How Your Posture Can Help (Or Hurt) Your Pelvic Floor Health

November 04, 2020

How are you holding your body right now? 

You’re probably sitting somewhere (in front of a computer or your phone?) and there's a good chance you are slouching or hunched over.

Except NOW there’s a much higher chance that you’re sitting up straight or course-correcting because you got called out 😂.

Well, we’re going to be doing some more of that today, because we’re going to be talking about ✨posture✨. We’ve addressed the connection to pelvic floor muscle activity a bit in past articles but today we’ll be expanding on how your posture affects your pelvic floor (there's more to pelvic floor health than just Kegels...). 

You sit (and stand) for a big fraction of each day, and think nothing of it, but HOW you do it can have a surprisingly large impact on a number of aspects of your body. And especially lately, there’s a good chance you’ve been hearing the term “ergonomics” a bit more than usual, too.

One of the side effects of working from home full-time because of the pandemic is working with a less-than-ergonomically-ideal setup. Most of us weren’t prepared to work from home and didn’t necessarily prioritize an ergonomic home office setup in the face of a, you know, pandemic. So if you’ve spent the past months shifting around on a borrowed dining room chair with a cushion wedged behind your tailbone in an attempt at lumbar support, or lying on your couch with your laptop for long periods of time, you’re not alone.

However, having poor posture isn’t good for your pelvic floor – the group of muscles and ligaments that bears the weight of your internal organs when you sit or stand. Postural factors can impact both the flexibility and strength of your pelvic floor. And the current need to stay at home and knock away at a laptop or relax in front of a TV isn’t doing us any favors.

Good posture strengthens both your pelvic floor and other core muscles, improves flexibility to keep everything inside your abdomen and pelvic region in the right spot, and even helps with breathing. Bad posture, on the other hand, can lead to back pain and pelvic pain and in general is not good for any part of your body.

So today, we’ll be talking about some common posture problems and some easy ways you can fix them.

What are you doing wrong?

Slumping / Slouching

If you ever heard your mom say, “No slouching!” when you were younger, then did we have the same mother?

To be honest, you’ve probably lost the proper posture you had as a kid (if you ever even had it), just because the typical individual in 2020 is probably slumped over something: your laptop, your phone, or your couch as you watch Netflix.

When you sit up straight with good posture, your pelvic floor muscles are getting used even when you’re just sitting there. On the other hand, if you’re sitting with slumped posture, your pelvic floor muscles are just sitting around without really doing much of anything and your pelvic floor can loosen. Slouching in a chair decreases the activity of your transverse abdominal muscles, which help provide bladder control (along with the pelvic floor muscles).

Slouching is also a problem for your pelvic floor (and other parts of your body!) when standing. Men and especially women often tend to suck in their stomachs to appear thinner and taller when they’re standing with slumped postures (beauty standards🙄). However, this posture forces you to breathe less deeply, and this prevents your diaphragm from exercising its full range of motion while you breathe. This is a problem because your diaphragm combines with your pelvic floor to keep the organs, muscles and other body parts in your abdomen in the right places, and when the diaphragm range of motion is limited, your pelvic floor is also missing out on the flexibility and strengthening it should be getting and could become overly tense.

Pelvic Position

The positioning of your pelvis can also contribute to bad posture (often in combination with slouching). When your pelvis is too far forward (also called forward pelvis tilt), it causes your lower back to arch more than it should (this is called swayback). In turn, this has three negative consequences:

1. As with slouching, it constricts the range of motion for your pelvic floor and leaves the corresponding muscles and ligaments weaker and tighter than they should be (i.e. a hypertonic pelvic floor)
2. It strains your hamstrings, which keeps them overly tight
3. It robs your glutes of the opportunity to get the work they should when you’re standing with good posture

Put it all together, and forward pelvis tilt / swayback can exacerbate issues relating to incontinence or pelvic organ prolapse.

This type of posture is quite common and contributing factors can include sitting too much, stretching too little, and not being sufficiently aware of your posture. But, the good news is that there are a number of steps you can take to improve your posture, specifically as it relates to your pelvic floor.

Easy ways to improve your posture immediately

The below are "best practices" and are generally helpful. But particularly for serious problems, see a physical therapist! Whether it's pelvic floor exercises or muscle activation in any other part of your body, physical therapy is the best way to get a totally individualized map to fixing your posture.   

The broadest advice, which underlies the rest, is to be aware! We know it’s hard to stay on top of your posture, especially when you’re paying attention to other things, but give it a shot. You can start by setting an alarm on your phone as a quick, periodic reminder -- this is admittedly a bit annoying and probably not a long term solution but it can help you get in the habit of checking in with your body and your posture. And don’t be too hard on yourself; building better posture habits is a long-term play and there will be times for everyone (lots of times…) when you forget and find yourself doing something you meant to avoid. But that’s OK. Just keep at it and you will find that you are making progress sooner than you think.

Sitting

Sitting posture is important. Some tips are below:

• Pay attention! Try to check in with yourself and how you’re sitting periodically.
• Choose a seat that promotes good posture and doesn’t prevent you from following the other suggestions below. Your knees should be at the same level as your hips or lower.
• Keep your feet on the floor and place your ankles directly in front of / aligned with your knees. Avoid tilting your knees in or out.
• Try not to be continually tense. In particular, try to keep your neck and shoulders relaxed.
• Use a low back pillow or support if you need to.
• Avoid crossing your legs, either at your knees (one ankle up on the other knee) or at the ankles with both feet on the ground.
• Lastly, don’t sit for too long without a break. Taking a minute every so often to get up, stretch, walk around, etc will help with your posture and beyond.

Standing

Standing posture is important too:

• As with sitting, pay attention! Try to check in with yourself and how you’re standing periodically.
• Keep your weight balanced, both from side to side and from front to back. Your weight should mostly be on the balls of your feet.
• Don’t lock your knees, and keep your feet between hip- and shoulder-width apart.
• Don’t jut out your hip to either side (typically this is done while you’re keeping most or all of your weight on the foot towards the side your hip is jutting out).
• Avoid letting your shoulders roll forward too much so you’re hunched over. But at the same time, don’t exaggerate the extent that you pull back your shoulders or straighten your back. You (probably) don’t have a drill sergeant yelling at you; don’t act like it.
• Also as with sitting, try not to be continually tense. In particular your shoulders and neck should feel (and look) relaxed.
• Pay attention to the position of your head -- don’t crane forward too much. Your earlobes should be aligned with your shoulders.

Stretch and Stay Loose

Having healthy muscles is not just about having strong muscles. If a muscle (any muscle) can’t relax or lengthen properly, it can’t actuate or contract properly.

That is especially true for the pelvic floor muscles and other abdominal muscles, like the glutes, that interact with your pelvic floor. When your pelvic floor is too tight (you may have seen this being called high tone / overactive / hypertonic), that can cause a number of problems including pain with sex or bladder control issues. Bad posture can contribute to muscles in your pelvic region and core that are too tight. Conversely, trying to make sure you don’t keep your muscles tense or actively stretching regularly can help make sure your core muscles can extend and contract in the way they need to so they can do their jobs. 

The Takeaway

Bad posture is bad. It can contribute to or exacerbate pelvic floor dysfunction as well as lower back or pelvic pain (among other potential consequences). And the vast majority of people could stand to improve theirs. But it can usually be improved by adopting good habits for sitting, standing and resting positions, as well as stretching, strengthening, and developing core strength. So, for your pelvic health and many other parts of your body, channel your inner parent and straighten up!