If you have stopped to read this blog you are likely…

1.…a fellow PT who is looking for new ideas and tricks.

2….a trainer (pre and.or post natal perhaps) that knows about this issue and wants more info on how to recognize it and not aggravate it in training.

3…a woman who has been told this by their physical therapist or doctor and are trying to figure out what the heck that means. A recent of patient, is just like you. A Pelvic PT told her her pelvic floor was tight, taught her how to self-stretch, but offered her no explanation on how it got “tight” or “hypertonic” in the first place.

Treating only the what (a “tight” pelvic floor) will get us nowhere fast. Instead, we must first treat the how and why.

We also need to carefully examine the words we are using. Is the pelvic floor really tight, short or hypertonic? Or is it just being used that way, i.e. over-recruited? If it is chronically over-recruited (the how), because of a faulty central stability strategy or dysfunctional fitness habits (the why), it may present as “tight” and sensitive (the what). So we need to back-up the truck, provide a new central stability strategy, so the pelvic floor can work in a balanced way with other stabilizers in function and fitness….and then see what is left in terms of true “tightness” that might be handled with direct interventions like self-stretching.

But what about for other populations beyond pelvic health, orthopedics and women’s fitness? How does this play out in pediatric and neurological populations? What can we glean from these populations to help us understand the issues with a new perspective? How can an understanding of the pelvic floor as a component of central stability, postural control and balance shed new light on issues of continence and constipation in pediatric and neurological populations?

I, along with my pediatric teaching partner Shelley Mannell, explore these ideas in this recording. It begins with the question: Can kids have hypertonic pelvic floors? The question came from a pediatric physical therapist at the end of a 2-day online course integrating the pelvic floor into treatment strategies. This was not a pediatric PT who specializes in pelvic health in kids, but a pediatric PT who works with kids with severe motor and developmental challenges (high tone=spasticity). The word hypertonic has a different meaning in that patient population, than it does in the sports/ortho/ women’s health world I tend to operate in.

But where can we meet in the middle? Can we look carefully at the terminology that we are using, what do words like “tight” or “hypertonic”communicate to our patients? I hope this conversation begins one for you!

Coming soon (early Feb), Shelley and I are releasing an online course addressing “The Challenge of Continence in Kids with Challenges”.  Applying these ideas to assist pediatric practitioners gain a new understanding of continence as a component of the same system that promotes postural control, central stability and balance. A neuromuscular approach to empowering pediatric PTs and OTs with tools to address continence and constipation in kids with developmental and motor delays (new tools for typical kids, too). Want to find out more, sign up for my newsletter for launch updates and exclusive launch discounts. Want to learn the whole system for peds populations, check out our full course online.

Coming soon (early Feb), the whole system online for adult populations! Join the newsletter for launch info and exclusive launch discounts!