Understanding the Reflexive Core

The Reflexive Core is comprised of the respiratory diaphragm, deep abdominal muscles
and the pelvic muscles. This is a pressurized system between all of these muscles (think
of a full balloon). The respiratory diaphragm and pelvic muscles are the exact inverse of
each other, so these muscles make up the top and bottom of the balloon. The
abdominals start at the front, wrap around your sides and connect in your back so think
of them as 360 degrees around the center of the balloon.
 How it works:

Some functional anatomy, here it goes! The diaphragm, abs and pelvic muscles are
connected. These muscles have to coordinate and communicate with each other in order
for the reflexive core system to function appropriately. See this video for what actually
happens every time we inhale and exhale.

Inhalation: diaphragm lowers, pelvic muscles yield to the pressure change, abs open
and release.

Exhalation: diaphragm elevates (recoils), pelvic muscles recoil from elongated

position, abs engage.

This is a balanced system and what it should look/feel like in every person when we
breath correctly

This system should activate reflexively (ie pelvic muscles tighten, abs engage) with
movement or any time there is increased pressure through our center (think: moving sit
to stand, bending to lift weights/children, coughing, sneezing, running, jumping, etc)

Sometimes, there is a fault SOMEWHERE in this system. It could be due to:

Diastasis Recti-a separation of the ab muscles. Think about a slit down the center of the
balloon

C-section scarring or perineal scar-This can inhibit the elasticity/stretch of parts of

the balloon

Weak pelvic muscles-not enough support/recruitment at the bottom of balloon to

respond to changes in pressure inside the balloon

Pelvic muscles that are too tight-what if the bottom of the balloon was so taught that
you couldnt breath into it and get it to open and expand? Due to its decrease in
elasticity, It certainly cant absorb any pressure/force. Tight pelvic muscles=
WEAKNESS.
 Over-gripped abdominals-Think about just squeezing the center of the balloon. Where
does the pressure go? This makes for very unhappy and compressed/descended pelvic
organs.

Decreased awareness of alignment/posture-the lean back & butt tuck posture or

slumped posture make for a balloon that isnt stacked. These muscles cant
communicate!

Poor body mechanics/exercise techniques-breath holding, bending incorrectly, or

exercise techniques that isolate only 1 part of the core system. What if only center of the
balloon gets exercised?

Hormonal changes that occur throughout the lifespan

A fault somewhere in the system leads to SYMPTOMS that may include:

urinary incontinence-ANY involuntary loss of urine

urinary urgency-intense urge to urinate, with or without urine loss

urinary frequency-more than 7x/day, 0-1x/night

pelvic organ prolapse-heaviness/pressure into the pelvis or vagina

bowel incontinence, urgency, frequency, constipation

pain with intercourse, pelvic pain, low back pain, hip pain, perineal pain, c-section
pain

What does this mean?

Correct the faults and decrease/eliminate the symptoms.

Note: This is why performing Kegels or traditional abdominal exercises may not be
effective or allow you to meet your goals. One must consider retraining the entire core
system and addressing all faults in order to be most effective for optimizing pelvic
health.
 So, immediate actions:

Watch your standing and sitting alignment. The system has to stack up

Breathe correctly. Breathing with your diaphragm (360 deg rib cage expansion)
decreases pressure on the pelvic floor and abs and brings diastasis separation closer
together

Exhale to activate the reflexive core when lifting, standing up from a squat, etc

Be mindful of exercise techniques that could be contributing to faults and symptoms

(This could be a entire other blog post!)

Seek help from a specialized PT, of course!

How will Physical Therapy help?

We have highly specialized training and we understand the pregnant and highly
complex postpartum body in depth. However, we do have training to support women
throughout the entire lifespan, even through menopause and beyond!

Proper evaluation is key. We will look for any and all faults and customize womens
physical therapy experience

Manual therapy. We will used skilled touch to address internal and external soft tissue
concerns. Trigger points, fascial restrictions, nerve irritations, poor musculoskeletal
alignment

Education. This is where we make behavioral, lifestyle, postural, ergonomic, body

mechanics changes needed for women to succeed in healing her condition/concern

Exercise. No more Kegels please! I could talk about this forever. We guide women on
re-training their entire system in a very functional way (ie how to bend, lift/carry babies,
run, weight lift without losing urine, etc)

Who can this approach help?

 moms (pregnant or postpartum)

female athletes

women in menopause

any female experiencing pain or inability to wear tampons, pain or inability to undergo
a gynecological exam or concerns with sexual health

The good news...symptoms and conditions are highly treatable, dont have to be
endured, and its never too late to seek care!

If you cannot access a Physical Therapist, or need a home program to compliment your
physical therapy plan of care, I highly recommend Restore Your Core ( at any point
postpartum) and One Strong Mama(prenatal) because they address and incorporate all
the important concepts discussed in the blog. Both being a very safe and effective
approach to optimizing your core, pelvic, and whole body health! (FYI: I am an affiliate
of both programs and I have been through the content extensively prior to becoming an
affiliate!)

All female bodies are unique. If you would like to talk about how the above relates to
your specific condition, feel free to contact me on FB. If you'd like to read more, you
can visit our blog here.