It takes practice to UNDO tensions.  Our tension patterns are so hard-wired.  Healing DR, UI and POP requires integration of the core system: head and neck, ribcage, diaphragm, abdominals, pelvic floor AND re-establishing new connection to our nervous system.
Try this right now:
Sit for a moment and notice your breathing. 
Now start to nod your head up and down as if you are saying yes, or lift your arm up and down. 
Did you hold your breath?   
It is a simple move, and yet more than likely, you held your breath. We should be able to move and breathe at the same time. 
​When we hold our breath we are tensing muscles and increasing pressure into our body wall.  This load to the tissue adds up over time.   Doesn't this make you curious how often you might be holding your breath all day long? One of the keystones to healing the pelvic floor and the abdominal wall is to connect to our breath, allow the abdominals and pelvic floor to move, decrease the tensions in the neck, shoulder girdle, ribcage and lower back.  

There are so many different ways to sit yet most of us spend time sitting in chairs at work, at school, at the movies, etc. And yes, there a lot of different ways to sit in a chair, but mostly when we sit we are leaning back into the chair, allowing our spine and pelvis to collapse. Over time, this constant load onto the flexed spine, the sacrum and supporting ligaments can create muscular and connective tissue adaptations. If we can make some simple changes in our sitting habits, we can change the loads and environment within the tissues to improve blood flow, cellular remodeling to potentially get us out of a back ache or even a pelvic floor issue.

A big part of my time in a session involves education.  Education and information for the client (anatomy, pain science, muscle function, etc.), and reeducation of the client's neuromuscular system. Our body is super smart; it finds a way to move and will continue to do this movement over and over again even though this particular strategy may not be the most effective for the health of the tissue or system.  Part of my job as a therapist is to see the non optimal strategy and teach the client how to reeducate their system for health and longevity.
One of the biggest areas of poor strategies and body confusion is at the core. The core is an area of the body that has a lot of hype.  Fitness pros are making bank teaching people how to strengthen their core to look ripped and lean. Unfortunately a "fit looking" core doesn't mean it is a functional core.

To understand the core, I like to start with the breath.  Little do we know that many of us are 1) holding our abs in all day so that the muscles don't get to fully move and relax or 2) barely breathing.
In an ideal world, when we are at rest whether sitting or in standing, all of our muscles should be at their resting length. Muscles can generate the greatest amount of force at their resting length: not too short, or not too long.

• Holding in abs:  When we are holding are abs in all the time, the muscles are already contracted in the shortened position.  When the body moves and the muscles are required for support, there is not adequate movement (because it is already shortened) to generate the greatest force.  That means that the smooth orchestration of timing, coordination of the muscles have also been glitched.  Misuse of the core happens and compensations result.  Holding in the abdominals also increases pressure in the system: upward toward the diaphragm or downward toward the pelvic floor.  These pressures and tensions can affect digestion/GERD, menstruation, organ prolapse, abdominal wall separation/hernias.
• Barely breathing:  Many people breathe shallow, with minimal diaphragm movement and mostly upper chest and neck movement.  This does not allow for the natural active range of motion that should happen with each breath. On the inhale the diaphragm shortens, pushing downward to make room for the lungs to fill with air.  As the diaphragm shortens, the abdominals and the pelvic floor oppose by lengthening.  Then on the exhale, the abs and pelvic floor shorten and the diaphragm goes back to its resting length.  This movement allows for blood flow, oxygen delivery, optimal muscle function and management of internal pressures.  Shallow breathing can lead to a hyper-ventilatory state which can present as:  increased tension, aches and pains, poor concentration and weird sensations in the body (numb, tingling). 

The first step to strengthening the core is to move all the parts.  The gif above shows the movement of the deeper canister: diaphragm, pelvic floor and abdominals.  The abs and pelvic floor are opposing the diaphragm during inhale and exhale. Can you feel your pelvic floor move during breathing?  Can you feel your abs move?  You might notice that you can only move your chest at first.  See if you can start to bring awareness into: upper abdominals, then belly button, then lower abdominals, then pelvic floor (typically I have people sense the anus- we are used to holding our sphincter muscles to prevent passing gas.  See if you can let the sphincter go on the inhale, then notice if it lifts back up on the exhale). Don't force or try to take big breaths, just direct your focus.  Allow your breathing to be effortless, inhale/exhale are balanced.   Remember your core cannot be strong unless is can access it's full range of motion.  
Know your core: 1) stop holding your core tight all the time (that includes wearing spanx) and 2) learn how to let your core move during breathing. 

The outermost membrane, the dura mater extends from the base of the skull to the sacrum and coccyx.  The dura is attached to the lining of the base of the skull and the upper cervical vertebra. Through the remainder of the vertebral canal, the dura does not attach to the vertebra until the end of the dural sac at the second sacral vertebrae. Extensions of the dura surround the nerve roots and continue into the connective tissue coverings of the spinal nerves.  So this tube that protects the brain, spinal cord and the spinal nerves is pretty important!  In order to have healthy dura and healthy nerves we need proper movement, hydration, nutrition and sleep to keep the connective tissue vital.  A lot of our days are full of stress, spent in static positions that lead to neck or sacral compression (sitting at the computer, driving in the car) or repetitive movements that can stress and dehydrate the tissues.  Try these movements to keep your nervous system healthy.

When our body can't move freely and our tissues are compressed, this will lead to decreased blood flow, decreased nerve conduction and decreased tissue hydration.  Over time this can lead to lymphatic congestion, stiff joints, poor circulation and pain. Tight pants also affect how we are able to sit, bend and squat.  Have you noticed how you sit in yoga pants versus jeans or pants?  

Chronic positioning of the pelvis into a posterior tilt can lead to all sorts of bad things like:

• Changes in pelvic organ position.  A tipped uterus can cause painful menstruation, urinary frequency and urgency.  For more info on this click here. 
• Changes in muscle and connective tissue.  Tissue adapts to how it is used, so habitual chronic positioning sets the stage for potential low back issues, SI pain, decreased hip mobility, tight and weak pelvic floor, hip flexors, hamstrings and calves.
• Meralgia paraesthetica, pain and numbness on the front of the thigh.
  
• Digestive issues: abdominal pain, bloating, heartburn, indigestion.

Please consider how your pants might be affecting your pelvic health.  Even if you wanted to try to sit with a neutral pelvis, your jeans may not allow you to get there.  Sometimes it is the simple changes that get you moving in a healthy direction.

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignforhealth.com.

STEP 1:  Get some stimulus to the lats and the muscles between the shoulder blades.  As the arms have moved forward to type on the keyboard, these muscles are now resting in a lengthened position.  This active shoulder girdle stretch takes the muscles into more of a stretch, just like a sling shot, so they can contract back into resting position.

STEP 2:  Stretch the neck and arm.  Lengthen the tissues in the entire arm and neck by holding onto a door jam and leaning away.  This provides a traction stimulus to the wrist and shoulder, which is a wonderful reprieve after sitting hunched in a ball at the computer.

STEP 3:  Get up out of your chair every 30 minutes.  Walk to the water cooler, stretch your arms to the ceiling, stretch your legs, something simple before sitting down again. 

Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT.  Helpful tips and other self care strategies can be found at www.alignintegrationandmovement.com.

3.  Hip Release and Hip Glides:  this is a video demonstrating how to do the self mobilizations to regain normal motion.