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I love chatting with the Adventures in Vaginas community. Like, kind of obsessed. Recently, I got an email saying something along the lines of:
I’m just re-entering working out since having a baby about a year ago, and I have a history of vulvodynia, pelvic floor tension, and incontinence. What are some basic movements to focus on?
Here’s the short answer: It’s hinging! In So. Many. Forms.
Here’s the TL;DR:
I love a hinge because it does a great job at addressing pelvic mobility, creating glute strength, and, when done correctly — releasing the pelvic floor and addressing back pain.
Moreover, hinging is a key skill for a huge chunk of traditional weight lifting. Wanna do a proper overhead squat, deadlift, single leg deadlift of any stripe, complex lunge lift, etc? You better figure out how to hinge.
While hinging is one of the easiest skills to scaffold, it’s also supremely overlooked. Often folks jump right in to more loaded, “challenging” positions and end up with back pain simply because they missed hinging.
Lastly, a hinge with good form loads the deep abdominal wall and therefore the anterior pelvic floor, meaning that if you struggle with urinary incontinence, this might be the key for you!
The deep dive:
Okay, okay. Let’s start with our good friend, anatomy. We begin with a view of the pelvic floor from the back and bottom, kind of like if someone is sticking their butt out at you:
See those two bones on the bottom? Those are your ischial tuberosities — colloquially known as your sit bones. See how all of the muscles of the pelvic floor attach to either the sit bones or the side of the pelvis?
Okay! Amazing! So when you do a successfully execute a hip hinge, the sit bones move away from one another, therefore gently stretching the pelvic floor. When you come back from the hinge, the pelvic floor (along with the glutes) contract.
And thus begins my love song to this beautifully well rounded, infinitely variable basic movement. I like to think about hinging as a “full spectrum” movement, since it both lengthens and strengthens the pelvic floor and glutes — and the reality is, 99% of us need both.
I begin with hip hinging as a basic movement for both folks experiencing chronic pelvic or back pain, as well as folks experiencing incontinence or pelvic organ prolapse. The beautiful thing about a hinge is that when you load it (aka hold a weight), the abdominals have to respond, and the pelvic floor gets even more tension (in a good way).
But! In order to have a solid hinge, you need to have a pelvis and two happy hip sockets that are comfortable with the movement — and lots of folks don’t have this ability (which is, perhaps, probably why I end up meeting them in the first place). What happens instead is that the spine moves into flexion (aka bending) in order to create the shape of hinging, like this:
PS, I hope you’re vibing with these old school PT drawings as much as I am.
But I digress. One of my favorite cues to say to folks with this compensation is that “It’s an ass-out affair! Stick your butt out!”
Another way to think about it is like a see-saw. Your head goes forward and down while your butt goes back and up. Your spine stays “straight”, which is to say it maintains its natural curves.
Here’s the take-home:
If you’re a beginner, my favorite way to begin is simply putting your butt on the wall. With your spine straight (you’ll feel the muscles on your back gently engage — this is okay!), and keeping a slight bend in your knees, hinge so that your head comes forward and down and, voila! — your butt should slide up the wall. We love some tactile feedback! As you bring your head up, your butt should slide right on down.
If you’re a more experienced mover, the classic hinge is a simple deadlift. Deadlifts are rad, but there are so many more ways to experience hinging, all of which are freaking awesome for your pelvic floor. You can hinge in a low or high lunge, in a lateral lunge, and from your knees! You can hold a weight, coordinate bringing a weight overhead, or do something else fancy!
So if you’re looking to move around and have pelvic floor ishes, start with hinges. Deadlifts, B stance deadlifts (aka Romanian deadlifts), and lunges with a forward hinge are a few basic faves.
If you’re looking for some inspo, I’ve created a little bundle that covers both some basics and creative flows centering on hinging. You’ll need to be a paid subscriber for access — scroll below!
As always, I genuinely love hearing from you. Email me at cait@ritualpelvichealth.com.