Monday, November 12, 2012

Tight Calves And The Pelvic Floor

For over a year now I’ve been studying with the Restorative Exericse Institute. Before I decided to go for the Whole Body Alignment course this Spring, I took the NoMoreKegels course which is all about pelvic floor health. I learned about the effect of our footwear and posture on the alignment of the pelvis and how this in turn effects the pelvic floor muscles. I also learned specific exercises to restore pelvic floor function. And one of the most fundamental of those restorative exercises is the calf stretch.

The CALF STRETCH? For my PELVIC FLOOR? Yep. It all begins with tight calf muscles. (Well, it all begins in the feet but that shall be another blog post.)

The calf muscle group is made up of the gastrocnemius, soleus and the plantaris. They all attach to the heel of our foot. The soleus attaches below the knee at the tibia. And the large gastrocnemius and the much much smaller, but oh so sensitive, plantaris attach above the knee at the femur.
Muscle always contracts from attachment point to attachment point. Which means that what goes on with the attachment points, i.e. how the bones are aligned, matters a great deal to what goes on with the muscle.

For example, when I wear a shoe with a positive heel, the natural heel of my foot where my calf muscles are attached to, is brought closer to the knee.
As a result the muscle is put in a shortened position. If the muscles are chronically held in this position because I’m in my positive heeled shoes all day, well, then they stay in this shortened position.

A chronically shortened muscle is a tight muscle. And a tight muscle isn’t very good at receiving or pumping blood and lymph and also doesn’t communicate well with the spinal cord. In short, a tight muscle isn‘t a strong, force generating muscle.

Another example is the posture of constant knee flexion. Check out any person running or walking on the street. They all have their knees bent. And then look at all the people sitting around. They also have their knees bent (surprise!).

Because the gastrocnemius and plantaris muscle attach above the knee, any kind of knee bending action puts slack in those muscles. Muscles can’t stay slack because then they have no force generating power so the muscle fibers simply adjust and shorten themselves. Now they can work again.  But because the knees are in flexion all day long (sitting, sleeping, walking with bent knees) the calf muscle is chronically shortened. And a short muscle is a tight muscle is a weak muscle  …

This constant knee flexion is one culprit for the pelvic floor problem. But to understand this, we have to welcome the hamstring group into the discussion.

The hamstring muscles all attach to the lower leg bones (tibia and fibula) as well as to the pelvis. Knee flexion causes slack in the hamstring muscles. The hamstring muscles get short and tight. And these shortened hamstring muscles are pulling and tucking on the pelvis causing the pelvis to be out of neutral (posterior pelvic tilt). Which then in turn puts slack in all the pelvic floor muscles causing the pelvic floor muscle to adjust and shorten.

And a short, tight, weak pelvic floor muscle isn’t very good at holding up the pelvic organs. A short, tight, weak pelvic floor muscle is also not very good at expelling babies. WOW!

Soooooooooo, if you have plantar fasciitis or heel pain or crampy, tingly, tired legs or knee pain or pelvic pain or if  you are leaking urine when doing jumping jacks or you have back pain or you were told you have have a hypertonic pelvic floor or prolapse or prostate problems, there are many things you can do right now to get better. Here are a few suggestions:

1) Stretch your calves and click this to read and see how.
2) Assess your shoe wear. If you wear really high heels, get into a smaller heel. And if you wear running shoes with a bit of a heel, consider getting a truly zero heel shoe. (Here is a list for minimal or ‚barefoot‘ shoes)
3)Increase barefoot time
4)Get out of the chair every 20 minutes and stretch your calves.
5)Get the Every Woman's Essential Body kit from the Restorative Exercise Institute (and I don't benefit from this recommendation in any way other than the fact that I was the source that led you to some amazing and cheap self help tools and knowledge)
6)You could even take the NoMoreKegels course yourself.
8)If you are in Ottawa, come to class or book a private session

PS: I can't let you go without saying this:
The abdominal muscles attach to the pelvis .... calf stretch anyone?

Monday, November 5, 2012

Belly Blues And What To Do About It

For many women the belly is a problem zone laden with negative emotions. Maybe you feel totally disconnected from this area of your body. Maybe the look of your belly in the mirror triggers a sense of hopelessness and depression.

So what do you do? You suck it in. You might suck it in to hide it. You might suck it in because you think this is what „engaging the core“ is all about. Well, sucking in your belly is disrupting the normal pressure in your abdomen  and has nothing to do with contracting your deepest abdominal muscles.

You CAN re-connect with your belly again. Over time you can even flatten it so you like looking in the mirror again.  All you need to do is get the muscles to work again. And the first step is letting it go!  Release your belly. Let it be as big as it wants to be. The hardest thing of all. But now the muscle isn’t “stuck“ anymore and it can actually contract.

Getting ready to contract the deep abdominal muscle (transversus abdominis aka TvA) correctly

How you position your pelvis and rib cage really matters to the proper functioning of your TvA  – after all the muscle attaches to large portions of both. Check it out on this image from Gray's Anatomy.

How should the pelvis be aligned?
Your ASIS (Anterior Superior Iliac Spine) and your pubic bone should be in a vertical line when standing or sitting. It will give you a nice curvature in your lower back. To find your ASIS you can just put your hands in your groin area and then walk them up until you can palpate the part of your iliac spine that most protrudes. Or maybe it makes more sense if I tell you to put your hands on your hips and find the point that protrudes in front.

So when you are sitting it should look like this.

Now that you are sitting in neutral pelvis, relax your belly and check in with your rib cage. Do you feel a strain in your upper back? Are you thrusting your rib cage forward? Try to relax your rib cage back and lower it down so it starts to align with your neutral pelvis. Relax your belly again. And breathe.

Some cues for you:
Take air in through your nose and let the air fill your rib cage.
If you notice your shoulders coming up to your ears when breathing, focus on sending the breath into the lower half of your rib cage.
Exhale through your mouth.
Take your time.
Your belly stays relaxed the whole time.

Once you get the hang of it and this feels natural, you can start doing some TvA contraction exercises.

Contracting the TvA
The TvA wraps around our waist like a girdle and contracts like one. Pretty cool.
So.... inhale again and now as you exhale through your mouth you draw your belly button towards the spine. Maintain the neutral position of your pelvis as you do this.
Also make sure that your rib cage is not thrusting forward.
Let your belly relax after each contraction and check in with your pelvis and rib cage and re-set if necessary.

How many? It's up to you. More doesn't necessarily mean faster results. Focus on maintaining neutral pelvis and dropping the rib cage as you go throughout the day and when doing the exercise. And ... relax your belly. Now that you know how to contract the TvA properly you can hopefully see that your habit of sucking in your belly has nothing to do with contracting your abdominals.

PS: One day you don't even have to think about contracting your abs, they will do it for you. Like they are supposed to. If only we used our bodies the way we should. Our habit of excessive sitting is not exactly helping. The exercise shown is a good starting point - since we sit all the time, we might as well sit properly and wake up our core. When you're done with it, get out of the chair, do a calf stretch, put a pair of really flat and comfy shoes on and go for a walk. It will help with the belly blues!

PSS: A quote from Katy Bowman, biomechanist, about core strength.
Core strength does not mean abdominal exercises! It is the ability to stabilize the bones in the upper body, rotate the torso with proper spinal curvature, and maintain pelvic position while sitting, standing, and exercising! It’s the ability to control the bladder, stabilize the ligaments of the knees with the lower abdominal wall, and breathe correctly while doing all of these!