We often talk about maintaining good health. We google different ways and try pursuing them to optimize our health. But do we really understand what good health looks like? Taking measures to stay in a good shape and health often revolves around eating healthy and exercising regularly. In my practice as a pelvic health therapist, I often encounter patients who “look” healthy in every possible way. Everything they eat is mindful and every exercise they do is aimed at getting stronger. But you know what, they are still coming to see a pelvic floor therapist. Does this sound puzzling? Are you also in the same boat?
Well, the truth is, we do everything in our power to make ourselves healthier except thinking about the health of our pelvis. Have you ever eaten healthy or exercised keeping your pelvic health in mind? I can bet, most of you will answer “No”. The pelvis is one of the most vitals structures in the human body. It supports the entire trunk and the head. It supports the pelvic organs. It offers a gateway for urination and defecation. In women, it offers a gateway for childbirth and houses the uterus which then houses the baby. It provides a junction for the hip joint that helps you move. And most importantly, it serves as the location for the pelvic floor muscles that support your bladder, bowel and sexual function. With such an important role to play, the pelvis also remains one of the most neglected regions in the human body.
However, just with 5 everyday habits you can strive to promote the health of your pelvis. Remember: if your pelvis is happy, then you will be happy.
- Diaphragmatic Breathing
This form of breathing is the most effective way to breathe because it helps in optimal engagement of the diaphragm. It helps to engage the core muscles and the rib cage muscles which promote contraction of the diaphragm to create space in the lungs for the air to enter. As the diaphragm contracts and descends to make more space in the lungs, the pelvic floor muscles also lengthen and relaxes. Diaphragmatic breathing also helps in reducing anxiety by inducing full body relaxation and reducing stress hormones.
How to do diaphragmatic breathing?
- Begin with lying down on your back. Place a pillow under the knees to keep them supported and the back relaxed.
- Place one hand on the chest and take deep breaths in, trying to breathe into the front of the belly, into the sides and into your back, letting the diaphragm engage in a 360-degree fashion. Try to feel the air moving into the front, sides and into your back.
- The hand on the chest should stay as stationary as possible, only allowing the diaphragm to contract with each inhalation.
Tips:
- Make sure that your back is feeling relaxed. If 1 pillow doesn’t feel enough, then use more pillows to relax your back.
- Keep your legs, shoulders and neck absolutely relaxed.
- If you have difficulty relaxing, then consider closing your eyes, or dimming the lights, or playing a relaxing music, or thinking about something nice that relaxes you.
2. Avoid “JIC” voiding
“JIC” voiding stands for Just In Case voiding. We all have practiced this kind of voiding at some point in our lives and many of us still practice it and make our children practice it too. Do you use the bathroom to void right before you leave the house or before exercising or before having sex or before traveling in a car even when you don’t feel enough urge? This is called JIC voiding which can be most detrimental for your bladder. When you void frequently often thinking you might not have a chance to void later, your bladder slowly adapts to holding only a limited and reduced amount of urine over time. This eventually leads to urinary urgency and increased frequency as the bladder starts contracting even when it’s just half full. Unknowingly, you reduce the holding capacity of your bladder just with practicing JIC voiding, and your child’s bladder is also being trained on the same path if you have been making him/her practice the same.
Tips: The solution is straight forward. AVOID JIC VOIDING. Nowadays, we mostly get restrooms almost anywhere we travel. For example, you are about to leave for the airport and want to void even when you hardly have any urge. Avoid peeing in the absence of an urge, especially if you have already peed only a while back. You know that you will find a restroom at the airport. Even if you have an urge to pee on the way, just stop at a gas station and use the restroom. Your bladder can hold more urine than you think. Let it do its job!
3. Fully Sit on the Toilet Seat
Raise your hand if you void hovering over the commode in public toilets? I am already imagining more than half of you raising their hand (atleast in their minds). Honestly, even I would have been raising my hand right now, had I not stopped this practice long ago. When you hover over the toilet seat, your pelvic floor muscles do not get a chance to relax. As a result, these muscles stay in a semi-contracted state throughout, while you are voiding. But what should the pelvic floor muscles “actually” do when you are urinating? They should relax and get out of the way to let the bladder empty. Now sit back and think- by hovering over the toilet seat you are not letting the bladder do its job efficiently. This repetitive pattern eventually leads to pelvic floor tightness resulting in symptoms like difficulty emptying the bladder or initiating urine stream, pain during sex or tampon use or pelvic exam. I am sure you don’t want to mess with your bladder.
Tips: Sit on the toilet seat and pee. The hard and cold surface of the toilet seat doesn’t allow infectious microorganisms to thrive. So, chances of catching an infection from the toilet seat in slim. You can always place toilet paper on the surface or carry disposable toilet seat covers with you if you happen to use a public toilet. Remember, your phone and even that kitchen towel you use for several days carry far more infection carrying organisms than the public toilet seat.
4. Relax your abdominal muscles
Many of us go through the day unknowingly clenching our bellies- holding in, tightening, bracing thinking it’s helping, when in fact, it may be making things worse. Here’s the truth: your core wasn’t designed to live in a constant state of tension. Constant abdominal bracing can increase pressure downward on the pelvic floor and keep it in a reactive, tense state. This can lead to increased tightness in the pelvic floor or eventual incontinence or a prolapse.
Tips: Place a hand on your belly, inhale gently, and let your belly soften and breathe. You don’t have to hold it all in. Unclenching your abdomen gives your pelvic floor permission to let go too- and that’s often where the real healing starts.
5. Breathe Out During Exercise, Pushing, Pulling or Lifting
Have you ever found yourself pressing your lips together with air trapped inside your mouth while lifting or pushing something heavy? That’s called as Valsalva Maneuver. Your pelvic floor is not a friend of Valsalva when it comes to exercising, lifting, pulling or pushing things. When you tend to trap air inside your chest and abdomen while lifting or while doing any of the activities I have mentioned above, the trapped air increases the intraabdominal pressure, which in turn increases pressure on the pelvic organs and pelvic floor muscles. Now let’s say, you are already experiencing urinary incontinence or have a pelvic organ prolapse. The increased intraabdominal pressure will exert more pressure downwards on your bladder and/or the prolapse, leading to leakage while exercising, pushing, pulling or lifting activities or eventual worsening of the prolapse. Increased intraabdominal pressure also causes the pelvic floor to tense up leading to eventual tightness of the muscles.
Tips: Thumb Rule: Always, always, and always Exhale when you lift, pull and/or push something heavy. When you are exercising, for example you are performing squats, exhale when you stand back up from a squatted position as you are lifting yourself against gravity. Similarly, if you are practicing push-ups, exhale when you push yourself up. Practicing this technique and avoiding Valsalva will not exert excessive pressure on the pelvic organs and pelvic floor.