Angie Mueller PT, DPT is the instructor of Low Pressure Fitness and Abdominal Massage for Pelvic Floor Care, a new course on the hypopressive technique and abdominal massage for pelvic health. Join Dr. Mueller on July 27-29 in Princeton, NJ to learn more!
One of the first things I do as a pelvic PT when helping a woman recover from pelvic or core dysfunction, is center her uterus. I believe the uterus is the center of a women- biomechanically, physiologically, and energetically. I have seen that when the uterus is out of position, everything else in the pelvis and core is largely impacted and functions less efficiently. This includes muscular, gastrointentinal, liver, bowel and bladder, hormonal and sexual function.
The uterus is supported by several important ligaments, which extend from the uterus out to the pelvic bones, as well as to the organs surrounding it- bladder, bowel and intestines. So if this magnificent central organ is out of her “center”- leaning forwards or backwards, or tipped to on side or the other- this can lead to a myofascial imbalance in the pelvis and cause symptoms of pelvic floor dysfunction, pain, and hormonal imbalances.
In treating thousands of women with pelvic dysfunction, I have observed that a uterus which is leaning too far forward (anteflexed) is often associated with urinary incontinence, issues with bladder urgency and frequency, and bladder prolapse (cystocele). A uterus that is tipped backwards is often associated with constipation, hemorrhoids and bowel prolapse (rectocele). A uterus that is leaning left or right is often associated with hip dysfunction, sacroiliac joint dysfunction and lumbo-pelvic alignment issues. This leads to and hip and/or knee and/or back pain due to asymmetrical pulling of the internal abdomino-pelvic fascia, especially the uterosacral and cardinal ligaments, which affects pelvic and sacral bone alignment, and then knee and ankle tracking. So centering the uterus will balance the internal pelvic and abdominal fascia, and can significantly improves cases of back pain, hip pain, knee or ankle pain.
Ensuring our organs are in their best position for receiving blood, lymph, nerve and hormonal support is critical to their health and function! If any organ in the body, especially the uterus, is not in its optimal position to receive blood, nerve, lymphatic and hormonal circulation, its function will be impacted. Therefore a mal-positioned uterus can also lead to problems with the menstrual cycle, painful periods, and fertility. When assisting any woman through a rehabilitative process, I have found it critical to appreciate how her uterine position contributes to and impacts her overall pelvic and core health- from a musculoskeletal, biomechanical and physiological perspective.
I have found that the best pelvic therapy outcomes result from use of both passive and active techniques to center the uterus. The first step is passive positioning of the uterus, which is most efficiently accomplished through abdominal massage. Abdominal self massage should be done daily. Abdominal massage will help to release any myofascial and ligamentous restrictions that are leading to a mal-positioned uterus. Abdominal massage also greatly improves blood flow and lymphatic circulation to the gut and pelvic organs leading to improved digestion and organ detoxification. Once her uterus is centered by the massage, it is important to immediately implement an active technique that will keep the uterus centered. This active uterine positioning technique must trigger the appropriate posture and breath that will keep her uterus centered with movement and throughout the activities of the day.
The second step to positioning her uterus is active activation of abdomino-pelvic musculature and key fascial chains that elevate and center the pelvic organs. This is accomplished through one of the latest core neuro-reeducation techniques- Low Pressure Fitness®. The Low Pressure Fitness methodology involves a seamless progression of postures and poses that cause a reduction in pressure in the abdomen and trigger an automatic response from the core muscles- abdominals, pelvic floor, multifidus, diaphragm. Low Pressure Fitness uses a breathing technique known as Hypopressive Breathing to reduce intra-abdominal pressure and optimize organ position. The term Hypopressive means “low pressure”. Traditional exercise, core training, sports, and most of our everyday activities are Hyperpressive – they increase the pressure in the abdomen. When the pressure in the abdomen is not appropriately managed, pressure increases, and this causes the spine to compress and the organs (especially the uterus) to move downward and away from their optimal “centered” position. But when the hypopressive breath is triggered, the pressure in the abdomen is reduced, the spine decompresses, the core musculature is gently strengthened, all of the organs lift, and the uterus is centered.
When the uterus is centered, magic happens… the fascial tension in the pelvis balances out; the resting tone of the abdominal and pelvic muscles improve and become easier to strengthen; the blood flow and lymphatic circulation in the pelvis is improved and sexual function and fertility is enhanced; hormones are better regulated and monthly cycles regulate; bowel and bladder function is optimized; the waistline reduces; pain in the back, abdomen and hips is reduced and posture improves. When all of these wonderful things occur, it is directly associated with improved energy, mood, creativity and self confidence. So remember, centering the uterus, through both active and passive techniques, is key when treating any woman. Self abdominal massage followed up by Low Pressure Fitness® are the most powerful techniques I have found to center the uterus and resolve pelvic and core dysfunction in women of all ages and lifestyles.