Can Meditation Heal Your Pelvic Floor?

When we’re talking about the benefits of hypopressives, we often mention the winding down of your nervous system, but I understand that for many this may seem a little vague and perhaps even far fetched. So I thought it’s a good time to write more about what your nervous system has to do with your pelvic floor, it’s such an important factor and should be on the top of everyone’s lists.

We’re starting to understand the connection between a calmer nervous system and a “calmer” body (I mean less pain, less discomfort, less tension) and just how important and powerful being able to calm down the sympathetic nervous system is. But we still aren’t utilising this very much in day to day (physical) therapy. It’s good advice to be spending 10 minutes a day doing mindfulness, meditation or just practicing diaphragmatic breathing, but unless we really understand why it’s integral when it comes to your recovery from pelvic floor issues, we’re pretty unlikely to do it with everything else going on. I would bet you’re more likely to be spending your time working on the physical symptoms in a physical manner rather than justifying why you need to carve out even more time for yourself doing the hippy stuff (ie drift off whilst meditating).

I always underline the importance of learning to turn on your parasympathetic nervous system when you’re experiencing pelvic pain or other pelvic floor symptoms and challenges.

Bringing this aspect into your day-to-day practice and integrating it into your program without it being a separate add-on, is going to be one of the factors that helps to break the vicious cycle of tension -> increased symptoms -> worry -> more tension -> aggravated symptoms -> worry… Making your rehab programme more time efficient and helps to secure that your nervous system is taken into account often enough to make a difference.

The effect you can have on your nervous system starts with your breathing, and we talk a lot about the importance of good breathing anyway when working with the pelvic floor. I’m sure you’ve come across this too and have heard about the connection between the pelvic floor and diaphragm, and how they move together as you breathe (if this is new to you then have a read of my previous blog where I go into more detail with the connection of the diaphragm and pelvic floor here). But breathing has other roles in pelvic health recovery than just helping your pelvic floor function; it is even more powerful than that.

So how can we change the state of our nervous system with breathing?

Let’s start by looking at what the nervous system actually is. Firstly the Nervous System (NS) is divided into Central (CNS = brain and the brainstem) and Peripheral Nervous Systems (PNS) and PNS is further divided into the Somatic and Autonomic NS’s. The Somatic NS includes you moving your body, contracting your muscles and the sensations you experience through it. The Autonomic NS, as the name states, is not in our control and is still further divided into the Sympathetic and Parasympathetic systems and these are what we’re interested in today.

We’re very used to working with our Somatic NS in rehab and when we’re working out, but I think understanding what our whole nervous system consists of can help us realise how it’s just one sliver of the bigger picture. It can be incredibly helpful to look at the other half of our Peripheral nervous system when we’re recovering from pelvic floor dysfunction. After all, our pelvic floor muscle tissue consists of both skeletal and smooth muscle fibre, and unlike skeletal muscles, smooth muscles are not under our conscious control. They’re controlled by the Autonomic Nervous System, similar to our gut for example, that contracts to move the food down towards our bowels without us being aware of it.

This is thought to be the reason why our pelvic floor is so quick to react to threatening situations by tensing up and why it “can store trauma”. It also might help you to understand why it can be impossibly difficult to release tension in the pelvic floor sometimes or for some people. It’s about the state of their Autonomic nervous system and it’s impossible for them to “just relax”(to a certain extent), and why stretching will only get you so far. It might also help you to understand why getting help from counselling and dealing with traumas (related to birth or assaults for example) will sometimes seem to resolve the physical symptoms too.

Let’s look at how the Sympathetic and Parasympathetic NS work to understand how we can work with them:

When you’re in the fight or flight state, your sympathetic nervous system is “turned on”. It’s responsible for getting your body functioning quickly in threatening, dangerous, or stressful situations by releasing a cocktail of hormones into your body, like adrenaline and cortisol. You’ll experience an increase in your heart rate and blood pressure, getting you into a high alert state and prepared for physical action, ie. to fight or run for your life in order to escape the danger.

Parasympathetic NS, on the other hand, is responsible for the quieter actions of your body, like digestion and repairing; the “maintenance work” of the body. It’s looking after the functions that aren’t vital when you’re fighting for your life, but that are integral for you maintaining good health.

