Following my blog about Brianne Grogan’s Ebook, FemFusion Fitness for Intimacy, that highlighted healthy muscle relaxation, there have been some outstanding questions about what to focus on throughout daily activities. If we know we need to strengthen our entire pelvic basket in our workouts, and we know we need to be able to achieve complete relaxation of these muscles when voiding and when lying down at rest, then what should our focus be throughout the remainder of the day?
The Answer is Posture! And posture is positioning! Let’s go back and review optimal postural positioning, highlighted in the Hab-It DVD and many of my blogs.
To obtain optimal posture, you should work to hold equal weight on each foot. You want to have “soft knees,” meaning that your legs are straight but you are able to wiggle your knees a bit (i.e., they are not locked back). Your hips and low back should be held in neutral spine, which means that you are not standing with your buns tucked under nor are you standing in a gymnast’s posture either. Rather, you should hold your spine between these two extremes so that you have a slight lift of your tail bone and a soft lumbar curve. To finish up through your spine, simply open up your hands. This simple action is subtle but it has huge effects, because it rolls your shoulders back and, where your shoulders go, your head will follow.
If your focus is on optimal postural positioning, you put every muscle in your body at the perfect length/tension to fire as needed. Re-read that statement. Appropriate positioning puts just the right amount of tension in your muscles because they will be stretched to just the right length. This allows them to fire efficiently before every reach, every push, and every pull.
What a focus on posture does not do is require a strong active contraction of our pelvic floor or pelvic basket. We simply have to set their position. Two areas of our body that I want to compare in this blog entry on positioning are our external rotators in our shoulders and our pelvic basket of muscles that stabilize our pelvis.
First, let’s talk about our shoulder external rotators. Similar to our pelvic floor muscles, this is another small muscle group that has such a dramatic effect on our body. Our external rotators have a significant impact on the health of our shoulders and neck, just like our pelvic floor muscles have a significant impact on the health of our lower back, hips, and pelvis. In my posture instructions I talk about “simply opening your hands and, where your shoulders go, your head will follow.” Positioning your body with your palms open throughout your day puts your shoulder blades and the muscles attached to them in the perfect position to fire and stabilize our shoulders and neck with every reach, every push, and every pull. Knowing our shoulder blades are the anchor for every muscle action of our arms and head is very important! Conversely, if our hands are closed so that when we look down, we see the back of our hands (vs. our palms or our thumbs) or if our arms crossed in front of our body, our shoulder blades are protracted or rolled around to the outside and positioned higher on our posterior rib cage. From this position, we have lost stability to hold our head in vertical alignment with our spine. Rather, our head will fall forward with gravity. We also have positioned our muscles so that our shoulder internal rotators are chronically held in a shortened, tight position. This makes it more difficult to lift our arms overhead and out to the side, and to take in a deep breath. On the opposite side, our external rotators are over-stretched making them ineffective in their role as stabilizers. This mess, all instigated by poor postural positioning (palms closed) can lead to shoulder pain, upper back pain, neck pain, radiating pain/numbness down your arms, and more.
So now let’s focus on this same effect of postural positioning of our pelvis. Similar to our shoulder blades being the anchor of our upper body, our pelvis is the anchor upon which our spine is stacked and to which all the muscles of our hips are attached. Without establishing the correct position of our pelvis, the curve of our spine can be exaggerated or flattened out. Also, without stability of our pelvis, we would lack the ability to stand on and push off one leg without pain. And there is that other, less obvious function of our pelvic floor that is significantly affected by the tilt of our pelvis – giving support to our pelvic organs: our bowel, bladder, and uterus.
