By Allison Danish, MPH

The holidays can be stressful. With all the demands of traveling, cooking, gift-buying, and bracing yourself for seeing relatives you don’t see eye-to-eye with—it doesn’t always feel like the most wonderful time of the year. Not to mention, the holidays can feel Bridget Jones’s Diary, reheated Chinese takeout, capital “L” lonely sometimes. 

A 2006 study found 38% of Americans felt more stressed out during the holidays, whereas only 8% experienced less stress. But what does that mean for our pelvic floors and how can we fit a little pelvic relaxation into our busy schedules?

What is stress anyway?

Let’s talk about stress for a minute! From a purely biological standpoint, stress is your body’s response when something challenging or scary happens. Your body makes epinephrine, norepinephrine, and cortisol—these hormones make you sweaty, increase blood flow to your muscles, and increase your heart rate. This is commonly known as fight-or-flight. Now here’s where things get a bit complicated: while we generally think of stress as a bad thing, that’s not necessarily true. 

Researchers these days posit that stress falls into three main categories: good stress, tolerable stress, and toxic stress. Let’s explore some examples of each:

• Good Stress: You’re at an Applebee’s and you signed up for a karaoke slot—understandably, you’re a little nervous. When it’s your time to shine, boy do you shine. Not only did you have fun, you’re Whitney Houston reincarnated. This is good stress because you’ve taken a risk/done something challenging, and you were rewarded with a positive outcome. Yay!
• Tolerable Stress: Uh oh! You broke your leg. Don’t ask how. But you strongly believe everything will be okay, you have a great doctor, you’re not struggling to cover your medical bills, your family and friends have been super supportive, and you’ve got a really cool knee scooter. Honestly, you’re walking faster than ever. This stress is tolerable because you have support systems in place that make you feel safe and somewhat in control of the situation. 
• Toxic Stress: Toxic stress occurs when either: 1) you had adverse childhood experiences that now leave you with a less robust ability to cope when “tolerable” stressors occur; 2) you have a limited support system so it’s difficult to handle tolerable stress; and/or 3) you’re experiencing severe, repeated, or prolonged stress events.

To complicate matters a bit more, a lot of us these days are under chronic stress—and to some extent we have the power to ameliorate the effects with healthy behaviors—like getting enough sleep, exercising, and eating fruits and veggies. Buuuuuut just getting enough sleep isn’t the perfect solution and “being healthy” all the time is near impossible. So what happens to our pelvic floors where we’re experiencing chronic or toxic stress?

How does stress affect the pelvic floor muscles?

Let’s talk more science! When our fight-or-flight response is activated in times of stress, two very important things happen: 1) Our blood vessels constrict to get more blood (and therefore oxygen and nutrients) to our muscles so we can fight or flee; and 2) Our muscles tense up to guard against pain and injury.

The pelvic floor muscles are no different! When we’re constantly holding tension in these muscles, a couple of things can develop:

• Trigger points—these are painful “knots” in the muscle
• Overactive pelvic floor muscles—this means your pelvic floor muscles are overactive, tight, and/or don’t have the range of motion they should

Aaaaand when you’ve got trigger points and/or hypertonic pelvic floor muscles, that might start showing up in your life as: 

• Bathroom troubles: IBS, diarrhea, constipation, incontinence
• Bedroom troubles: pain during sex, erectile dysfunction, premature/painful ejaculation
• Pain: chronic pelvic pain, interstitial cystitis/painful bladder syndrome, chronic prostatitis

What exercises can you do at home for your stressed-out pelvic floor?

First thing’s first—if you’re experiencing those symptoms above, we always recommend going to see a pelvic specialist. In the meantime, these simple chair stretches from Dr. Sherine Aubert, DPT are a great place to start:

Ballerina Twist

For spine mobility

First, twist to one side as you sit in your chair. Keep one hand holding the edge or arm of your chair while you hold the other above your head—kind of like a ballerina. Hold this for 3-5 belly breaths and then switch sides.

The Lean

To open up quadratus lumborum and the obliques 

Begin by sitting your chair with your legs in a neutral, forward position. Drop one hand to your side as you lean to one side, dropping your head to the side and holding your arm above your head (again, kind of like a ballerina). For this one, be sure your sitz bones (those are your butt bones) are both on the chair and make sure your ribs are stacked over your pelvis. We’re going for a nice stretch here—no worries if you don’t feel like you’re leaning that far over. Hold this again for 3-5 belly breaths and then switch sides.

The Sleepy Monk

For mobility between scapulae and the thoracic spine

For this one we’re going to do the unthinkable—go ahead and slump over in your chair. Yeah, that’s right. Don’t even try to sit up straight. Cross your wrists over each other and grab the underside of your chair. Reeeeally round your upper back here so you feel a stretch between your shoulder blades (or your scapulae, if you’re feeling fancy). Drop your head real lazy-like. If it feels right, lean slowly from side to side.

Fists of Fury

To decompress the pelvic floor muscles

Sitting up straight this time, press your fists into your chair on either side of your butt until you lift off the chair a little. You should feel some lengthening in your spine as you do this. You can play around with this one as well by rocking your hips left to right and tilting your pelvis front and back. 

The Bend (And Don’t Snap)

To mechanically stretch the pelvic floor

Unfortunately we have to stand up for this one. Once you’re standing, place your hands on your desk/table and stand with your legs more than hip-width apart. Sit back into your hips, and allow your pelvis to rock back. Feel your sitz (butt) bones spread and enjoy the nice stretch from your hamstrings to your calves.