However, these systems can’t work at the same time, and when one is on, the other one has to be turned off. In the modern world we’re under a lot of stress but often unable to run away or fight it. These stressors also last for long periods of time which gives our parasympathetic NS fewer opportunities to turn on to do the “inner work” of maintenance, keeping our digestion on track, sleeping, and recovering well. Chronic stress and feeling threatened keeps our alert system (the Sympathetic NS) on, which also has a connection with our perception and experience of pain.

Pain is always created by our brain, it translates sensations from the body into pain based on the brain’s interpretation of the likelihood of threat or damage to the tissues. How the state of our nervous system affects our pain is perhaps easier understood through the the following analogy, where your Cup is being filled with potentially threatening sensations, and once it overflows you feel pain. When you feel safe (your fear/threat Cup is empty), it’s going to take longer for the Cup to fill up, overflow and you to feel pain. If your baseline is already stressed and feeling threatened (your Cup is already half full), it’s going to overflow quicker (with fewer potentially threatening sensations) and you experience pain sooner. If your alert system is very high, your brain might even start to perceive “normal”, non-threatening sensations as posing a threat and overflowing your Cup with these. You are still in just the same amount of pain as you would in a low-alert state and the pain is still as real as in any other time. It’s not about your pain tolerance, it’s about your nervous system being on overdrive.

There is so much more to pain science than this very brief summary, and I think chronic pain is incredibly “interesting”, this is just a little scratch of the surface for now. But let’s move on and talk about breathing next.

Diaphragmatic breathing has a connection with your parasympathetic nervous system and helps to activate it, which in turn is going to shut down your fight or flight state - the Sympathetic NS. Overall, being able to “turn off” your stress response, ie sympathetic NS, will mean you are likely to be more comfortable and, in the long run, it will probably help you to maintain a better general health as well!

Diaphragmatic breathing is often taught as belly breathing; you place your hand on your tummy and direct your inhale towards your belly button and let it flow out, often blowing through pursed lips. But if you have pelvic floor dysfunction, especially a prolapse, this will not necessarily be the most optimal way to breathe. Firstly, we need to understand that the increased pressure created by the newly inhaled air is going to be directed to the area of least resistance. With a pelvic organ prolapse this is most often your pelvic floor. Now you’re breathing into your tummy and creating pressure that is going to be directed to your pelvic floor, which might not be able to counter the pressure. And if you’re sensitive to your prolapse symptoms you're likely to feel your symptoms aggravated. It’s not dangerous by any means, and you won’t be making any further damage to your pelvic floor by breathing! But for some this could be one of the reasons their pelvic floor symptoms are so constant. After all, prolapse is described as a pressure regulation problem. Breathing is constantly changing the pressure in your body.

With the 360-breathing that we use in hypopressives, we direct your inhale to your rib cage which is meant to move with your breath. It’s very flexible, it’s where your lungs are, and where your diaphragm attaches to, so breathing into “your sides and into your back” is also diaphragmatic breathing. But this time you’re not directing that increased pressure down towards your pelvic floor. With this simple change you might experience some instant relief to your symptoms!  

360-breathing is also excellent for back issues or stiff middle backs as it keeps it mobile and moving. I’ve said it before, and I will keep saying it, but one of the benefits of hypopressives is that it works on so many levels at once. Every time you do the physical practice of hypopressives and train your Somatic NS, you’re also doing the breathwork and so calming down your Autonomic NS, teaching your body (with every inhale and exhale) how to switch to the Parasympathetic NS (the calming one). And you’re working on all the fronts that play a part in your pelvic health (like posture, myofascial release and muscle tone) and will be more likely to create that lasting change to reduce symptoms.

To finish, I would like to say that hypopressives aren’t rocket science, it’s something everyone can learn. It’s a very gentle technique where less is more, and that often can be the main difficulty when starting. We’re so used to pushing ourselves and going hard, but in this case that’s counterproductive and will likely slow down your recovery. And if we’re working with a nervous system in high alerted state, pushing yourself beyond your resources is just going to add cortisol and adrenaline into your system, potentially only fuelling your original physical problems further.

So, take time for yourself. Book in those 10 minutes a day with confidence to do the mindfulness or meditation practice. Because your nervous system and your pelvic floor are going to thank you for it!