Okay fine, let's talk about abs

Part One: Your six pack dreams may never be the same, and it's for the best.

When I was in my twenties and teaching yoga full time, I loved me some core work. So! Much! Core! Work!

Hit me with a boat pose, sure. How about a thousand mountain climbers (knees to chest from a plank position), but make it yoga? Always make it seem like yoga.

If the hairs on your neck are standing up whilst reading these lines, you’re not wrong. Diet culture is everywhere around us, especially in this blessed New Year season, where I can’t get groceries without running into huge Jump Start January! banners extolling the virtues of avocados or whatever.

Diet culture shows up in your pelvic floor, too. So much. Today, I’m going to dig in on core work, the mythical six pack goal, and the effect of tight abdominal fascia on pelvic pain. Later this month, I’ll be talking about the effect of excessive abdominal training and intra-abdominal pressure on the pelvic floor and the stats on weight regarding pelvic floor outcomes.

What you need to know right now is that you can have a happy-ass, functional AF pelvic floor at any size.

Let’s do this.

Here’s the tl;dr:

• Abdominal fascia is neurologically and physiologically connected to the tissue of the pelvic floor. That means if your belly is tight AF, it’s going to have a downstream effect on the pelvic floor.

• That whole sucking in your belly thing creates more tension and pressure in the abdominal cavity that, once again, messes with your pelvic floor.

• As always, breathing has a lot of relevance here. If you’re not breathing, your belly isn’t moving, and your pelvic floor follows suit.

• The big upshot is that if you do experience chronic pelvic pain and dysfunction, working on mobilizing and loving the shit out of your belly can be a game changer!

The deep dive:

I could just kiss the author of this old AF but aptly entitled paper, “Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome.” Caveat: In more recent decades, science has made huge leaps in fibroids, endometriosis, interstitial cystitis, adenomyosis — the list goes on — that parses out specific causes of linked abdominal and pelvic pain.

So no, I wouldn’t say that abdominal pain is the “leading” cause of pelvic pain, but the neurological connection between the muscles and fascia of the abdominal wall and the pelvic floor remain highly, highly relevant.

So many of my clients are shocked when I suggest doing abdominal release work. Like, how would that even work?

And yet. Magic ensues.

If we look at the very basics, the definition of “chronic pelvic pain” includes discomfort anywhere “between the umbilicus and the upper thighs". So there’s some clear overlap between what we consider to be the abdomen and the pelvis. But what if you have something like vaginismus, where the pain feels far away from the belly?

I like this image to demonstrate how the abdominal blood and nerve supply are interlinked with that of the pelvic floor:

Source: El Sevier

Sometimes I see this and am like “Woah, I forgot the abs went down that far!”

Quite simply, “the perineal fascia is a continuation of the abdominal fascia.” The perineal fascia being the connective tissue that encases the superficial muscles of the pelvic floor — the ones that would hurt if you’re having pain on initial penetration, like in the case of our vaginismus example.

We can think about the abdomen as a potential weak link or a golden key to recovery — or both.

Let’s talk about the weak link theory: Now that we know that tension in the abdominal fascia leads to tension in the pelvic floor, it’s worth examining how one might be stressing out one’s belly.

Umm…. well… let’s just talk about that time when I was 12 and watching some VH1 deep dive on Britney Spears’ core workout routine. Supposedly she did 1000 crunches per day, bless her.

The problem isn’t a crunch, or ten, or even a hundred. Remember, there’s no bad movement. Crunches aren’t inherently bad. The problem is the entire vibe of the anecdote.

The cultural agenda to create perfect abs is what drives so many folks’ urges to suck in their bellies, wear super tight, compressive clothing ALL the time, to hold their breath on the regular, and yes, to do endless, I’ll say excessive, “core work”. All of this can and does lead to pelvic floor dysfunction and pain.

But let’s look at the flipside: If we care for our bellies and create space and connection to the abdominal fascia, we can find a back door to healing the pelvic floor in a way that is far more accessible than internal pelvic floor work.

Here’s the take-home:

Let’s take a breath, shall we?

You are a good person. At this risk of making a collective, assumptive statement, I’m going to go out on a limb and say that we are all victims of diet culture in one way or another. So if you find yourself guilty of exclusively wearing compressive high waisted leggings (slowly raises hand), it’s okay. You’re a good person. It’s fine.

As a survivor of thirteen brutal years of disordered eating (and as a postpartum person and as a person who needs to demo my bare belly for multiple professional reasons on a somewhat daily basis), I get how difficult it can be to simply look at — let alone touch and massage — one’s abdomen. That’s real.

So let’s start this process by simply breathing. As I’ve gone on ad nauseam in the past, breathing is essential to pelvic health, and there are many specific techniques to optimize it — breathing into the sides of the ribs is one of my favorites. But screw that for now. Right now, just lay down. Get cozy. Breathe in and allow your belly to expand — that’s your only cue. As you exhale, allow your belly to soften.

Expand, soften, Expand, soften.

If you feel safe doing so, place your hands on your belly while you do this. Holy shit. You’re doing it! Maybe, just maybe, imagine that expansion going all the way down to your pelvic floor. My favorite way to describe this is to imagine a slinky (it’s your vagina!) that is slowly lengthening on your inhalation, and returning to resting state on the exhalation.

Keep at this on the daily. You can do this for one minute or twenty. But begin to create a time and space where you feel safe in your bod. You’ve got this. As always, I am rooting for you.

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If you’re itching for more ways to access your belly and release tension, I’ve created a bundle for paid subscribers (see below). Being a paid subscriber is the best way to support my work and ensure that I keep doing it!

The second-best way to support my work is simply being here! I love hearing from you. If you have any feedback, leave it in the comments, or email me directly at cait@ritualpelvichealth.com.