Pelvic floor and postural gymnastics

A big thanks to Rebecca, professor of postural gymnastics, pilates and rehabilitation gymnastics for the live dedicated specifically to the pelvic floor. Here you will find the transcript of the video content, available @ Facebook group «Endometriosis: united despite covid19».

Hello everyone, my name is Rebecca, I deal with postural gymnastics, pilates and rehabilitation gymnastics.

I made this video to try to explain some useful exercises to loosen the pelvic floor and all attached and connected muscles.

I take this opportunity to thank who involved me in this project for the month of raising awareness of this problem that is often underestimated.

In this gymnastics video, you will see a small extract of what could be done to achieve some improvements. I also take this opportunity to remind you of the importance of doing physical activity in general, enjoying the benefits at the muscular, skeletal and even mental level, improving and strengthening the immune system.

When we work out, our bodies secrete substances that, by joining the immune system, strengthen it; in fact it is very important to do physical activity, regardless of individual pain, discomfort and any pathology.

One of my students (who is a gynecologist) introduced me to the pelvic floor for the first time; of course, I remind you that I deal with gymnastics teaching and that I do not want to replace any professional medical figure. I always try to be prepared in my field through continuous study and updating in order to give the best.

Years ago, this student asked me if I was interested in learning and then taught me pelvic floor rehabilitation techniques.

At that time I was very young to understand its importance. I was more focused on the world of fitness.

Years ago, this gynecologist student asked me if I was interested in learning and then taught me pelvic floor rehabilitation techniques.

Talking to her, I understood the importance of all the muscles of the pelvic floor. I started studying by also combining my qualifications to teach corrective gymnastics and she put me in touch with people who needed to do it.

These people gave me encouragement and determination to dedicate myself to this new topic (unknown to me), especially when they began to feel better; someone got lost and ceased to be constant (unfortunately many taboos on the subject still persist). It is for this reason that initiatives like these are very important to overcome them.

I will briefly explain what I tried to do in this class. It is a miniclass of about 20 minutes.

When we have pain (in any part of the body), we tend to take analgesic positions that make us stay “closed”: if a shoulder hurts, we will tend to keep it stretched forward to avoid moving it and feeling pain.

This will create an additional problem: one or more unused joints will become stiffer and hurt more in response to movement. Not to mention those that involve, for example, the pelvis (focus of this video) which contains very important organs. If we do not move the pelvis and lumbar spine correctly, we will not move the femurs well because we will notice pain: the longer we keep them “still”, the more the muscles will be tense.

Rigid muscles adaptively shorten and lose elasticity. The moment we try to move them, the pain we will feel will increase because it will be a pain of both the internal organs and the muscles that we are trying to move, that we are trying to stretch and shorten, but that, being adaptively shortened, have become less elastic and hurt when we try to stretch them. Then, in the case of a hip joint, the head of the femur rubs into the acetabulum, causing pain and inflammatory states that create wear. In the lesson that I prepared, I tried to give elasticity and mobility to the hip joint and lumbar spine with few exercises.

Some muscles are attached from the lumbar vertebrae to the femur and pass into the pelvis, so they are adjacent to the internal organs. So the stiffer they are, the more they can cause discomfort to the organs inside our pelvis. Trying to stretch these muscles gives us a little relief: it is important to try to relax them, creating a more favorable, less contracted, less closed, less oppressive environment since the inflammatory state that could occur is a problem of various pathologies such as endometriosis.

Therefore, hip mobility exercises, lumbar tract mobility exercises, pelvic anteretroversion exercises and our pelvic floor awareness are very important.

Consistency is essential because already after 2 weeks of interruption, the training curve begins to decrease and you run the risk of having to start again.

The elasticity of the pelvic muscles is very important and should never be overlooked. We can choose a 10-15 minute mini routine to repeat every day: it is important to find the time to do it in order to improve.

Often, the solution is sought abroad, with medications or supplements, which can undoubtedly be useful, but which do not serve to elastify a joint in a correct and functional way: to achieve this, you need to exercise. Occasionally, I am asked about the electrostimulator which tones the muscles and reaffirms them (perhaps it gives them an aesthetic effect), but on a functional level, it does not help to move the joints.

It is important to shake off a little laziness to try to work out more.

Let’s start to answer your questions now:

what is the most suitable posture for those who work seated 8 hours a day?

The sitting posture is incorrect since it tends to flex the back and leads us to take incorrect positions.

The pelvis is more than fundamental to our skeleton: it supports the spinal column and everything above it; therefore, I cannot think of eliminating a pain, a tension in the cervical tract, if I have a misaligned pelvis that leads me to assume incorrect positions.

