The Four Pillars of Pelvic and Core Health

The Four Pillars of Pelvic and Core Health

October 14, 2021

In 2021, women are STILL being told that “doing their kegels” will help absolutely every issue with the pelvic floor and core muscles.  In fact, pelvic PTs see patients every single week that come to us so sure that they just need help with doing a better kegel.

Unfortunately, the deep core and pelvic floor muscles are a bit more complex than this.  And the number of issues a person could have with their core and pelvic floor are many.  For example, there are actually many reasons why a person may have issues with bladder leaks.  Not all women leak because their muscles are weak.  It is my job as a pelvic floor specialist to be a great detective to find the cause of an issue and then the best solution.

But the good news?  The deep core and pelvic floor muscles have common basic needs regardless of the person or issue.  Over the years in the specialty, I have found that there are 4 main pillars of pelvic floor and core health that we all need regardless of the issue.  Focusing on these 4 pillars most often leads to resolving pelvic and core issues are maintaining our pelvic and core health.

I would love to share these pillars with you as well as how we help our patients get to their ultimate goal of thriving without pelvic health concerns.

1.   Breath:  Breath is the foundation of core and pelvic floor muscle function. Through healthy and coordinated breath, our core muscle health can be restored and maintained. In the journey to restore core and pelvic floor health, breath will always be a part of the first steps.

2.   Alignment:   Our muscles can only work optimally when our bodies are aligned well. Poor body positioning can put muscles into excessively long or short positions which can make them extra tense or not be able to turn on at all. Factors like pregnancy or having to sit at work, can result in a body that cannot easily find healthy alignment.

3.   Coordination then Strength of the Core and Pelvic Floor Muscles: Our deep core muscles need to first be able to coordinate together as a TEAM before we can focus on getting stronger. This includes when pelvic floor muscles are stuck in a short tense position. We must first help them to regain normal tension/length before it is appropriate to improve strength.  Repetitively tensing pelvic floor muscles alone, will only lead to more leakage, pain, or pressure issues.

4.   Hip Strength: Our hip/glute muscles are the foundation for our back, hip, knee, core, and pelvic health. Poorly activating glutes are an epidemic in chair using societies. Regaining the ability to fully access our glute muscles can help resolve back pain, hip flexor tension, pelvic floor dysfunction, and core strength. Example: pelvic floor muscles can not function well if the glutes cannot stabilize and move the pelvis.

Often, most patients will have challenges with all 4 pillars.  Through a thorough evaluation, we can target the factors leading to a pelvic floor or core issue and most fall under one of these pillars.  Initial exercises will typically be isolated to one pillar at a time such as breath work or reconnecting with glute muscles.  Patients who are close to reaching their goals in therapy will be doing exercises that involve all 4 pillars together.  These exercises should look like cross training and a LOT like how we live our life!

We have found that this framework helps our patients to see where they are in their healing journey better with more clarity in how far they have come and where they are headed.

If you would like a visual summary of these pillars, you can click the link below to download the 4 Pillars of Core/Pelvic Health Guide.
Do you have an issue you would like us to help you with?

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