posture when you are 80 years old, you will prevent future back or hip problems, and you will prevent a re-occurrence of your pelvic floor dysfunction. Take note that continuing pelvic floor exercises for life doesn’t mean that you have to lie in front of the DVD for 20 minutes 3x/week, but that you are conscious of working pelvic floor exercises into your daily routine. This could be in the shower, before you get out of bed, or whenever it works for you. If you fail to remain consistent with exercise and posture, your pelvic floor symptoms will remind you just like a good coach!