The importance of intimacy….

This blog is a long time coming.  It is a sensitive subject and one to likely make some if not most people a little uncomfortable.  However, I think I get more personal messages and private emails on this subject than any other subject related to core rehabilitation. Most people do not want to post a Facebook question about their personal sex life, so in respect of privacy I have written a short but hopefully helpful blog to answer as many of the questions as I can.

Let’s be clear, I am not a specialist in this area.  Nor do I feel like I am a specialist in pelvic floor (although it is very intimately connected to the core so I have learned quite a bit over the years). Bottom line- sex is important.  Intimacy is essential in a healthy marriage.  Unfortunately, it can get a bit lost in shuffle in the early years with babies and toddlers.  Even in that season, we encourage you to remember that sexual intimacy is the key ingredient that sets your marriage apart from a partnership or friendship.  Without that key ingredient, we can lose sight of our spouse and become disconnected and too independent. 

Eventually, (hopefully) our children will become productive adults and leave our homes to have their own lives and families and we will have our marriage.  You cannot ignore the intimacy in your marriage for 18 years and have it be there when the kids are gone.  (I know that seems like an extreme statement but it happens- too often.)

In Core Rehabilitation, we educate  clients about all the activities and positions that cause damage and can continue to damage  the connective tissue of the abdominal wall.  We instruct to avoid all crunches and crunch-like movements.  We help people with alignment and proper activation of the internal core muscles.  We instruct against bulging the abdominal wall out, holding the breath, flaring the ribs and minimize plank type positions when the connective tissue is thin and vulnerable.  We know there is no way to eliminate all of these movements but our goal is to increase awareness, and minimize as much of the stress these movements have on the connective tissue as possible to allow it to heal and restructure.

So as intimacy can create some of these vulnerable positions, inevitably we receive many question and concerns about sex. 

Some examples…

“What positions are ok?”

“I noticed my stomach crunches during sex and the diastasis bulges.”

“During orgasm, there is no way I can control not bulging out my tummy.”

“To avoid damage during this healing process, I told my husband we need to be on a sex fast.”

And many more even more personal and detailed questions.  I really did not think I would ever write a blog about this but I also realize this is important.  I feel blessed that people feel comfortable enough to ask such vulnerable and personal questions.  I feel it is important to address it because sex is a normal and healthy part of our married lives.

My answers are simple.  Sex is important.  Use common sense.  If something, anything, causes pain then you need to modify what you are doing. 

When we talk about looking at your lifestyle postures and positions and movement patterns, we want you to focus first on what consumes most of your day.  Sitting, standing, lifting, exercises, etc.  Unless you are on your honeymoon, sex is likely not consuming most of your day.  The small amount of time you are in these positions and the even smaller amount of time that your body is “out of your control” is very minimal and likely is not the ultimate cause of your core issues.  J

That being said, I completely understand that for some (likely a small percentage) of our clients that have very severe diastasis and vulnerable abdominal walls it can be very difficult to knowingly put yourself in these situations.

So here are my second set of simple answers.  In most cases, I feel you should be free to take your splint off for sex.  If this feels too vulnerable for you, it is possible to wear the splint and still enjoy yourself.  Do your best to avoid extreme positions (no elaboration here- you will have to use your imagination for what I as a PT talking about neutral alignment might think is an extreme position).  If you can, exhale and engage your core during the event- sometimes that actually helps ‘things’.  And last, I encourage you and your spouse to experiment with positions that may put you in a better position to keep your core safe (again no elaboration here- this is your personal experimentation time). J

Hopefully, that tastefully answers the most common core related intimacy questions.  If you are having further concerns or pelvic floor issues that are contributing, I highly recommend a Skype session with myself or our other PT Gillian who specializes more in this area.  We would love to help you. 

Sex is important, you do not need to eliminate it in order to completely heal your core. So now let yourself be free of fear and enjoy your spouse.