Abdominal Wall Mechanics and Physical Therapy
Have you noticed an increased bulge in your lower abdomen? You know the one…the lower belly pooch that won’t go away regardless of your eating or exercise habits? You’re not alone! We at Thrive are here to help explain why you’re seeing what you’re seeing, and how we can help.
The lower abdominal belly bulge is common amongst all persons regardless of gender or age, and is a sign of muscle coordination issues in the abdominal wall. For the purposes of this blog, we are going to use toileting mechanics to illuminate common and treatable abdominal muscle dysfunction that contributes to this belly bulge. Ultimately, bowel and bladder habits tell us a lot about pelvic floor muscles, the abdominal wall, and diaphragm function. For example, in order to eliminate liquid or solid waste, there needs to be a slight increase in abdominal pressure prior to evacuation. This pressure signals to the pelvic floor that it should relax and allow the passage of stool from the rectum or urine from the bladder. This cycle should be fluid. Ideally, one experiences a sensation that suggests that the bowel or bladder needs to empty, goes to the toilet, and easily eliminates waste. It’s like turning on and off a faucet, and one should be able to feel fully emptied each time.
For some, this is not what they are experiencing! Many feel like they have to strain to go or are not fully evacuating their bowel or bladder each time. These symptoms often indicate that there is too much downward pressure coming from the abdomen, and this pressure does not allow the pelvic floor to relax. Some abdominal pressure is good, but more is not necessarily better! Those who have a long history of constipation and who develop forceful pushing habits will often disrupt and overstretch the structures that support the organs in the abdomen. Over time, this disruption causes the internal organs to descend. This descent puts strain on the muscles of the pelvic floor and they tighten in response. This makes it harder to relax the muscles for elimination! From an abdominal perspective, this downward pressure contributes to the appearance of a lower belly bulge.
Too much downward abdominal pressure causes dysfunction not just in the bathroom, but also in other facets of life. Poor pressure dynamics can make the pushing phase of child delivery difficult and long. It can also disrupt healthy mechanics in weight lifting practice. For those who breath hold and bear down while lifting, I’m looking at you!! These habits transmit load downward into the pelvic floor and lower abdomen via the obliques, and make it harder for your body to maintain appropriate tension in the lower portion of the abdomen. Over time, the lower abdomen becomes unable to contract properly, and “the bulge” is born. One will often see the tightness in the upper abdomen and the appearance of a little pooch in the lower belly. If this describes you, and/or you notice a line going across your belly button when you contract your abs, it’s a sign your muscles are out of sync.
Ultimately, if you notice difficulty with bowel evacuation, lifting mechanics, or have questions regarding baby delivery strategies, Thrive is here to help! Abdominal pressure mechanics influence many parameters in our life, and a multi-factorial and personalized approach to care is important. You can make a lot of small changes that have large scale impact, and your pelvic floor PT is uniquely positioned to help. If you don’t have any symptoms, but think you might have abdominal control issues, prevention is the best medicine! Book a session today to get a pressure biomechanics assessment and stop problems before they start.
