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February 25, 2018

Pelvic Core Neuromuscular System (PCNS) Dysfunction

by Kaleena Ruskin

At Gymnazo, we treat and handle a lot of movement dysfunctions that fly under the radar. As a pioneer in the emerging Movement Industry (bridging the gap between Physical Therapy and Fitness), we don’t just want our members to improve their fitness, we want them to live pain free lives while enjoying a socially active lifestyle! So we try to continually raise the bar on our education and understanding of every musculo-skeletal dysfunction that our members could possibly have. We are motivated to stay on the cutting edge of movement science so that we can better treat anyone who walks through our doors.

I want to talk about one of the most common dysfunctions among women, that we’ve recently become more aware of called Pelvic Core Neuromuscular System (PCNS) Dysfunction. What on earth is the PCNS? Well, it’s composed of four complex body systems:

  1. Respiratory Diaphragm
  2. Abdominal Muscles
  3. The Back and Hip Muscles
  4. The Pelvic Floor Muscles

This system of muscles work together to, essentially, hold all the organs in your abdomen and pelvic bowl where they’re supposed to be. It is also critical to neuromuscular support, bladder and bowel control, sexual function, and core mobility/stability.  When a woman experience PCNS Dysfunction, it can present with symptoms such as:

  • leaking urine with coughing/sneezing/laughing/jumping/running
  • Strong urge to go to the bathroom often during the day; more than 8 times in 24 hours.
  • Waking up more than 1x/night to use the bathroom
  • Pelvic/groin pain
  • Pain with sexual activity
  • Muscle spasms in pelvis
  • Pelvic pain

One of the most common causes of PCNS Dysfunction is childbirth. The more children you have, the higher likelihood of developing PCNS Dysfunction. Too many moms in our community are living with pain or inconveniences that they believe are just a normal consequence of having a baby. I’ve been informed, on many occasions, that I can look forward to peeing my pants when *insert any activity* from the time I have kids until I die. That’s gunna be a “No” from me. I’m not buying it! As someone who continually wants to help our athletes reach new heights in their fitness, having a roadblock like this infuriates me. I’m hoping to bring to light that discomfort and pain should not be considered “normal” and that there are ways to relieve symptoms and restore function to the PCNS.

Another big hormonal change that our bodies go through that is another common cause of PCNS Dysfunction is menopause. We see a lot of women that are perimenopausal, menopausal, and postmenopausal experiencing the same symptoms.

If you identify with any of the above symptoms, you’re not alone! Some fun research:

  • After delivery, 35% of new moms experience stress urinary incontinence (leaking urine when abdominal pressure increases; running, jumping, sneezing, etc).
  • More than 50% of women have a diastasis rectus abdominis (splitting of the abdominal wall, before, during, or after pregnancy)
  • 20% of first time moms show severe pelvic floor muscle injury after a normal pregnancy/delivery
  • 25% of women with pregnancy related pelvic girdle pain during pregnancy remain in pain after delivery.

Below is a list of everything that can happen for women post-delivery if they are passive in their recovery:

  • Pain and discomfort in the pelvic floor
  • Back/ Knee/ Hip pain and other body aches
  • Incontinence
  • Avoidance of sexual activity (due to pain)
  • Discomfort with exercise
  • “Pooching” or “Doming” of the stomach
  • Loss of a functional tensional network in the core (Diastasis Recti). This is a separation of the rectus abdominis muscles. The split occurs at the meeting point of all the muscle groups of the abdominis (Transversalis, internal and external obliques, and the Rectus Abdominis). So essentially, they all are compromised. This lack of protection and stability affects the whole body both aesthetically and functionally

Sadly, in our industry there is a massive gap in understanding of how to help moms of any age rebuild their bodies’ function. Often we see trainers target sit-ups or traditional abdominal muscle building exercises as if there are not structural differences between men and women. For one, our pelvis greatly differ than the male pelvis. We have a wider, shallower, and anteriorly rotated pelvis designed for…wait for it….childbirth. This means that there are critical differences between the Male and Female Chain Reaction. This dysfunction hides behind the common title of “pelvic core issues” but most practitioners and trainers are ignorant to what is ultimately impacting women. It’s not just the muscle and connective tissues that need restoration in the pelvic girdle, but the nerves too! Common exercises administered to only focus on the tissues without retraining the nervous system is equivalent to training for the run and bike legs of a triathlon race but not the swimming leg. You’re not going to get the full result by ignoring a core component of the dysfunction.

Thanks to the incredible educator and Female PCNS specialist Christina Christie, I recently completed a course that focuses entirely on Female Chain Reaction through the Gray Institute. Since diving into the content and science, it’s easy to see why this type of dysfunction is not being trained correctly in our industry. What makes PCNS so tough to treat without an Applied Functional Science background is that it incorporates so much more than just the core. Unless trainers have a comprehensive understanding of the biomechanics of the body, and how each of our moving parts interacts with the other, it is impossible to treat PCNS Dysfunction properly.

This dysfunction wreaks havoc with our female members’ bodies and daily lives. They also may never be fully restored to that pre-baby life without proper techniques and training. As someone who has dedicated my professional career to helping our members maximize their body’s function, this topic and the scary statistics that come with it, motivate me to be part of the solution. There are countless women I know and train here at Gymnazo that could benefit from PCNS rehabilitation. If you’re experiencing PCNS Dysfunction and want to do something about it, we do, too.

Do you suffer from PCNS dysfunction? Take our quiz to evaluate your risk.

For more information about our Female Core Conversion sessions click here.

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