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Pelvic floor dysfunction is more prevalent than ever, prompting an ongoing search for the best pelvic floor exercises. This rise in cases coincides with a shortage of trained therapists, who do not necessarily have to be physical therapists, leading to a decrease in the time available to teach patients how to perform exercises independently.

Why is Pelvic Floor Health Important?

Your pelvis is the foundation of the trunk and because of its important role, its stability is crucial to almost all aspects of your health. That is perhaps the reason why the walls of the pelvis are reinforced by muscles on the inside and the outside.

The muscles inside the pelvis being the wall and the floor of the pelvis end up reacting and changing to provide the needed stability if the muscles of the outside of the pelvis need those changes and modifications. Pelvic floor health does not exist by itself and depends on the health of the surrounding too. That is an important fact to remember since the general treatment of pelvic floor these days seems to be directed to the floor and something that I don’t agree with!

What is the Pelvic Floor?

The pelvic floor is the area between your genital and anus, known as the perineum, and is the receiving end of what happens (or does not happen properly) related to the pelvis and what is connected to it. That means the pelvic floor ends up being impacted by the joints within the pelvis itself, the spine above, and the lower extremities below.

Pelvis bones

(courtesy of https://orthoinfo.aaos.org/)

Treating issues related to the pelvic floor by addressing the muscles of the pelvic floor IMO is the wrong approach in treating pelvic floor dysfunction. That is like treating the muscle spasm as a result of a disc herniation and expecting the herniation to go away because the muscles of the back are massaged or worked out.

Pelvic floor muscles don’t randomly get tight or weak but as a response to their surroundings and therefore proper treatment of the pelvic floor should include a comprehensive approach to include many factors that are outlined in this blog.

Can Pelvic Floor Muscles Be Stretched?

Muscles of the pelvic floor are meant to stretch and strengthen naturally. In nature, with Biological Breathing in, these muscle stretch and relax.

Can Pelvic Floor Muscles Be Strengthened?

In nature, Biological breathing out happens as a result of contraction of the muscles inside the pelvis which practices the muscles to strengthen. The closest ‘man-made’ version is what Kegels are but not the way they are taught! Stopping the urine midstream in an attempt to leach contraction of the muscles of the pelvic floor creates a dyssynergy of the involved muscles and the nerves which are not helpful.

The only way to understand what is going on is to find out what the blueprint of movement reads using the principles of Postural Neurology. The other extreme is how the muscles function in movement which is the functional assessment exam through Developmental Kinesiology protocols.

The first step toward the resolution is enabling Biological Breathing which is addressed below. It is only through these methods of assessment and treatment that we are able to see a drastic improvement in patients’ complaints at our clinic.

What Are the Step-by-Step Pelvic Floor Exercises?

Let’s think here for a moment; if all babies on this planet, you and I included, start as helpless infants and end up becoming running toddlers without any gyms, bands, weights, or training, doesn’t that mean that we are hard-wired to follow those patterns of movement? Strength came as a result of following the right mechanics over and over!

So then when it comes to having issues related to any movement patterns, it only makes sense to go with the factory-designed patterns and implement the correct mechanics and repeat over and over to build strength, right?

That is exactly what we do at our clinic using the principles of Dynamic Neuromuscular Stabilization or DNS and the first exercise is Biological Breathing!

What is Biological Breathing?

The first step is mastering Biological Breathing, as demonstrated in our video. Next, it’s crucial to understand the role of stabilizers (torso and pelvis) and phasic muscles (arms and legs). Often, weak pelvic floor muscles result from stabilizers and extremities switching roles due to habits, lifestyle, and injuries.

What Are Functional Exercises?

Isolating hip, lower back, and pelvis muscles during exercises is often where treatment fails. Pelvic floor muscles don’t work in isolation; their dysfunction affects overall movement. The most effective exercises are functional ones, such as Dynamic Neuromuscular Stabilization (DNS), which integrates biological breathing and focuses on both the abdominal and pelvic diaphragm.

While many procedures for pelvic floor dysfunction can lead to improvement, partial treatments yield partial solutions. My pelvic floor dysfunction protocol includes DNS, Active Release Technique (ART), postural correction, biological breathing, and, sometimes after patients are able to understand and show some functionality in holding a posture, I use Emsella Chair with its 400 Kegel contraction a minute to address the internal pelvis muscle tonicity and contracture so both sides of the pelvis reinforce the walls of the pelvis so stability is long-lived.

Pelvic floor dysfunction is more than the floor but the whole pelvis instability that needs attention. If you have a history of chronic lower back pain, chronic sacroiliac pain, hip mobility issues and pain, postural decline, or any other generally understood presentations of pelvic floor dysfunction, contact me.

Dr. Shakib

Recommended Reading:

How Is the Treatment for Pelvic Floor Dysfunction?

What Is Pelvic Floor Dysfunction?