2020 is almost over and thank God!  We see a light at the end of the tunnel and are hoping it is not the next train barreling toward us as we travel what seems to be an endless tunnel with one crisis after another; COVID, BLM, the election, and a number of other stressors to deal with in our lives as they dramatically change from what we use to consider our “normal” lives. 

Our stress reaction has evolved to surge in the moment.  We are presented with a threat, real or imagined does not matter.  Our very fast subconscious reptilian brain sees a threat and sounds the alarm to get ready for fight or flight causing our focal folds, diaphragm, and pelvic floor muscles to tighten to give us a more rigid core so we can do something with our arms and/or our legs.  This is perfectly natural and is why pain takes our breath away just as much as a scary movie.  Our conscious higher brain, the slow one, then has to decide to 1) fight, 2) flight, or 3) stand down.  Most times in today’s world we can use option 3 of standing down and relaxing back to where we were before the perceived threat. 

But this hasn’t happened this year.  We have been under what seems to be under perpetual attach from more and more sides and our stress reaction has not had a chance to get back to normal and instead keeps escalating to higher and higher levels and more and more people are suffering in silence and when they are breaking their silence it is with a burst of emotion on social media, at their friends and families, and often times results in the prescribing of a medication.  I have also joined the ranks of people who are new to psychotropics and am now on a low dose of Lexapro, which has been helping while I ramp up my other self-care routines such as eating better and getting more physical activity plus a “social media diet” where I limit TV and FB to certain amount of time every day. 

Aside from people feeling more agitated and lashing out with emotion or feeling depressed and unable to engage the world anymore there are a few other consequences of chronic stress that is showing up in my clinic and that is pelvic floor muscle dysfunctions manifesting in surges in prostatitis, erectile dysfunction, painful intercourse (vaginally and rectally), constipation, and general pelvic pain just to name a few.  This makes perfect sense to me because when we dive deeper into the role of the pelvic floor muscles they not only help us make our core more rigid for fight or flight but they also create our urinary and anal sphincters as well as the vaginal opening.  These muscles are designed and happiest when they are a nice round shape which occurs when the pelvic floor muscles are gently slung from front to back like a hammock.  When we need to tighten one of our openings the pelvic floor muscles contract and the whole system lifts up a little allowing us continence and sexual function.  When we are ready to void the pelvic floor muscles relax and bulge down a bit allowing the sphincters to open more fully.  If stress is keeping this system engaged in fight/flight mode and they are now staying “high and tight” then they are no longer going to work properly which can lead to pain as well as poor control of bladder, bowel and the sexual organs.  Think of it this way.  We lift a weight and then we put it down.  What happens to our arm muscles when we try to hold that weight in one position for any length of time?  The longer we are holding it the more unhappy those muscles will be, and our first strategy will be to shift the weight to other muscles in order to give the one doing the work a rest.  Eventually we have to put the weight down. 

If you are having difficulty putting your “weight” down and are having any pelvic floor muscle problems manifesting as urinary, bowel, hip or back pains or sexual dysfunctions then I encourage you to reach out to me, let’s talk and see how pelvic physical therapy can help you.  This is even more imperative if you have a history of abuse, sexual or otherwise.  You can call/text me at 443-742-0019. 

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