Incontinence. Even reading that word made you want to turn away. It’s an initial warning sign that the strength of your pelvic floor is compromised in some way and no longer has the strength to hold the contents of the pelvis. The initial symptoms are leaking urine and can progress to the point of pelvic organ prolapse.
Pelvic health is the conversation no one wants to have, so, unfortunately, incontinence has become all too common. And millions of people are suffering in silence. And with the number of incontinence products and adult diapers popping up in stores, we’ve normalized the issue. But being incontinent at any phase in your life is anything but normal. And people feel hopeless for a solution.
There are several different types of incontinence. I won’t get into the technical definitions here but will describe how you know if you’re experiencing incontinence. If you find yourself leaking every time you sneeze, cough, or exert yourself in some way then you’re experiencing incontinence. If you find yourself rushing to the bathroom way too often or having anxiety about not being near a bathroom, then you also have incontinence. You might also be experiencing a combination of these symptoms.
Incontinence has become such an issue it’s one of the top reasons women end up in nursing homes later in life. And it’s also a strong risk factor for having future falls. I want to stress again that incontinence at any point during the lifespan is NOT NORMAL. The good news is it’s very treatable and reversible. By changing your environment and your movement you can change the health of your pelvis.
There is a bigger picture going on than just a loss of integrity of the muscles of the pelvic floor. Your pelvis performs many essential functions for your body. It is an attachment point for your legs, attaching your upper body to your lower body, and contains vital organs. It is also an integral part of your core. For these reasons, a pelvic floor problem is not happening in isolation. The other issues may not be apparent initially, but a lack of deep core strength tends to come along with pelvic floor issues.
I’d be remiss if I didn’t address the issues with the blanket advice given to do Kegels daily to avoid incontinence. I want to stress that if you are experiencing incontinence, Kegels may not be the answer or might even be making the issue worse. The pelvic floor has difficulty functioning if the muscles are either overly stretched, or too tight. In the case where they can’t function due to tightness, Kegels will actually make this problem worse. To know if this is you it’s important to be evaluated by a trained professional like a pelvic health physical therapist for guidance.
So now that we’ve addressed the Kegel issue, let’s move on to 5 practical steps to a healthy pelvis.
Wearing flat footwear is an essential first step to optimal pelvic health. The muscles that maintain pelvic integrity were designed to function best when we’re barefoot. By wearing a rigid shoe or shoe with ANY amount of heel lift, you’re causing the rest of your body to adjust to your footwear.
In order for the muscles of the pelvis to do their job, they need to be in the right position. The only way this happens is with footwear that is as close to barefoot as possible. Being barefoot allows your pelvis to maintain a neutral position, whereas wearing a heeled shoe will force your pelvis into a tucked position. Pelvic tucking throughout the day prevents your pelvic floor from doing its job effectively. By taking this step alone you’re allowing the muscles of your pelvis to work for you throughout the day, rather than you having to consciously activate them and *hope* that they’ll work.
Most of the furniture we sit on throughout the day also prevents us from maintaining a neutral pelvic position, or from activating our core throughout the day. If you want to train your pelvic floor and core muscles to work together again start sitting on the floor instead of in chairs as much as possible.
On a similar note, squatting is essential to a healthy pelvis. Even resting in a supported squat helps. Start to notice how many times you bend over to pick up items off the floor and start squatting for them instead. Your core and pelvis will thank you.
Above I mentioned maintaining a neutral pelvis to keep the muscles of your pelvic floor in an optimal position to promote function. Another important component to improving the function of your core and pelvic floor is to keep your ribcage dropped. The function of your abdominal, pelvic, and breathing muscles depends on the relationship between your ribcage and pelvis.
Due to being told for most of our lives to “stand with good posture”, most of us have the habit of ribcage thrusting. This is an excellent example of how focusing on “good” posture can lead to dysfunctional alignment, which doesn’t promote great muscle function over time. Check-in with your ribcage by placing on a hand on your lower ribs on the front of your body. If you feel them pushing forward let them drop down toward your pelvis until you no longer feel them pushing forward. Keep checking in with this position throughout the day and remind yourself to drop your ribs.
Like wearing flat shoes, stretching your calves and hamstrings on a daily basis will allow you to keep a neutral pelvis throughout the day. If the backs of your legs are tight, the muscles will pull your pelvis into a tucked position. So make this an important part of your daily routine.
Walking is one of the best activities you can do to promote a strong pelvic floor, especially walking in flat shoes. Aim for 3 to 5 miles per day, and better yet if that distance is spaced out throughout the day. Walking gives your pelvic floor an opportunity to work and strengthen with each and every step you take, as long as you are able to keep a neutral pelvic position. If you do the above step and stretch BEFORE you walk you’ll get more strengthening out of your walk.
By taking these simple steps you can both reverse incontinence and set yourself up for a healthy pelvis throughout your life! Better yet, these steps are simple and require little to no equipment investment to get started. So there’s no excuse not to get started today. Try it and let me know how it goes!