When we are confronted by pain and dysfunction in the pelvis especially when it involves among our most important and intimate function of sex and urination and defecation there can be a proclivity to treat our bodies with more fragility than is necessary for recovery and challenge less when we need healthy and proportional challenge to learn how to integrate the pelvis with our body to move with full potential.
A few words about how me I came to be interested in this area…
My name is Grant Headley, my degree is as a Doctor of Physical Therapy from Creighton University in Omaha, and I practice at Bridgetown Physical Therapy & Training Studio in downtown Portland, OR. I also am a certified yoga instructor and use yoga to heal myself and teach others how to listen to their own body. My path to being where I am today started in my own love of pushing my body in training and transforming my body with exercise. I got into bike racing while earning my Exercise Science Bachelor’s at University of Iowa. While I was gaining connection to the people in the bike community and the opportunities being a competitive athlete opens up, I found myself disconnected from my own body, constantly in pain in my back, abdomen, and pelvis made worse with training or prolonged positions. This disconnect was amplified by intimacy. All the effort of hard training without any balance of relaxation or awareness of breathing left me a ball of tension. It took a long time to find help, multiple doctor exams finally led me to a physical therapist who specialized in pelvic pain and then to yoga that focused on alignment, breathing, and listening to the body. Years later I am still learning how to listen to my body and always will be. Now in a position as a physical therapist and yoga teacher I can help others learn to listen to their own body. My painful experiences in the past has turned into a great opportunity to help others.
Some aspects of pelvic physical therapy have a specific focus; education about the muscles, bones, joints, ligaments, blood vessels, and nerves. As a physical therapist, I can play a role in helping the patient work from their current level of function towards the movements and activities they want to be able to perform in order to live their full life. I see my role as listener first, then educator, exercise trainer, manual therapist, and problem solver. For instance if a patient says that they love doing bike races but after a training ride or race, they are unable to or have painful sex with their partner, I help the patient find a way to take the activity of biking from something that diminishes their function to a healthful activity that improves their function in all ways. Physical Therapists with specific training in the pelvis can have specific cues and tools that help patients learn how to use their pelvic muscles to improve strength and the ability to relax. My experience also helps me identify when a patient needs referral to a medical doctor, psychologist, or other healthcare practitioner to provide care beyond my expertise.
Other aspects of my practice that I think are important to learn for those of us with pelvic dysfunction and for everyone are breathing, proper alignment, diverse whole body mobility and strength. As Dr. Kelly Starrett says, alignment of the joints relative to gravity for the task at hand is like making sure your tires are pointed straight down the road so that with each repetition we are not prematurely wearing out our bodies and stressing our joint structures. When aligned properly we get stronger and reduce risk of injury. A few cues and specific exercises that help a person ingrain better habits can go a long way to unlocking more power from the movement, relaxation instead of tightness, and finding a way for our exercise or daily postures help us rather than wear us out. As breathing is directly affected by our posture, as we learn awareness of breath it helps us find the best position for what we are doing. Awareness of breath also helps us calm under pressure, whether during a 10K run or a business deal. The pelvis is directly affected by our breathing. Deficient breathing and posture puts undue stress and tension on the pelvis muscles. In optimal circumstances the pelvis and diaphragm muscles work together as shape changers during breathing. If the pelvis is tight, it is hard to have full natural breathing. We may start to use the upper chest and neck muscles to compensate to get more breath, which may lead to increased stress breathing response and neck tightness and headaches for instance.
Lots of people tell me they “forget to breath.” I know I do it all the time too. It is happening automatically in the background so we need not be self-conscious of our breathing for it to happen. It may be helpful to think of breathing like a barometer for our posture, stress level, exercise intensity. It is a daily practice working towards being able to experience the full spectrum of human movement. Everyday we should work on moving through a range of movements and different challenges to keep the body able to adapt to different conditions. Movement teacher Ido Portal that specializing in one discipline shuts off our potential and leaves us vulnerable to gradual degeneration of our ability to experience the world through the body. Watching him move looks fun and fluid, full spectrum. The rest of us weekend warriors are leaving a lot on the table. Yes we have day jobs but we can work on our limitations everyday.
Yoga encompasses a diversity of physical skills and different positions. It is not the end but a good beginning to a solid daily practice that will help us adapt to different physical demands from sports to moving heavy boxes. We challenge, alignment, strength, endurance, mobility, all while emphasizing breathing through holds and transitions.Yoga can be a good way to warmup and cooldown from weight lifting as it moves through similar range of motion with body weight. Likewise for running and cycling where yoga can give us opportunity to move through end range compared to repetitive mid range cycles in these repetitive sports. These activities are neither good nor bad for patients who have pelvic pain or dysfunction. It is all about listening to your body, being smart about progression, choosing a suitable load, being patient not to progress too soon while also allowing yourself to be challenged to the point of breaking position. The learning happens when we are challenged. If you are suffering from pain it is not something to ignore or hold on to but it can be the opportunity to learn all these aspects that cultivate focus, awareness, and most importantly how to listen to your body.