/ April 13, 2023

Your Core, Your Pelvic Floor and Your Mental Health

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After over a decade of working in Functional Core Rehabilitation, it is impossible to not see the connection between the core, the pelvic floor and mental health.  Understanding exactly what that connection is has been a more challenging journey. 

Mental health has become a more openly discussed topic over the past decade and even more so in recent years with the mental health residual effects connected to the COVID-19 pandemic.  At The Tummy Team we have naturally looked at our clients holistically as the emotional and mental components are always impacted by the physical ailments and visa versa, but clients have not always been open to telling us about what they are dealing with in a mental health aspect when they are getting physical therapy for what they perceive as a purely physical issue.  That has begun to change, and the impact has been incredible.

The first time I truly saw the direct connection between core weakness and mental stability was in my clinic almost 10 years ago.  I was working with a new mom who was in the clinic for diastasis recti and postpartum functional core weakness.  The mom brought her newborn with her as many of our clients are encouraged to do. The mom was overwhelmed, anxious, emotional, stressed. The baby was screaming, fussy and distraught.  Mom was trying to sit in the chair and tell me all her symptoms but she could not sit still, she was collapsing, readjusting and constantly reaching down to rock the baby seat.  The more the mother tried to engage with me, the more the baby screamed.  I instinctively asked the mom if I could put an abdominal rehab splint on her and could give her some lumbar support in her chair before we continued.  Immediately upon splinting the mom and adjusting her seat, she visibly calmed down and more remarkably, the baby stopped crying and within minutes had fallen asleep. That experience shifted the way I considered the emotional component of a functionally weak core.  Over the past decade, I have seen this situation repeat itself over a hundred times.  It is not about the splint!  It is about what the splint provides to the mom that she was missing and desperately needed.  

The muscles of our core connect our upper and lower body, support our organs and stabilize our spine, but they offer much more than that.  A strong connection to the core helps you feel grounded, whole and secure within yourself.  Lack of this connection forces our body to grasp for compensation patterns and struggle to feel.  

The muscles of the pelvic floor are structural, respiratory and postural in nature. There is a strong connection between the jaw and the external pelvic floor muscles (when you clench your jaw, you often clench your pelvic floor muscles/sphincters). There is also a strong connection between your respirator diaphragm and your pelvic diaphragm.  So when you hold your breath or use ineffective breathing techniques, you often bulge your pelvic floor or create excessive tension in the pelvic diaphragm.

So how is this all connected to our mental health?

At first I thought the connection was rare or subtle, but the more our clients are encouraged to share about their mental health symptoms, the more we see direct and common correlations between the core, pelvic floor and mental health. 

Consider these simple physical components of some common mental health issues:

Depression: inactivity, disconnect, chronic pain, body fails, discouragement, loss of sense self, identity questions.

Postpartum Depression: instability, disconnect, fatigue, chronic pain, body fails, loss of sense of self, exhaustion, inability to physically care for self and/or infant

Anxiety: disconnect, instability, loss of grounded feeling, fatigue, floating feeling, uncertainty, feeling out of control

Body Image: body dysmorphia (obsessed thoughts of flaws in body), disconnect, loss of self, anxiety, depression, isolation.

Here’s how clients describe what it feels like to live with Functional Core Weakness:

– collapsed posture – even if you want to stand or sit tall, you cannot maintain it

– thin, weak, and deflated abdominal muscles

– back pain (low, mid and even upper back)

weak and disconnected feeling from your core and your body

– feeling like your back or hip could “go out” at any moment (instability)

– sluggish intestinal function

– weak pelvic floor function

When you look for it, it is easy to see the connection.  But it is more than just symptoms and body parts.  Your body helps you live your life and your mental health helps you live it fully.  When we learn to listen to what our body is saying and stop punishing it when it is simply asking for support and help, we start to see the connection even more.

The Tummy Team approach to functional core and functional pelvic floor rehab addresses the entire body. We ask you to do a full inventory of your symptoms (even things you thought were not connected).  We ask you to look at the history of trauma you have endured and also trauma you have buried because it was not the time or space to safely address it.  We ask you to look at the current demands of your life, what is required of you and what is going on outside of your control?  All of this has an impact on your body and how it is trying to help you live your best life. 

As we work on reconnecting to the muscles of your core and retrain our posture, your endurance and your confidence to move pain free and stable, we introduce you back into the life you love.  Sometimes working on the physical component can open a door to the mental health component that has you stuck or overwhelmed.  

Learning to breathe fully and release compensation patterns can release your pelvic floor muscles to do the structural work they were designed to do without additional tension or clenching. Addressing how you sit, stand, walk, work, and play all sets the stage to help your muscles heal and function optimally.  

Pain relief, stabily, confidence, and connection set the stage to get up and get out into the world again.  Feeling grounded and strong impacts your anxiety reactions.  Feeling long, lean and lifted changes your body image issues.  Feeling yourself again helps with postpartum depression and anxiety.  There is much more going on than you think. It is all connected and more importantly it is all treatable. 

You are not alone in this journey.

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