The legs support the pelvis, the pelvis supports everything that lies upon, so it often causes pain as it takes on a lot of work, both static and dynamic, and many times we don’t have enough trained legs to support it all.

Sitting for 8 hours leads to an excessively relaxed position, the pelvis feels “entitled” to work less because we are seated.

Thus the muscles of the pelvic floor tend to loosen. These, which support the pelvis from below, lose their strength. The pelvis assumes incorrect positions because it is not strong enough and the spine sags. When this happens, the head “moves” forward and this affects everything else. It is necessary to strengthen the muscles of the pelvic floor and the muscles of the abdominal belt that surround the lower back, toning them up and assuinge more correct postures, trying to maintain the physiological curves.

You will find on my social networks a lesson to do only when seated, which can be very useful for this purpose. These exercises will help us to assume a more correct position, to relocate the shoulders in their position and to relax/tone the muscles of the pelvis while we are working.

It is important to find a more correct position by doing specific exercises constantly.

The muscles of the pelvic floor must remain elastic, they must be tonic, they must function properly, in order to place the pelvis in its physiological position, as well as the spine, which has natural curves: a dorsal kyphosis and two lordosis at the lumbar and cervical level.

When one of the curves loses its correct position, the others must adapt. The muscles of the pelvis train more effectively while standing, even in the simple act of standing, thanks to the leg muscles, internal and external, which are active and also activate those of the pelvic floor, by connecting with those of the pelvis.

somebody recommended me to do pilates and then advised against it. What is the correct indication?

Pilates is one of the possible postural and corrective gymnastics. Many teachers use standard pilates techniques (those of its birth and development by its inventor” who mainly referred to people doing stand-up jobs (exercises that would facilitate bending). Since we work “curved”, pilates (with the help of other postural corrective gymnastics) should propose an extension training to regain the upright position, so why is pilates recommended?

It is the best known form of postural and corrective gymnastics and it is available to everyone. Even orthopedists often offer it without knowing it enough. A prudent teacher should analyze the story of the student before proposing a certain type of training: his/her profession, if he/she has undergone musculoskeletal operations, a cesarean section (for women) or an operation on the abdomen (for men) as this leads to scars that interrupt the muscle tissue that must then be re-welded (with a specific work). The teacher must know a good amount of correct exercises for the student to do based on all this information.

For example, many pilates exercises will be fine, others will not. If we don’t take into account pathologies such as endometriosis (that cause shortening, tension, discomfort in the muscles that pass inside the pelvis and connect to the femur, to the lumbar tract that passes adjacent to the internal organs), the student could make exercises that worsen the condition. This is not because the exercises are wrong, but because they are not suitable.

I understand that it is difficult to find the right trainer; it is important to get advice from competent people and eventually try it.

Certainly, many exercises of the pilates method are not indicated in this case because they are performed in flexion and bring the femur closer to the pelvis (as when we are seated). If performed lying on the floor, with the muscles connecting the femur to the pelvis functioning, they must be shortened to maintain the right angle of the femur in the pelvis. Shortening, they increase the internal tension of the pelvis, so they are not suitable for those who suffer from this pathology.

You have to find the right teacher who can offer you the correct exercises. Doing postural and corrective gymnastics is like wearing a dress made by a seamstress: I can buy one from Armani, beautiful and very expensive, but it will never look as good as the one tailored for me by the seamstress; in the same way you need to find a good coach capable of doing the same.

in case of cystitis and acute pain, can I work out or should I stop doing it?

This is very subjective. Certainly, it is better to limit physical activity, not because it increases pain, especially if it is adequate. You have to think of an athlete who is preparing for a great competition and who cannot stop because of the pain of period, cystitis or endometriosis (even if she is in pain, she will have to continue her training). When a student tells me they are in pain and asks if they can train or not, I simply ask if they feel they can do it in the first place. At that time, the teacher will indicate what exercises should be avoided, which could worsen the pain in that part of the body, etc. Certainly, if you want to train, even with pain, it is important not to take pain relievers, because when we do not notice the pain, we could exert ourselves and do exercises that will worsen the pain right after. So, a softer workout (always followed, moderate and calibrated on the pain we have) is fine.

It is important not to give up, not to stop as much as possible, as well as with diet.

– in case of adhesions and inflammation in the muscles such as the psoas (which connects the lumbar vertebrae with the femur, passing inside the pelvis and which is one of the most difficult to stretch, since it requires even a little uncomfortable positions), how can we improve?

