Exercise and Intra-abdominal pressure
Bridget Coley PT, MSc. PT, BKin
As the weather gets warmer and we wake up from our winter slump, it’s natural that our activity level starts to increase. Before we get too caught up in the excitement at no longer being cooped up inside, it’s important to remember how our daily activities play a role in our pelvic health.
Our pelvic floor muscles perform a variety of functions, some of which are:
They support our organs against gravity and intra-abdominal pressure
They control the openings of our urethra and rectum to help prevent leaking
They assist in maintaining stability in the pelvic region between the hips and lower back
Different activities naturally come with an increase in intra-abdominal pressure which can result in a greater burden being placed on the pelvic floor. Some things to look out for while exercising include any sort of incontinence, pain, or any significant pressure causing feelings of discomfort. While incontinence during exercise is common, it is not normal and can be addressed.
Incontinence experienced during exercise is a form of stress urinary incontinence whereby there is an increase in intra-abdominal pressure (or pressure within your abdomen). We can manage this stress incontinence and potentially other symptoms by focusing on managing our intra-abdominal pressure. It can be challenging to identify if you have a pressure management problem by yourself. But we can improve pressure management with some simple techniques.
The first technique is breath coordination. This involves controlling our breathing in manner that helps us control our pelvic floor muscles. When we inhale our diaphragm descends and the pressure within our abdomen increases. At the same time, our pelvic floor naturally descends and lengthens. When we exhale, both our diaphragm and pelvic floor come back up.
We can use this to our advantage when exercising. When picking up something heavy, we want to exhale into exertion. This brings the diaphragm and pelvic floor up and reduces pressure within the abdomen. This makes it easier for our pelvic floor muscles to create a proper seal at the openings of our urethra and rectum, which can assist in managing stress incontinence. It is better to inhale before an exertion to prime our lungs to exhale into an exertion.
We can also condition our pelvic floor muscles to function in tandem with the rest of our body by consciously engaging our pelvic floor prior to exertion. By initiating a pelvic floor contraction before a rise in intra-abdominal pressure we can condition our body to coordinate various muscle groups to better control our pelvic floor.
A last area of focus is strengthening our core muscles. A strong core is generally beneficial for symptoms such hernias and can also assist with better managing our intra-abdominal pressure.
IF you think you may be struggling with intra-abdominal pressure management or incontinence, please seek help from your pelvic PT.