Intra-abdominal pressure and the pelvic floor

_{Photo by Max van den Oetelaar on Unsplash} 

by: Emily Davies

Learning to feel & play with intra-abdominal pressure is immensely beneficial to anyone experiencing sexual pain, pelvic tension, pelvic organ prolapse, and other pelvic floor issues like hypertonic pelvic floor.

Working intelligently with intra-abdominal pressure allows you to discover the sneaky places where tension settles, and make a direct impact on the release of that tension and any associated emotions.

Once you learn to feel the movement of breath alongside of this pressurized system, you can build a strong neurophysiological connection to your pelvic floor, and a strong central energetic & physical core.

Another benefit that comes from this new physical awareness using IAP is a deeper understanding of how the core works, and how to effectively employ the yoga bandhas during asana and pranayama. (More on this in another blog!)

For those reasons and more, learning to feel intra-abdominal pressure is a helpful tool for mastering core & pelvic floor wellness.

Let's dig in...

IAP is pretty cool to work with.

To start to feel this synergy of breath and pressure, I love to remind my students to breathe like a singer.

Singers have this way of opening up their central channel from the pelvic floor to the dome of the skull.

Singers know how to use their diaphragm to breathe.

Inhale = increase of IAP

Exhale = undoing

Your Entire Torso is for Breathing

Think of the torso as the container. This container is made up of muscle and bone. Inside of the this container are your vital organs.

Ideally, the soft tissues of this container - front, sides, back - are pliable and elastic enough to expand and contract with the changes in pressure of the breath.

The bottom of this container is your pelvic floor.

Inhale = increase in pressure, expand inside spaces

Exhale = undoing

In this way, IAP is like a gentle massage to the organs of the entire trunk, abdomen & pelvis included, & the nervous system as it weaves in and out of the spaces in the trunk... yummy.

It keeps oxygen flowing to the soft tissues, keeps the neural pathways tone, and flushes hydrating fluids in to the connective tissues. All of this movement encourages healthy cellular processes.

This won't happen with your everyday, walking-through-the-grocery-store kind of breath. These are intentional breaths, like we use in the yoga practice.

I always think of the old adage, "Move it or lose it!" If we don't breathe like this sometimes, how do we keep things flowing in the deep inner spaces of the body?

Challenges on this pressurized container that is your torso

We need the soft tissues to be strong enough to hold the joints in place, and responsive enough that they "fire" in moments when they are truly needed.

When we sneeze or cough, lift heavy things, laugh - things that dramatically, and sometimes spontaneously increase the LOAD of pressure on the trunk… the pelvic floor & the rest of the muscles of the container of your trunk need to be both tone & elastic enough to hold it all together. They need to work WITH the unexpected pressure changes …

Consider that the pelvic floor is at the bottom of this pressure system.

If we don't learn to use this pressure system to benefit our health, it can sometimes work against us causing an excess of downward pressure that pushes on the organs.

What goes wrong?

Our postural habits can result in soft tissues that become stiff and eventually locked into place and numb (known as sensory motor amnesia). Here are a few common examples of tense tissues causing a displacement of pressure:

Low back tension - If you're holding an excess of tension in the lower back (like me!) when you breathe in, the breath is dumped into the softness of the belly, or lives only in the chest.  Without a postural correction, the low back doesn’t get a stretch or benefit from the movement of the breath and can become locked in hyperlordosis. . 

• Correction - find a neutral pelvis, align the ribs over the pelvis, and hold the chain of muscles from the pubic bone to the sternum (consciously tense them) to bring the stretch & breath into the low back 

Pelvic floor tension - If the pelvic floor muscles are locked tight and therefore not elastic, they are likely not strong either, and they may also be relatively numb. A sudden increase of pressure can force the urine out, poo out, queefs, or worse, the organs (i.e. organ prolapse).

• Correction - Practice stretching and breathing to release the tension and awaken sensory perception of the pelvic floor. Then, intelligently tone the muscles so they can respond to changes in pressure. Bladder training may also help.

Pelvic floor laxity - If the muscles of the pelvic floor are not strong, for example, after having a baby or if you've lost a lot of weight in the belly, they are also often numb or have very low sensation. Sometimes the sphincters of the pelvic floor cannot hold strong enough against the increase of pressure and you may experience a loss of urine, poo, or queefs... or worse - pelvic organ prolapse.

• Correction - Practice stretching and breathing to release the tension and awaken sensory perception of the pelvic floor. Then, intelligently tone the muscles so they can respond to changes in pressure. Bladder training may also help. 

Low belly tension - If the muscles of the deep belly are locked tight - maybe you suck them in because you think you need to look skinny, or you've been practicing too much moola bandha & uddiyana bandha for the yogis... (there is a chance that the pelvic floor is tense, too). The breathe & IAP aren't creative any movement in the belly or pelvic organs at all… So, they aren’t getting that tender massage :( …  

In this case, where does the pressure go? It depends. But, likely you are only breathing in the upper cavity of the chest and not getting that full movement of the respiratory diaphragm. BOO = you might have anxiety or panic attacks, back tension, IBS...

• Correction: Practice deep belly breathing. Practice it daily. Observe how your body responds to stress (i.e. feel the belly tense when you get stressed), so you can also feel it relax and let go.

We could work with the upper torso, too, in a similar way.

Working with intra-abdominal pressure is a fun way to explore your body

You can discover where the tension is hiding.

You can discover where you are not getting motion with the breath (upper neck & shoulders anyone?).

You can learn how to open your entire trunk, creating a strong neurophysiological connection to your pelvic floor, and build a strong central energetic & physical core.

For those reasons, learning to feel intra-abdominal pressure is a helpful tool for mastering core & pelvic floor wellness.