Psoas, due to its position, can create problems with the internal organs, especially if they are shortened. Adhesions: I have previously spoken about scars which are relevant not only at the level of the skin but also of the muscles, since the moment they are sewn, no matter how well they can be sewn, they certainly lose elasticity.

Therefore, each adhesion should be managed as when we are told to apply a cream to the skin, try to soften it, massage it, etc. In the same way, it should be done with the muscles, stretching, etc., to prevent them from further shortening.

So how does the psoas stretch? The movements you will find in the lesson I have prepared are useful. There are no specific stretching exercises for psoas in that lesson because they are a bit complicated because of the position to take to perform them. However, it is important that you stretch it.

The person who asked this question surely works in a sitting position, probably in a position of greater shortening of the psoas throughout the day. I would advise to find a center where they also perform gymnastics for the pelvic floor to relax the muscles with specific exercises which can be done not only in the gym but also at home, in brief sessions.

In this way, we will fight pain more effectively and we will not allow the muscle to contract too much, having to fight more and more to stretch it and move the joint; the shortened muscles lead to a close-up of the joint heads, of any joint. These, as soon as they try to move, rub against each other and create inflammatory states and then wear out over time.

So if I already have pain in the internal organs, I have shortened muscles that compress them, I crush the joints, I don’t get out of this anymore! and I have to live with these pains whenever it is possible to avoid it.

why osteopathy is a good approach in case of adhesions?

In my small center in the city of La Spezia, Italy, I have an osteopath available once a week, a physiotherapist present every day and a biologist nutritionist for food suggestions in case of structural overload on the skeletal muscle system (and here the focus returns to our poor pelvis and pelvic floor).

When students or applicants arrive with more complex problems, I always suggest a preliminary visit with the osteopath; in some cases, they follow a session before the training begins.

The osteopath will do a passive work on the person that allows an active work. The osteopath is essential in case of adhesions. He/she helps with his/her manual skills to do what we could do with a cream on a possible skin scar; he/she has the means, with expert hands, to relieve the tension in the scar that was formed in the muscles as we cannot do so independently and even the coach cannot.

it is difficult, it turns everything into a vicious circle with more medicines and painkillers…

This topic interests me a lot. I certainly do not want to start a conflict with those who sell medicines because when necessary, I also use them nor with those who sell food supplements which are sometimes essential, especially in case of deficiencies. We still can’t solve everything on our own by only taking random products.

Unfortunately, pain relievers, when it comes to the health of our skeletal muscle, should be avoided as much as possible because they no longer allow pain. If we feel pain somewhere in our body, we have to listen to it, because it means that something is wrong.

The moment we take a pain reliever, we cover our ears, we are not listening to our body. We can do it at a particular moment when we have a real need to face an important commitment, but then we have to investigate the origin of that pain as soon as possible: why is there pain in that point? How can we solve it? Who can help us (doctor, osteopath, physiotherapist, coach, etc.)?

When we are in pain, our lives are affected, the focus is there and negatively affects the rest of the day. Therefore, taking pain relievers eliminate the pain, but the problem persists; we need to find a solution with the help of appropriate professional figures to ensure to fix this pain little by little, not with pain relievers, however not always.

There may be a period when they are needed then we must learn to understand what we can do to feel good without always delegating to others. The others can be professional figures who help us without replacing us. Another very important thing is to read medicines package insert: there are indications and contraindications to know.

Returning to the issue of articulations, they are called that because they must be articulated: if we block them, we keep them still, we harm them and even worst if the joint contains important organs.

For example, the thorax: if we are always closed, we close the ribs in the lungs and the heart; without moving, the muscles will lose elasticity. To maintain ideal lung capacity, we must keep the spine mobile and healthy, for example, the spine and the shoulder girdlewhich also helps those who work long hours at the desk.

The same works for the internal organs of the pelvis. If we have pain in the abdomen, we close and compress. So the muscles shorten, we continue to feel pain, it extends to the lumbar spine, it returns to the back, we assume an incorrect posture at work, we take painkillers, the pain is still there but we don’t notice it… in short, a negative spiral that thanks to work out can certainly be resolved.

Find yourself an appropriate center, a teacher who listen to you and ask you some questions: sometimes we can seem intruders (it should always be done with the proper education of course, still all these details are necessary to help us to understand what is best for you and what to avoid when talking about exercises and training).

Don’t stop: movement is at the origin of life!

Find a suitable gymnastics, someone competent to help you on this path so that you can use as few pain relievers as possible.

Yes to food supplements when necessary, yes to healthy eating, no to a sedentary lifestyle. Furthermore, in a period like this in which we are forced to remain at home, we must find a way to move in some way.

I thank you very much for your attention. I hope I have motivated you to work out.

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