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Moves to Strengthen the Pelvic Floor

One in three women has some form of pelvic-floor dysfunction—for example, incontinence, pelvic pain or pelvic organ prolapse (Christie & Colosi 2008). The start of pelvic core muscle weakness is commonly associated with pregnancy. Many pregnant women have low-back pain and diastasis recti (splitting of the abdominal muscles at the linea alba), which can lead to the lower abdominal protrusion or “pooch” that so many women develop after childbirth or significant weight loss. The pelvic core muscles may also lose their reflexive capability to “turn on” automatically, and as a result they will be unable to support the entire core from the bottom up. In these cases, a potential solution is three-dimensional core training (Moen et al. 2007).

What Is the Core?

The body’s core is an integrated system that includes many parts. The “roof” is the respiratory diaphragm; the abdominals support the front wall; the back and hip muscles make up the back wall; and the pelvic-floor muscles make up the bottom. Together, these parts can be referred to as the Pelvic Core Neuromuscular System (PCNS).

The fascial system provides a network of functional feedback through the nervous system, linking the musculoskeletal system to the core. This synergistic activity should happen without conscious effort. If it does not, the PCNS must be trained. In this regard, a valuable connection to understand is the fascial connection of the pelvic-floor muscles (levator ani) to an important hip muscle (obturator internus) via the arcuate tendon. The pelvic-floor muscles are also fascially connected to the adductors, which provide a balanced, equal and opposite reaction to the obturator internus. All these interconnections produce chain-reaction activation of the pelvic-floor muscles when hip rotation moves are added to a core-training exercise.

Pelvic-Floor Exercises

The exercises below produce subconscious activation of the PCNS. Introduce the following moves in a class that has a functional or postnatal theme, or simply add them to an existing core-training class. Cue participants to exhale upon exertion. Perform all exercises in sets of 10 repetitions.

Bridging With Hip Rotation

  • Begin supine with knees bent.
  • Lift hips and rotate knees toward each other.
  • Return to start, then lift hips and rotate knees away from each other.
  • Perform with toes turned inward and with toes turned outward.

Squat With Hip Mobility

  • Stand with feet neutral (shoulder width apart, both feet facing forward).
  • Perform a mini squat and roll knees inward, then rotate your hips in clockwise and counterclockwise directions.
  • Perform with toes turned inward and with toes turned outward.
  • Repeat whole series with knees rolled outward.

For another exercise, references and more information on this topic, see the full article in the November-December 2008 issue of IDEA Fitness Journal or online in IDEA’s Health and Fitness Article Library.

To purchase the DVD The Female Chain Reaction—Core Conversion Integration by Christina Christie, PT, and Rich Colosi, DPT, filmed at the 2008 IDEA Fitness Fusion ConferenceÔäó, visit the IDEA Store.

Christina Christie, PT

Christina Christie, PT, is the president of Pelvic Solutions, LLC and inventor of the Pelvicore™. She is a senior physical therapist at the outpatient rehabilitation department of Advocate Lutheran General Hospital in Park Ridge, Illinois. Christina specializes in the evaluation and treatment of womenÔÇÖs health issues, orthopedics and sports-related injuries. She is also a childbirth educator and has lectured extensively on the evaluation and treatment of womenÔÇÖs health for the APTA, IDEA and in other settings.

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