Another post on the Pelvis. I warned you there would be more!
This picture is of Dr. Sarah Ellis Duvall of Core Exercise Solutions holding a model pelvis. In the top left you can see from the side she is holding the pelvis in a posterior tilt (PPT). Her hand is kind of in the way, but if you look you will see the pubic bone is just a hair ahead of the ASIS (or hip bone, if you prefer).
On the top right we see her holding the pelvis at this same angle, but we can see straight down. Notice how open it is. If we took a golf ball and dropped it into the pelvis it would drop straight through!
The bottom left shows Sarah holding the pelvis in neutral.... well, actually she has it in a slight anterior tilt (APT) so the pubic bone is slightly behind the hip bone. Bottom right we can see the pelvis at this angle from above. Our golf ball could not fall through when the pelvis is in this position.
Do you see where I'm going with this?
When you hold your pelvis in a post tilt where your pubic bone is ahead of the hip bones and your bottom is tucked under your pelvic floor is open and has lost the ability to hold your pelvic organs stable. Like the golf ball your organs can fall through. This is pelvic organ prolapse waiting to happen. This isn't a weak pelvic floor, this is a poorly positioned pelvic floor. It is positionally unable to do its job. Whereas the bottom pelvis has the advantage of support.
Here is test for you. Do you leak urine when you sneeze or cough or laugh? Check your pelvic angle. I see many women tuck their bottoms under when they cough or sneeze. Can you see how that would cause leaks? Try this: UNTUCK your pelvis before a sneeze or cough and see if that helps. Even better: If you have warning see if you can get a really good, deep inhale before the sneeze AND untuck the pelvis. If you have been to a pelvic floor pt and they have taught you the knack do that with an untucked pelvis.
So if you imagine that your pelvis is a bowl of soup you do not want your soup pouring out of the back of your pelvis. You also don't want it pouring out of the front, but that is a story for another day. The take away is try to keep you pubic bone in line with or just a hair behind your hip bones, but don't go overboard.
I want to note that this untucking before sneezing or coughing is a band-aid approach. It doesn't fix anything. BUT:
LEAKING DURING SNEEZING, COUGHING, LAUGHING, JUMPING, RUNNING, OR ANY ACTIVITY IS NOT NORMAL. IT IS COMMON.
In other words do not just live with it! Do mention it to your health professionals! If a health professional tells you it is just normal find another health professional. There is help out there that has nothing to do with surgery. Find a great pelvic floor pt that has lots of extra training in women's health. Then find a trainer that has lots of training in the pelvic floor so you can work the muscle imbalances and breathing patterns that put you in a poor position in the first place. I've known many women with leaking and even prolapse that have been able to safely run, jump, and lift heavy weights with this approach. If you're in the DFW area come see me! I can hook you up with amazing resources and we can get you moving and breathing better so you don't even have to think about leaking or prolapse anymore!
Until next time!