THE IMPORTANT PELVIC FLOOR BY JAKI NETT
T
he pelvic floor is a topic that is approached very gingerly when discussed in a yoga classroom setting. It is not an area that we talk openly about like we do our back, legs, arms, or chest. As teachers, we tend to be cautious about how we include the subject—especially in a general yoga class. But it’s important nonetheless.
The pelvic floor is referred to in two ways: the pelvic floor as an area or the pelvic floor as an anatomical structure. It is important to understand the anatomical pelvic floor and its accessory muscles to be able to work with the pelvic floor area in your yoga practice.
The Anatomical Pelvic Floor Pelvic floor muscles are postural muscles—slow twitch muscles, endurance muscles. Pelvic floor muscle dysfunction affects muscle fiber length and contractile force. Stretched and stiff muscle fibers have a decreased ability to generate power for support.
perineal muscle group is more superficial and comprises the perineal body, which is often referred to as the “perineum.” The perineal body is the strong center-supporting member that supports the pelvic floor muscles. When there is damage to the perineal body it weakens this important support.
The anatomical pelvic floor has many functions. First, the muscles of the pelvic floor connect the front body to the back body. Second, they close off the bottom of the pelvic outlet. Third, they are responsible for the support of the abdominal viscera. And forth, they resist the internal downward force called the “Valsalva maneuver,” which is a silent wrecker of the pelvic floor muscles. What is the Valsalva maneuver? It is a natural force that increases interabdominal pressure—the internal force we use to stabilize the core of the body when any form of elimination is needed; it helps force things out. The dynamic, anatomical/mechanical chain reaction of Valsalva is the sequential inhalation and retention of the breath, which flattens out the diaphragm, blocks the throat, contracts the abdominal muscles, and constricts the sphincters in the pelvic floor and anus. It can have a different result depending on which valve or sphincter is open or weak when Valsalva is expressed. We experience Valsalva when we laugh hard and loud, sneeze, cough, vomit, defecate, lift a heavy weight, or when we do Paripurna Navasana. These actions can set fear into a woman with weakness of the urethra sphincter, also known as “incontinence.” The push during childbirth is Valsalva to the 100th power.
Pelvic Floor Area The boney boundary of the pelvic outlet is created by the pubic bone, the ischial tuberosities or sitting bones, and the inferior sacrum or coccyx. Two muscle layers close off the pelvic outlet: These two layers are the perineal and the levator ani muscle groups, collectively called the perineum or pelvic floor. The levator ani is referred to as the true pelvic diaphragm or true pelvic floor. The perineal muscles are known as the urogenital diaphragm. The levator ani is the deeper of the two layers. The 26
Pelvic outlet with perineal muscle groups transparency overlaying levator ani muscle groups
Pelvic Floor Dysfunction There are three pelvic floor dysfunctions that can occur separately or together: • Incontinence • Vaginal laxity • Overstretched levator ani and perineal muscle groups, i.e. weak pelvic floor Incontinence can occur in two basic forms: stress and urge. Stress incontinence is when there is a sudden build up of Valsalva and the pressure forces urine out. Urge incontinence is when the bladder has lost its ability to feel the slow filling-up of urine, creating the sudden urgent need to get to a toilet. Vaginal laxity is when the vagina has become stretched and has lost its ability to contract. In yoga, when a student inverts, air sometimes enters the vagina, and when the student comes down, it expels with a sound. The ability to consciously contract the vagina along with correct alignment will help control this issue. Yoga Samachar Fall 2015 / Winter 2016
