Today, I want to talk about stress.

It seems in the year of 2021, even our stressors have stressors...and it piles and piles and piles up until there is no more room! But where does all our stress go? How are we coping with everything going on in our world at the moment? Because it seems to me that we do not have the outlets for stress that we used to. It feels harder to get together with friends to talk it out or make a quick weekend getaway to relax. 

Stress can present itself in a lot of different ways. It may mean racing thoughts or never feeling quite settled -- like you just don’t have enough bandwidth for everything going on. Stress can also externalize itself in your body. This may mean having tight muscles that never relax no matter how much you stretch them or stress headaches or not sleeping well. 

Now, our bodies are designed to handle a certain amount of stress. This harkens back to our hunter-gatherer days where “fight or flight” could literally mean the difference between life and death. The “fight or flight” response is an automatic reaction designed to give our muscles more energy, divert blood flow to the heart, make us more alert and sharpen our senses. But the mechanisms in our body designed to help us survive a large animal attack have not kept up with the demands of the modern world. This is because the “fight or flight” response is designed to be short-term. But, we have so many chronic stressors nowadays, our bodies have kicked this response into overdrive. 

You may be familiar with the stress hormone cortisol.

In small doses, cortisol helps us metabolize energy, control blood pressure, and reduce inflammation. But, because we’re in such a chronic state of stress, our bodies are continuously releasing cortisol -- depleting our natural stores. That lack of cortisol leads to increased inflammation, muscle breakdown, pain, fatigue, and mental fog. And, because our bodies are not designed to rest in a stressful state, the loop is constantly reinforced. 

Another place that stress can affect things is in your pelvic floor.

And those muscles deserve a little more credit! The pelvic floor is literally holding *it all* together. The pelvic floor allows us to void and have sex and (as a woman) have a vaginal birth; it helps pad and protect our lower intestines, and is even super important with breathing! Often when we are feeling stressed, our pelvic floor is subtly contracting to help regulate our bodies, particularly in the abdomen, diaphragm, and spine. This means that if we are in a stressful state for a long time, our pelvic floor muscles will remain co-contracted -- and have difficulty relaxing. Many studies have found a connection between stress/anxiety and pelvic floor dysfunction. 

This has a lot of implications for us. A tight pelvic floor may mean we have difficulty with bladder urges or voiding, pain during sex, or even pelvic organ prolapse. But it can also go beyond that. A tight pelvic floor can lead to back and sacroiliac joint (SIJ) pain. It can lead to decreased diaphragm expansion. When we have decreased diaphragm activation, our chest muscles take over -- which can lead to feelings of increased anxiety. 

So what can I do to find out how my body is responding to stress?

There is a simple strategy you can do to assess how your pelvic floor is responding to stress. Lay down on your back with one hand on your chest and the other on your belly. Take a deep breath in and then slowly exhale. The hand on your belly should move in when you inhale and move out when you exhale. Do this a couple of times and then shift your focus down to your pelvic floor. When you exhale, you should feel a slight relaxation of your pelvic floor muscles. It is very subtle and may take a few attempts to sense. If your pelvic floor is unable to relax, it may be “hyperactive.”

And this is where a pelvic floor therapist can help!

Diaphragmatic breathing is also a great coping strategy for stress in general. It is easy, quick and can be done throughout the day whenever you're feeling overwhelmed. Mediation and yoga are also great ways to practice mindfulness, especially when developing that mind-body connection. There are plenty of free apps like Insight Timer and guided meditations on YouTube. 

Sometimes, though these strategies are effective, it may just not feel like enough. Doing a mental health check up with a licensed professional counselor may also be beneficial. 

So...no matter where you are at -- no matter where your pelvic floor is at -- there are a lot of tools available to you. It is easy to feel isolated and lost and like the stress is about to gobble you up. But you are not alone! So find the strategies that work for you to help you manage your stress. And do not be afraid to consult a mental health counselor or a pelvic floor physical therapist. We are here for you!

<3 the Recharged Performance Therapy Team

(321) 802-1630

Sources

https://www.intimina.com/blog/impact-of-stress-on-the-pelvic-floor/

https://n2physicaltherapy.com/b/the-year-2020-how-anxiety-is-affecting-your-pelvic-floor

https://pubmed.ncbi.nlm.nih.gov/29688899/

https://pelvicpainhelp.com/why-stress-triggers-and-perpetuates-pelvic-pain/

https://www.healthdirect.gov.au/the-role-of-cortisol-in-the-body

Levac K. Research on Diaphragmatic Breathing. National Qigong Association Available at: https://www.nqa.org/index.php?option=com_dailyplanetblog&view=entry&year=2019&month=07&day=01&id=35:research-on-diaphragmatic-breathing

Physiopedia. Impact of Stress and Coritsol Levels on Pelvic Pain and Pelvic Stress Reflex Response Available at:  https://www.physio-pedia.com/Impact_of_stress_and_cortisol_levels_on_pelvic_pain_and_pelvic_stress_reflex_response#cite_note-:0-1