The pelvic floor is a group of muscles located at the base of the pelvis. The pelvic floor muscles act as a support system for your abdominal and pelvic organs. They also help close off the orifices they surround, including the urethra, vagina, and anus in women, and the urethra and anus in men. Unfortunately, due to poor posture, sedentary lifestyles, hormonal changes, and childbirth many of us experience dysfunction in our pelvic floor over time. The length-tension relationship in the muscle fiber changes, or injuries to the muscle fibers occur, causing all manner of problems related to Pelvic Floor Dysfunction.

It was also found within the study that, asymptomatic women had increased curves in their lower back compared to those suffering with stress urinary incontinence. Proper breathing is incredibly important for healthy pelvic floor function. Our primary breathing muscle is the diaphragm, a dome-shaped muscle which operates like a parachute. It connects to the lower part of the ribcage. The intercostals, little muscles that fit between your ribs, also play a primary role in breathing. The muscles of the pelvic floor (PFM) support the abdominal and pelvic and are active in standing and sitting. Furthermore, because the abdomen is a fluid-filled cavity, intra-abdominal pressure (IAP) is distributed in all directions and the Pelvic Floor Muscles, which form the floor of the abdominal cavity, contribute to its control. As a result of this contribution to control of IAP, the PFM are likely to contribute to control of the spine and pelvis. The slouched posture places prolonged and excessive pressure on our internal organs and pelvic floor which can worsen urinary incontinence, pelvic pain, and symptoms related to prolapse and rectus diastasis. For example, if we collapse our chest while sitting, we end up with a “C-curve” in the spine. This makes it challenging to take a deep breath, and as a consequence, the muscles of the pelvic floor don’t receive the gentle ‘exercise’ they need, stretching and contracting with every breath in and out.

Research has shown that when we sit in a slumped posture, our pelvic floor muscle activity is significantly less than when we are sitting tall. Additionally, slouched sitting postures decrease the activity of your transverse abdominal muscles. Proper breathing pattern encourages the pelvic floor to move more dynamically. Dysfunctional breathing patterns inhibit this dynamic movement of the pelvic floor.

How to Correct Posture in Standing?

· Stand with your feet hip width apart

· Balance your weight evenly

· Lengthen your spine by lifting the crown of your head towards the ceiling

· Tuck your chin slightly so that it is not poked forwards

· Relax your shoulders back and down

· Maintain your normal inward lower back curve

The standing posture shown left is is the correct posture to maintain during your standing pelvic floor exercises.

How to Correct Posture in Sitting?

· Sit on a chair, stool or exercise ball

· If using a chair sit away from the back of the chair

· Position your feet about hip width apart

· Balance your weight evenly between your sit bones

· Lift the crown of your head towards the ceiling

· Tuck your chin slightly so that it is not poked forwards

· Lengthen your spine

· Ensure your lower back has your normal inward curve

An assessment by a registered pelvic health physiotherapist includes a thorough postural examination. Your pelvic health physiotherapist will be able to identify your unique postural compensations and can help guide you on the road to improved body positional awareness.

FOR EVIDENCE:

1. Sapsford, RR. et al (2006) Sitting posture affects pelvic floor muscle activity in parous women: an observation study. Aust L Physiother. 52(3):219-22

2. Reeve, A., Dilley, A., (2009) Effects of posture on the thickness of Transverse Abdominal Muscle and Pelvic Floor Muscle Exercises for Stress Urinary Incontinence: A Randomized controlled Trial. J Phys Ther Sci. 26(8): 1161-1163.