Hernias, Abdominal Separation + Pelvic Floor Dysfunction – They’re All Connected!

Postnatal DVD film shootI once met a client who came to my postnatal Pilates classes who had all 3 of these issues:


1) Abdominal separation (3 finger width gap above and below the navel)

2) Pelvic floor weakness (she was wetting herself on impact), and

3) An umbilical hernia (diagnosed by her GP)


I’ve rehabilitated and lessened the symptoms all of these 3 conditions in a lot of women (and men) over the past few years.


And, what’s surprising is: they’re all linked.




Let me explain a little further:



The human body has 3 cavities:


1) thoracic (chest and ribcage area)

2) abdomen

3) pelvic


If you have too much pressure building up in one of those cavities, something eventually is going to give.


Ideally, you’ll want to disperse that pressure out of the wrong cavity safely – that’s relatively easy to do.


But, just so you’re clear on the mechanics of what’s going on, there are only 3 ways that pressure is going places once it’s reached the pressure cooker stage.


That pressure with either go:

Hernia pfd and dr blog title


1) Up

2) Out, and/or

3) Down


x`What?!  So, that pressure rises up and up and up until it disperses:


1) up into the diaphragm (hello hiatus hernia where part of your stomach pushes up into the chest)

2) out through the belly button (hey presto – abdominal separation and/or umbilical hernia)

3) down onto the pelvic floor (that’s pelvic floor dysfunction and/or inguinal/femoral hernia right there)




One of things I teach, recap and educate over and over about continually in my pregnancy and postnatal exercises classes is correct breathing.


The first thing I do when I see a new private client for personal training or is check out their breathing mechanics.


I actually worked with a guy just this week who’s had part of both of his lungs removed due to an infection (I don’t just work with women), but one thing’s for sure – his breathing pattern has been severely compromised since that recent surgery (or was it that his breathing was already compromised beforehand…?).


Let’s read on.


If, when you take a breath in, you feel your chest and/or your belly lift/distend first on that inhalation – that is NOT optimal.


Thoracic breathing, where you fill your lungs up and the rib cage cavity fills first is the most optimal way of getting oxygen into the body.


Considering we take 20-25,000 breaths a day, can you now see how if you continue to breathe into your chest or belly, those breaths are just attributing to the issue, that pressure keeps building up and up, and your clients’ pelvic floor dysfunction, diastasis recti (abdominal separation) and/or hernia is going nowhere?




Three, is a magic number.


I like the number 3, so continuing with this theme, you will most definitely want to ask your clients these 3 questions (I’ve listed my associated answers underneath):


Client Question 1:

Do you sit at a desk all day, working at a computer, writing and/or use equipment, or do something like caring for a newborn that requires you to hold your arms and hands out in front of you all the time?


That equals = rounded shoulders, tight chest and forward head posture which can hamper someone’s body’s ability to breathe optimally – no question.


Client Question 2:

When you sit down do you sit on the back of your pelvis, with your tailbone tucked underneath you?


That can compromise your pelvic floor muscles making them tighter than they should be. 


This is not great if you client is pregnant right now and is at some point soon, going to push a baby out through their vag.


And, if your client’s postnatal and has pelvic floor weaknesses, a tight muscle isn’t able to re-gain strength in it, without first lengthening it.


So, in both cases, what your clients’ pelvic floor muscles need is ‘releasing’.


Client Question 3:

When you catch yourself slumping or slouching, whether it’s seated or standing, do you automatically lift up your chest to accommodate and re-set yourself?


(OR, maybe you as their instructor use cues such as: ‘stand up tall’, ‘lift your chest as though you have a wonderful necklace you want to show off to the world’)


Ok, so this is known as rib thrusting.


You’re physically displacing the base of the front of your rib cage out in front of you.


This leads to upper back pain, a heck of a lot of psoas jacked-up-ness, and an abdominal unit that’s no longer functioning because you keep moving the ribs away from the pelvis, day-in-day-out, lifting that rib cage further away from the pelvis.


How can the core switch on if you keep cueing your clients to move the muscle attachments away from one another…?  It ain’t.


Got it?  Ok, so technically, that was 4 questions, and I promise I have just one more now.


BONUS Question 4:

Can you lessen your clients’ chances of getting abdominal separation, pelvic floor dysfunction or a hernia during pregnancy?


Sure.  Just re-read this article and start applying the tips in your classes now.


I cover all of these issues in the same fun, factual way in my Your Pelvic Matters online teacher training programme 


And there you have it.


Tell me which points you’ll be implementing next week?


What stood out most to you?


Any ‘ah-ha!’ moments?


Comment below and let me know!






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