The Pelvic Floor & Stress During Coronavirus

Times are challenging. Between figuring out school days for kids, worrying about how your birth plan has changed, and managing a drastically different work environment, our ability to adjust is being tested. Now it is more important than ever to restore and replenish our bodies to allow the best chance at surviving with grace. 

Our bodies have specific physiological reactions to stress to help us cope with the next twist of fate. One of the first places to react are our pelvic floors. Similar to your abdominals, the pelvic floor muscles are an important part of your core that is always working to support your sphincters and keep you from leaking. They also lift your pelvic organs, help keep you upright, and assist with sexual pleasure. 

Additionally, the pelvic floor is connected to our sympathetic nervous system, which lets us flight-freeze when we experience danger or stress. Sound like every day this week? The pelvic floor is integral in our response to stressful situations. To illustrate this response, researchers observed women’s pelvic floor muscles while exposed to a threatening stimulus: watching scary films. In response to a scary stressor, pelvic floors increase in activity and tighten up. 

COVID-19 is one long scary stimulus. Your pelvic floor may be holding too tight because of the emotional difficulty of the current situation. Tight or “overactive” pelvic floor muscles can cause pain with sex, abdominal discomfort, trouble fully urinating or defecating, increased urinary urgency, and digestive system slowdowns. I propose we save this survival mechanism for the split second we need it, and let go of what we can’t control. To return your body, brain, and pelvic floor to a relaxed state, here are a few options: 

1. Deep breathing: Inhale through your nose and focus on letting your ribs expand outward as your belly fills up. Then let the air woosh out of your mouth. Try five breaths in a row. If you can’t feel your ribs move outward, put your hands on your ribs and let your breath press your ribs outward into your hands as you inhale. 

2. Pelvic floor relaxation: Focus on the muscles at the bottom of your pelvis. Imagine the bottom of your pelvis is a hammock. As you take a breath in through your nose imagine a little girl is gently sitting on the hammock and the fibers are slowly stretching open. Let your muscles drop down with an inhale and come back up to their normal state as you exhale. Practice again, imagining those muscles moving down and opening gently. 

3. Mini pelvic floor squeeze and full release: Many ladies I see have trouble simply “letting go” of their pelvic floor muscles. We don’t have great awareness of our pelvic floor. So instead of trying to relax, try a mini-squeeze and release. Start by sitting down. Take a breath in. As you exhale, gently squeeze your pelvic floor muscles like you are “holding back gas.” Ideally, try to engage in the tiniest, almost imperceptible squeeze. Then, let your pelvic floor muscles relax into the chair you are sitting on. Imagine that movement releasing down and away. 

4. Let your belly go: As women, we often hold our abdominal muscles tightly. Our abdominal muscles need to be able to react to movement, so they should be released most of the time. Throughout your day, check in with your abdominal muscles and let them release. There is no need to hold them tight all of the time. 

One last thing: as a pelvic floor physical therapist, the first thing most women ask me is, “Shouldn’t I be focusing on doing 1000 kegels to fix x, y or z?” Especially right now, the answer is “No. Please don’t overdo it.” It’s great that there’s growing awareness of kegels — they’re important — but that’s the focus of this post, as excessive kegels are often exactly the opposite of what our pelvic floors need. 

The current situation is hard on everyone. If you need help with relaxing your pelvic floor muscles, have back or pelvic pain, or are experiencing incontinence, constipation, scar pain, pain with sex, pelvic organ prolapse, or want to prepare your body for birth, many pelvic floor physical therapists are offering virtual visits.