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The pelvic floor and the core

The pelvic floor muscles work as part of the ‘core' to regulate the internal pressure in the abdominal cylinder along with the abdominal, back and breathing muscles.

During exercise the internal pressures in the abdomen are constantly changing. For example, as you lift a weight the internal pressure increases, and as you put a weight down the pressure normalises.

In most people this pressure regulation happens automatically, however if any of the muscles in the core, including the pelvic floor, are weakened or damaged, then this automatic action may be altered.

In the ideal situation the muscles of the core work together in a co-ordinated way: as load is placed on the spine, the pelvic floor muscles lift, the abdominal and back muscles draw in to support the spine and it is easy to breathe (diagram 1). Alternatively, if when a client lifts a weight they hold their breath or draw the abdomen in without engaging the pelvic floor muscles, they may place excessive pressure down on the pelvic floor (diagram 2). If repeated stress or strain is placed on the bladder and bowel (and uterus in women) this may result in a weakening of the ligaments and leakage or pelvic organ prolapse may occur.

 

Correct and incorrect pelvic floor muscle action 
 Diagram 1. Correct action                    Diagram 2. Incorrect action

Stabilising the core

The act of drawing the belly button to backbone has been advocated to turn on the core and stabilise the spine. New research is showing however, that some people tighten their back muscles, draw in the abdomen, hold their breath and place pressure down on the pelvic floor in an attempt to stabilise the spine. It has become more common for clients to try and brace their core muscles constantly during a whole exercise session in the belief they are toning the abdomen and supporting the spine. 

To work well, the core muscles need to be flexible and contract and relax. Constant bracing can lead to stiffness. Leakage may occur because the pelvic floor muscles are weak, but can also occur because people have been bracing the core too much and have made the muscles stiff.