Understanding Your Core – Article for Ostomates Magazine 2022

Did you know your abdomen has four layers of abdominal muscle? And that the surface layer, or “six-pack” muscle, runs perpendicular to the deepest layer? I find this fascinating, that a muscle in the same group, and sharing the same location, can run in a completely different direction. This is, of course, because they have different functions. The four layers of abdominal muscle form part of our wondrous myofascial system. Our abdominal muscles synchronise with our diaphragm (breathing) muscle and pelvic floor muscles to form an internal system of support that is often referred to as our “core”. Our core serves an important purpose in maintaining and distributing pressure as we go about everyday life. We rely on this system of connective tissue to move, stand, sit upright, sleep and even breathe. In fact, this interconnecting network of tissues is the reason that when we stand up, our internal organs don’t just drop into the base of our pelvis.

Our internal organs, including the bladder and bowel, are held in place by ligaments and fascia, supported and mobilised by muscles. Our myofascial system is vital to our daily lives and integrates with our skeletal (bones), visceral (organs), gastrointestinal, neural (nerves) and emotional systems to function well. Our myofascial system is disrupted by surgery, as fascia and muscles are damaged during the surgery process – this is especially so in the case of stoma formation.

Parastomal hernia occurs in up to 50% of people after stoma formation, and refers to a bulging of the abdominal organs through the abdominal wall. Parastomal hernia arises due to weakness in the myofascial system i.e. muscles and fascia, caused by surgery. Sometimes, there is significant weakness in this area prior to surgery, due to factors such as pregnancy, previous surgery, obesity, sedentary behaviours, connective tissue type and/or recurrent straining (eg heavy lifting, coughing, constipation, straining to pass urine). Whilst it is best to be proactive and assess these factors with a pelvic health physiotherapist prior to surgery, for many ostomates it is not until after a hernia has occurred, that the need for physiotherapy assessment becomes apparent.

Pelvic health physiotherapists are specialised physiotherapists who have undertaken postgraduate training in issues specific to women’s, men’s and children’s pelvic health. We have expertise in assessing and managing problems related to bladder and bowel function, pelvic floor muscle weakness, pelvic and abdominal pain, and “core” rehabilitation. At Consano Pelvic Health Centre, our pelvic health physiotherapists investigate the systems within the body that may be contributing to the presenting problem, whether it is parastomal hernia, pelvic organ prolapse, constipation, soiling, urinary incontinence, abdominal weakness or sexual pain. We take time to listen and approach management holistically. We are very active in helping the body to heal itself. Our unique, specialty clinic caters for private patients seeking one to one consultations and/or exercise rehabilitation.

For more information or to make an appointment, please call Consano Pelvic Health Centre on 92745666 or email info@consano.com.au