Foot to Pelvic Floor ConnectionJul 02, 2023
Believe it or not, the function of your foot can have a lot to do with your pelvic floor and the muscles that stabilize the hips. If you have a foot that lacks the ability to lengthen and load properly into the ground or lift and spring to push you forward and you are constantly struggling with hip irritation, SI joint problems, pelvic floor tension, prolapse, incontinence, etc., and the strategies you are using in those particular areas are not working, then it might be time to look at your feet.
There are two things I believe can make a massive difference in improving all of the issues I mentioned above:
1. Learning to relax the posterior pelvic floor so the pelvic bones and the sacrum can wiggle, and the sit bones can act like heel bones and tip forward and back. This takes an incredible amount of strain and pressure off of the hips and pelvis, and allows the pelvic floor to be more dynamic. If you want to learn more about this, check out this blog post, but don't forget to come back and check the feet as well.
2. Learning to relax the arch of the foot so we can also spring the arch back up. When the foot is responsive to the ground then other areas of the body don't have to work as hard or overly tense to try to provide support, and the next line of defense is usually the hips and pelvis.
(Side note: If you can't relax either of these areas, you may notice some unhappy knees who are stuck in the middle.)
Here are a couple of scenarios that are fairly common that you might recognize in your own body:
1. Feet that are overly rigid / high arches, that don't seem to drop down.
Common ways people will address this is by stretching or rolling the bottom of the foot with a hard ball but this doesn't get to the root of the problem, because it is NOT just a tissue problem, but a joint problem that affects the entire kinetic chain, and you have to learn how to allow the bones of the foot and ankle to tip forward, glide back, widen and spread into the floor.
Check out the video above so you can see what that looks like.
2. Feet that are super flat and often times may be turned out.
As the ankle begins to drop inward, the arch begins to flatten. This makes it very heard to spring back up to push ourselves side to side in gait and to control the initial contact when we heel strike. In both toe-off and heels strike, we need the arch to come up.
In both cases we need to retrain the ability to pronate and supinate and often times, even in the flat foot situation we need to create more length to encourage the tissues to spring back up. Here is a quick video you can try for your own feet.
So how does this affect the pelvic floor?
Let's start with the overly rigid arch and a couple of compensations I see often.
1. When the foot can't spread and widen then it can't decelerate effectively as we go through the gait cycle. As we go from heel strike to mid stance this deceleration is really important.
It allows us to better manage gravity and forces into the ground so we feel less "shock" in the rest of the body. When that shock absorber is not working well we will feel more shock up the chain and the pelvic floor is an area where many people will grip, along with the abdominals to provide a sense of safety. When the pelvic floor is constantly tense and our abs are gripping it can lead to pelvic floor symptoms like leaking, prolapse, etc. as well as faulty movement patterns. Just try to run, touch your toes, do a squat while you are clenching your pelvic floor. It ain't gonna happen!
2. When the foot is in a more supinated / inverted shape, the entire kinetic chain is spinning out. The tibia, femur and hip are in a more externally rotated position. This shortens or creates a lot of tension in the muscles on the back of the pelvis and hip. When these muscles become shortened it creates a lot of pressure pushing forward into the front of the pelvic floor and decreases the space in the back of the pelvic floor for the organs to rest comfortably in the pelvic bowl. This affects multiple systems of the body and interrupts our optimal breathing pattern because the coordination between the thoracic and pelvic diaphragm is not optimized.
Let's talk about how a flat foot affects the pelvic floor.
1. In heel strike and toe off, see picture above, we need to be able to create a supinated shape of the foot to spring off the ground with ease. If we can't achieve this position because the tissues are over lengthened and no longer responsive, it becomes a bit like walking in quick sand. We have less "pep in our step". From a pelvic floor standpoint this makes it harder to propel our organs and guts up against gravity so we may find ourselves unable to contract effectively or constantly working very hard with our pelvic floor to try to compensate for the feet.
2. When the foot goes into a more "pronated" or everted shape this creates a ripple affect up the chain as the tibia, femur, hip may rest in a more internally rotated position. In this position we may lose the ability to contract the glutes effectively making stability at the hip and pelvis a bit more challenging. As a secondary compensation to try to alter this, I will often see the feet start to turn out in an effort to facilitate the deep hip external rotators to help out, but this never feels good and can end up affecting the ability of the pelvic floor to function optimally.
What is the solution?
You can start by learning how to release the back of the pelvis and getting the foot to move better but a full body approach is really the best approach.
If you are interested in learning more and really diving into what your body needs for the foot and how to optimize your strength training and exercise selection to take a more holistic approach then I highly recommend you sign up for the 4 Week Functional Foot Course with Rali Malcheva. You can find out more details here.
Rali also does one on one sessions if you want a very personalized approach. You can learn more about those here.