Since I joined Evolution Physical Therapy three years ago, I started thinking a lot more about the pelvis, and I haven’t stopped! From performing pelvic floor rehabilitation, helping clients improve core strength, and providing visceral manipulation to the bladder and uterus, working with this region of the body is a significant part of my PT practice. Due to lack a general lack of awareness of the pelvis and (by close association) the hips, our focus on this area takes on extra significance.

Perhaps it is our puritanical New England roots that leave us dissociated from this part of the body. This trend may go even deeper into history, as the name for the nerve that innervates the pelvis- the pudendal nerve- has roots in the latin word pudendum meaning “parts to be ashamed of.”

It is delicate work to normalize discussion of dysfunction in this area (bowel, bladder, sexual function) while also leaving the shame behind. In one of my first pelvic floor continuing education classes, I was encouraged to say the word “vagina” over and over again in front of a mirror until I could do it without blushing. Just the fact that this exercise could be thought of as beneficial says a lot about our society.
A lack of connection to the pelvis can originate in many scenarios, ranging from history of trauma (physical and/or emotional), history of chronic pain, problems with self image, or simply living life not moving in this particular area. As a society we spend a lot of time sitting – in cars, at desks, at home on the couch – and this can limit mobility in the hips and pelvis. Our pelvic floor muscles (which are present INSIDE the pelvis) are an area where one can hold chronic stress (similar to tension in the upper neck) and yet these muscles are unseen and therefore often unnoticed. Changes in our breathing pattern can affect the pelvic floor, as this area also has to move with the inhale and the exhale.

There is a lot of research to show that once a brain/body connection is lost it is not necessarily spontaneously reestablished. This is another version of “if you don’t use it, you lose it!” Perhaps it’s time to check in with your pelvis and re-establish that relationship.

Begin by noticing your sitting posture: Are you sitting in a cross legged position, with your pelvis rounded and increased stress on the tailbone? This position creates tension in the pelvic floor. No matter where you are right now, bring your awareness to the area between the navel and hips. Notice your breathing pattern. Does your breath travel down that far, or does it stop in the abdomen? With the next few inhales try to breathe into the area between the legs (also called the perineum). Are you able to feel that area swell with the inhale? If this is difficult, try sitting in a comfortable chair or exercise ball, with light pressure placed on the perineal area. This can give you some gentle feedback so that you can develop additional awareness.
As you do this exercise, notice what thoughts arise.  Notice if there is any negativity in your mind towards this area of your body.  Can you relax the pelvic floor, hips and back?   Can you allow your mind to soften and accept yourself, and your pelvis, just as you are? This is practicing ahimsa towards yourself.  Be patient.  It takes time to allow the tension and holding to release and awareness to be restored.  Your pelvis is the foundation of your spine and hips and needs to be in balance for good spinal health.  Notice the effects of this exercise and start to incorporate this into your day to improve awareness and relieve tension.
​- ​Michelle Downing DPT, E-RYT

Interested in learning how to increase awareness and mobility in your pelvis and hips? Join Michelle for a 2-hour yoga wall workshop on Friday, March 23 to develop your understanding of the anatomy of these areas, and learn how yoga can help to support pelvic movement without strain.

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