If you have incontinence, pelvic pain, constipation, painful sexual intercourse, chronic lower back pain, chronic sacroiliac pain, hip pain, and bad posture, this blog is for you. It is important to look at all that is mentioned here as different chapters of the same book titled: Pelvic Floor Dysfunction.

The problem in treating pelvic floor issues is that you are looked at, not as a whole, but in bits and pieces so the whole picture is missed and you become tired of failed treatments and lost hope, meanwhile so much time and quality of life is wasted in the process.

This blog will put the pieces together for you with the hopes that you understand the importance of looking at the posturenutrition, and emotions associated with the area which are 3 pillars of all musculoskeletal treatments.

Why Breath?

When you are born, the first thing you do is to take a breath, not only because you go from a liquid environment to a gaseous one but also because, with every breath, you reinforce the axial line(midline) of your skeletal system so everything else is built on that foundation.

Let’s think about all babies on the planet! We all go through the same process of developmental stages regardless of the many differences we have and end up with. We do them automatically which means we are wired that way and our ‘software’ dictates such progression.

With each breath, we oxygenate the body which is absolutely crucial in the function of ALL aspects of our existence including the drainage of our master lymphatic ‘septic tank’ called the Thoracic Duct which happens to sit right behind the abdominal diaphragm and the front of the spine. Imagine that!! Every breath oxygenates you and allows your body to detoxify itself at the same time.


Thoracic Duct

thoracic-duct- by http://graphdiagram.com

The Breathing Apparatus

From the functional perspective and the role of breath in the posture and pelvic floor, and to simplify the process, imagine a barrel with a top. The top is the Thoracic or Abdominal diaphragm, the bottom is the pelvic diaphragm, the sides are your Transverse Abdominis and Oblique muscles, the front is your abdominal muscle (Rectus Abdominis) and the back are the muscles of your lower back and the lower portion of the mid-back.

This barrel safeguards you from collapsing forward, twisting, bending wrong, and any movement that leads to a partial collapse. This is how you were meant to be and the reason why babies have a big tummy. They breathe functionally!

Breath, Functional Movement, and Breathing

Going back to the first 2 years of our life, the barrel plays a huge role in building muscles and movements and the reason why all babies (with the exception of genetic diseases) all move the same way and 100% functionally. These are all explained by Dynamic Neuromuscular Stabilization (DNS) which is one of the two core treatment regimens for my patients.

Through the process of baby movements, from tummy time to walking, we develop the neurological pathways to movement, which adds more detail to the blueprint of movement (Homunculus) that we are born with. This is what Postural Neurology is all about which is a part of my examination for all musculoskeletal conditions including pelvic floor dysfunction. This blog is not about postural neurology but I strongly suggest you read about it because where I see most failures in rehabilitation treatments take place is when we don’t trace the problem all the way to the brain which is the control center of all functions AND malfunctions.

How to Fix Pelvic Floor Dysfunction

Regardless of what ‘chapter’ of the book called: “ Pelvic Floor Dysfunction’ you read, you ought to know that first of all, in many cases, the site of the problem is not the source of the problem; for instance, did you know that trigger points or tender points in the muscles of your inner thigh called Adductors can cause Urgency or Urinary Incontinence or an Overactive bladder? Sadly, most of the time, addressing the adductor muscles does not even enter in the treatment of overactive bladder.

Secondly, you cannot address any pelvic floor issues without addressing the joints and muscles that are attached to the floor. Imagine a paper bag with a bottom that has become weak; the moment weakness starts (for whatever reason), the walls attached to this bottom will be compromised and before long, the whole bag becomes weak and easy to fall apart. Reinforcing the bottom of the bag without the sides means the weak sides will be the reason why the whole bag will fall apart.

Now think of your whole body and posture as this whole bag. You can never address strengthening the floor of the pelvis without addressing the sides of the metaphoric barrel we have been talking about. Sometimes we get too wrapped up with the floor that we forget to look at the whole body and the feedback loop of posture and floor.

A great example is constipation! Constipation is almost always looked at as a dietary issue. Does nutrition play a role? Absolutely. Does activity play a role? For sure. How many people think of posture, breath, and pelvic floor integrity as the contributory factor? Hmm, not too many.

The question now is, who should you seek care from that will take into account and look into all the non-generic approaches to treat pelvic floor dysfunction and how to find that person! I suggest you ask around and search online. On my website, I, for instance, explain what makes our office so unique so you will be surprised what you can find with a little bit of research time.

Most often, pelvic floor issues are chronic because it is easy for the therapist to look at the area with a close lens while there are great therapists out there that are masters in treating the patient with internal manual therapy, hardly anyone addresses those comprehensively. My blog on the right and wrong exercises for pelvic floor show how so many therapists recommend exercises that hardly put a dent in stretching the tight, strengthening the weak, and allowing coordination of movement in all muscles of the body which influence the pelvic floor directly or indirectly.

I suggest you visit my Youtube channel to better understand what is going on with the pelvic floor and contact me if you have any questions.

Dr. Shakib