Posture, Breathing, and the Pelvic Floor

Aparna Rajagopal, PT, MHS, WCS, PRPC, Capp-OB Certified, and Leeann Taptich DPT, SCS, MTC, CSCS co-authored the course, Breathing and the Diaphragm: Pelvic and Orthopedic Therapists, which helps clinicians understand breathing mechanics and their relationship to the pelvic floor.

Assessment of both static and dynamic posture is something we are taught very early on in physical therapy school. Posture and postural deviations have been shown in the literature to have a direct correlation to pelvic floor function and dysfunction. Multiple EMG studies have demonstrated that foot/ankle position can influence pelvic floor activity and that there is increased pelvic floor activity with the ankle positioned in dorsiflexion.(1)

Similarly, increased thoracic kyphosis and decreased lumbar lordosis can increase the likelihood of developing pelvic organ prolapse by influencing intra-abdominal pressure and causing extra pressure on the pelvic floor. Postural deviations far away from the pelvic floor can also affect the pelvic floor. Rounded shoulders and forward head posture are common findings during our assessments. Shoulder protrusion is a common finding in chronic pelvic pain patients.(1) 

Education about posture during Activities of Daily Living by itself can lead to significant improvement in Pelvic floor muscle power, and endurance.(3) Understanding myofascial connections, is a small start in understanding how/why some of these things occur. The myofascial connections from the Thoracolumbar fascia connect the pelvic floor muscle to the sacrum and the neck.(2) It also connects the Gluteals, the Latissimus dorsi, and the External Obliques to the pelvic floor.(2) Optimal functioning of the pelvic floor depends on the entire chain of the musculoskeletal system. 2 Incorporating a full body assessment including the myofascial system is important in treating patients with pelvic dysfunction. 

In the Breathing and the Diaphragm course taught by Aparna Rajagopal and Leeann Taptich, various commonly seen postures, thoracic mobility and how it relates to these postures, as well as all the myofascial connections to these postures will be discussed.  The implementation of a regional interdependence model is discussed to ensure a holistic assessment and treatment plan.  Join them on December 9 and 10, 2023 to learn more about posture, breathing, and the pelvic floor.

References:

1. Zhoolideh P, Ghaderi F, Salahzadeh Z.  Are There Relations Between Posture and Pelvic Floor Disorders?  A Literature Review.  Crescent Journal of Medical and Biological Sciences.  2017; 4(4): 153-159.
2. Tim S, Mazur-Bialy AI.  The Most Common Functional Disorders and Factors Affecting Female Pelvic Floor.  Life. 2021; 11: 1397. https://doi.org/10.3390/life11121397.
3. Jorasz K, Truszczynska-Baszak A, Dabek A. Posture correction therapy and pelvic floor muscle function assessed by sEMG with intravaginal electrode and manometry in female with urinary incontinence.  Int J of Environ Res and Public Health 2023;20:369. Doi:10.3390/ijerph20010369.

Breathing and the Diaphragm

Price: $450.00          Experience Level: Beginner          Contact Hours: 14 hours

Course Date: December 9-10

Description: This remote continuing education course is presented live on Zoom and is designed to expand the participant's knowledge of the diaphragm and breathing mechanics. Through multiple lectures and detailed labs, participants will learn how the diaphragm, breathing, and the abdominals can affect core and postural stability through intra-abdominal pressure changes.

As an integrated approach, the course looks at structures from the glottis and the cervical region to the pelvic floor and helps in understanding a multi-component system that works together. Optimal function of the diaphragm and breathing patterns are key to a healthy pelvic floor, a normal functioning core, and postural stability. Evidence-based methods to assess the diaphragm and breathing mechanics are presented along with easy-to-apply practical intervention strategies.

This course includes assessment and treatment of the barriers by addressing thoracic spine articulation and rib cage abnormalities in the fascial system of muscles related to breathing and the diaphragm. The assessment concepts and treatment techniques can easily be integrated into a therapist's current evaluation and intervention strategies. 

The course information is applicable to patients who present with Diastasis Rectus Abdominis, pelvic pain, incontinence, prolapse, cervical/thoracic/scapular/ and lumbar pain. In addition, current literature has shown that these breath and diaphragm training techniques can effectively improve athletic performance in Labs will be demonstrated and will be participatory where possible.

Participants may practice labs on a family member or friend or team with a fellow participant where possible.