Often, when people think of core muscles, the “six-pack” ab muscles are ones that get recognized in the limelight. From the perspective of pelvic and spinal health, it is important to acknowledge a group of muscles that lie behind these superficial muscles and are difficult to see. They are the pelvic floor muscles that lie in the pelvis, deep abdominal/back muscles, and in the diaphragm that lie at the bottom of ribcage. This “inner core” system must be strong and active when we do many everyday activities such as sitting, standing, lifting and getting up from a chair or the floor. You can easily modify your everyday postural habits in order to avoid injury to the pelvic floor, abdominals and spine.
For most of the day, we are upright, and the inner core muscles help hold us up against gravity. It is important to view core strength in relation to helping us do everyday activities throughout our lives, as opposed to short-term gains.
To minimize risk for injuries to the pelvic floor, abdominals, back and spine, the inner core muscles must be trained to be “core-dinated” as a team rather than working against each other. In everyday activities like getting out of bed or sitting, many people have habits that create a less efficient and coordinated system throughout their bodies. This can predispose them to problems related to the inner core muscles.
- For example, if you get out of bed using a sit-up motion, there is strain put on the belly and pelvic floor muscles. In this case, we are not training and building the endurance of our deep core muscles to hold us upright against gravity. The proper way to get out of bed is to use a motion similar to a log roll.
- The same strain is placed on these areas of the body when someone holds their breath when lifting heavy objects like dumbbells, a baby, or groceries. It is important to exhale as you lift perform its job better. Research shows that the diaphragm not only helps us to breathe but to also hold our spine upright in place. Train your exhalation to occur at the same time that you rise against gravity and over time, the inner core muscles will be activated to help you bear the load of the object being lifted.
Certain exercises, especially when done incorrectly, can cause damage to your pelvic floor. It is important to be cautious of not overtraining the outer abdominal/back muscles without training the inner core muscles first. It is also important to seek pelvic health therapy if you experience these symptoms when exercising:
- Urinary incontinence during weight training, jumping or running. This is a sign that the pelvic floor is either not strong enough or may be too tight, leading to leakage.
- Holding your breath during weight-training.
- Bulging or pressure in the vaginal area, which may indicate prolapse. It is important to avoid high impact activities like jumping jacks, crunches, sit-ups in order to decrease more downward pressure onto the area while building up the inner core system.
You should be especially cautious if you have had a hysterectomy, abdominal or back surgeries, or if you have had recurring ankle, knee, hip or back injuries.
Pelvic Health Physical Therapists can collaborate with your fitness trainers to ensure that that your workout routine will continue to keep your body well–functioning throughout more decades of your life and minimizing the risk for injuries down the further down the road.
For pelvic floor rehab services within the Cone Health System:
To locate a pelvic health physical therapist nation-wide:
Shin-Yiing Yeung is a pelvic health physical therapist at Cone Health’s Alamance Regional Medical Center. She received a Bachelor of Science in biology and botany from the North Carolina State University in 2004 and a Doctor of Physical Therapy from Elon University in 2013. She has completed multiple specialized pelvic health courses from Herman & Wallace Pelvic Rehabilitation Institute and currently serves as an assistant teacher for two of their courses.