12 Mar 2021 Pelvic Floor Health in Hypermobility

Pelvic floor function in hypermobility is a big topic. Leave me a comment below if you have ever had issues with your pelvic floor tissues. It comes up a great deal with my clients. Many hypermobile people experience a hypertonic pelvic floor with often debilitating symptoms. Both women and men. The pelvic floor can often try to act as a trunk stabiliser all the time. This leads to tightness not just in the pelvic floor but with all it’s close relations like the hip, low back and abs. In turn this presents as tightness and pain. Recent research from Australia has shown a tight pelvic floor can lead to SI joint issues, which makes perfect sense due to its intimate connection.

If you follow me on social media, you will know I’m not a fan of ‘core’ training in the ‘traditional’ sense of pulling belly button in and pelvic floor up to exercise. The last thing someone with a hypertonic pelvic floor needs to do is more gripping and sucking in. We are so often diagnosed with pelvic floor weakness. We are instructed we need to strengthen and tighten the pelvic floor muscles. And yet we actually need the opposite so that all the surrounding structures can learn to glide happily together. We need to unwind the pelvis and teach it that it is safe to move. This takes time, as you are dealing with some of the deepest muscles – be patient and gentle.

Here’s my personal story of my pelvic floor issues. After the birth of my second son, things started to change. Let’s just say running and jumping was out of the question. I felt weak, out of control and extremely upset. My GP sent me for women’s health physio. I was given pelvic floor exercises that involved squeezing and holding in the pelvic floor. I did these religiously three times a day for weeks.

At each appointment, I would be strapped up to a machine and pelvic floor strength assessed. Every week I got worse. Every week I got more upset. I was discharged because the physios didn’t know how to help me.

Thankfully I found a pelvic floor expert a three-hour drive away. She diagnosed a hypertonic pelvic floor. No wonder I was getting weaker. The more I squeezed and pulled up my pelvic floor, the more fatigued the muscles became. They couldn’t support me. The muscles gave up.

But at last, I had an answer. Pelvic floor exercises that contract may not be the right strategy. I didn’t know I had EDS then, but I now see this pattern a lot in my EDS clients too. Many people with hypermobility and EDS end up with imbalances and pain caused by a hypertonic pelvic floor.

The strategy to a healthy pelvic floor (and now I can run – see my very proud photo) was 1) unwinding the pelvis, 2) treating all the muscles around the pelvis with mobility and stability and 3) breathwork. Breathing was a game changer. For a hypermobile body, bracing or guarding is a common occurrence in daily life. This inhibits the breath. I call this guarding false stability because either we think it’s helping, or we are not even aware we do it. To be told to brace or guard more before doing an exercise is going to lead to more tension and pain. That’s why I never tell my clients to pull in their abs or ‘activate their core’.

Learning the intimate relationship between the diaphragm and the pelvic floor, learning not to guard or brace my abs or glutes, re-learning correct belly breathing. To belly breathe, we must learn to expand the thoracic spine first.

I have several videos on breathing over on my YouTube channel if you’d like to explore the power of your breath too.