In order to perform all of these stabilizing tasks, our pelvis needs to be held in neutral position, which is marked by a soft lumbar curve of our lower back and a gentle lift of our tail bone. In my posture instruction, I talk about placing your hands on your hips and feeling how you can rock your pelvis forward and back so you can feel the extremes of your available range of motion. When you rock your pelvis, you can see and feel the effect it has on your lower spine. If you rock your hip bones back (resulting in buns tucked under position), your lower spine is flattened out, losing its healthy curve. In this flat back position, your back extensors and multifidi are stretched beyond an effective length, allowing your spine to round out up through your mid back and down to your tail bone. This C curve of your spine leaves your pelvic floor muscles much too short to fire effectively since your tail bone is tucked too close to your pubic bone. Your transversus abdominus muscle as well, is rendered ineffective because it lacks a solid anchor to pull against, having lost the lordotic curve that perfectly interlocks each vertebrae of your lumbar spine. A flattened or rounded back can lead to more than just the obvious low back pain. It leaves you with pelvic basket muscles that are essentially asleep and no longer able to support your pelvic organs as they should, that no longer control urine, gas, or bowel movements consistently, that can cause deep pain as muscle imbalance takes away dependable pelvic stability.
For those of us who don’t have a flattened lumbar curve, our pelvis can also become unstable because of an exaggerated lumbar curve, created by our hip bones being tilted too far forward (with a gymnast’s posture). In this posture, our tail bone is extended so far that our pelvic floor muscles are always pulled to a tight stretch. When these muscles are held in this tight position day after day without relief, we start to see decreased blood flow and an inability to contract because our muscle fibers are stretched far enough that they no longer have a strong connection. We also have a transversus abdominus muscle that is over-stretched across the front of our pelvis, and our multifidi muscles of our lower back that are shortened so much that they no longer fire. Without active muscles, our pelvis completely relies on ligamentous stability that can decrease over time, leading to dysfunction of our pelvis, hips, or low back.
Both scenarios above talk about pelvic positioning that leaves our pelvic floor muscles, our transversus abdominus, and our multifidi muscles ineffective because of either “over-stretching” or “over-shortening. With pelvic basket instability we may experience prolapse, incontinence, hip pain, pelvic pain, low back pain, and more. So how do we help our muscles? By holding our pelvis in a neutral position! This means we find that happy medium between the two extremes of our pelvic motion where we have a gentle lumbar curve that gives a slight lift to our tailbone allowing our multifidi muscles to engage, allowing our transversus abdominus muscle to pull against solid interlocked vertebrae, and allowing our pelvic floor muscles to pull against a solid tail bone to contract when needed and come back to a neutral resting position when not being called upon. Positioning of our pelvis allows our muscles to fire when they need to fire, and when they are “resting” they are held in a position of light tension that leaves them ready to work the instant they are called upon again.
So, what do I want you thinking about throughout your daily activities? Is it pulling your transversus abdominus and pelvic floor muscles “up and in”? NO! Leave that for the set amount of time you work your strengthening and stabilizing exercises. Rather, I want you thinking about positioning. Give your muscles the best opportunity to fire when called upon by positioning your pelvis in a neutral position. Think about where your pelvis is while you are standing in the grocery line, where your pelvis is while typing on the computer, and where your pelvis is when you are folding laundry. Make sure it is in neutral!
The doctor says I have a mod. to large Bladder Prolapse. I train horses for a living, just wondering if i will do more damage to my prolapse if I continue to ride. Just recieved your dvd and its great. I have been doing a few wrong things that I am working on changing. There needs to be more information about this subject, thanks so much
I just want to say how much I enjoy this information. TMulligan, What motivated you to call this blog “Posture Must Be Consistent”, not that the title does not go with the content, I am just wondering. Thank you for the article TMulligan.
Great explanation, Tasha. I agree that if your body is well-aligned you won’t need to consciously contract the muscles of the core (which I refer to as “zipping up”) during normal, non-strenuous activities of daily living. As you said, “If your focus is on optimal postural positioning, you put every muscle in your body at the perfect length/tension to fire as needed.” YES!
I do encourage “zipping up” — i.e. providing an extra “boost” of core muscle activation — during activities that are more strenuous (lifting, bending, pushing, pulling), during focused core strengthening exercises, and/or during activities that require extra balance.
If anyone has any specific questions about my recommendations re: when to “zip up,” etc, after reading my book please feel free to direct them my way. I want to be sure I don’t lead anyone to believe that they should be “zipped up” all day long. 😉
Thanks for all of the wonderful work you do. I just sent another women’s-health-PT-to-be your way.