The Core and the Pelvic Floor
Deborah Bowes, DPT, GCFT
It seems as if everywhere you go for advice about your physical health, you hear the words 'you have to use your core'. Whether you are dealing with back pain, or hip trouble or bladder issues, the core is involved. But what does this mean? The idea of the 'core' is useful, giving the concept of an inner column of strength. But it can be misleading, too. Although it seems to refer to a noun or a thing to be used, the core actually refers to an integrated system that works together in all of your movement and functions.
For healthy and pain free movement, the 'mechanical' parts of the core system, like the muscles and the bones, have to work well together with each part doing it's share. The breathing is an integral part of the core. The core system is dynamic, meaning it changes constantly depending on what we are doing. Generally, the core includes the pelvic floor, the deep spinal muscles, and the abdominals.
Any injury or weakness to one part of the core can upset the balance and cause some parts to work too much, or too little. You can improve the pelvic floor and ease a lot of the symptoms you have with Feldenkrais lessons that are targeted for coordinating the pelvic floor with the rest of the core.
The pelvic floor muscles are inside the pelvis and attach to the pelvis, the sacrum and the hip joints. They lend support for posture and movement, and the organs.
The deep spinal muscles attach right on the spine. They keep the vertebrae from slipping. Moshe Feldenkrais often said we need to 'stiffen' the spine. Not stiff in a rigid way, but holding the joints in just the right relationship with each other to allow both flexibility and support.
The abdominal muscles attach to the ribs, the spine and the pelvis. Research shows that the deepest layer of these muscles, called the transversus abdominus, is very important in supporting the organs and the spine.
For example, the pelvic floor can be injured, or too weak or too strong. Pelvic floor dysfunction is very common. Symptoms include pain in the back or pelvis or with sex, balance difficulties, incontinence or constipation. Some of the common reasons for this are due to hormonal changes, trauma, childbirth, abdominal or hip surgeries, or a decrease in exercise. This is not just for older women. You might be surprised to learn that younger women, and men also may have pelvic floor imbalance, sometimes from doing too many crunches, or stress or, for men, an enlarged prostate.
In Feldenkrais we know that trying to change one part doesn't work, you have to include the whole self. That's part of the reason traditional Kegel's often don't work. When the whole system works better, difficulties as diverse as balance issues, incontinence, pain, constipation and sexual function improve.
Deborah Bowes, 2010