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The Transverse Abdominus Muscle: Stop Peeing Your Pants

Updated: Jun 5

In the clinic setting, I often see moms struggling with issues of urinary leakage with exercise. These moms are strong in all of their large muscle groups and are participating in high level exercise such as CrossFit or Barre. Unfortunately, they’re limited in participating because of leakage.


During this post, we’re going to dive into the “missing link” that’s holding these ladies back.



The Deep Core

The deepest layer of our core muscles is known as the transverse abdominus (or TA muscle). This muscle is attached to many areas of the core system including the ribs, diaphragm, pelvis and pelvic floor muscles. The diaphragm and pelvic floor make the top and bottom borders, with the rest of the structures sitting between them. These structures work together to create a “canister system” of sorts that helps to manage pressure within our bodies, especially during exertion. 


Pressure management within this system is important as well during exercise activities. If the transverse abdominus is not properly engaged during a lifting or jumping activity, the resulting pressure is dispersed downward putting excess pressure on the pelvic floor. This is what can lead to urinary leakage. This same issue can also occur during coughing and sneezing, normal activities outside of exercise. 


In that same token, pressure within the canister system can also disperse outward. If there is muscle weakness of the abdominals, pressure can push anteriorly resulting in another condition termed diastasis recti.

Muscular Endurance of the Core

Most, if not all core musculature functions at its best with adequate muscle endurance. The transverse abdominus muscle, as well as the muscles of the pelvic floor and diaphragm must be trained in the proper manner to achieve optimal function. Before working to gain coordination of this muscle, I often focus on a foundational concept with patients in the clinic - breathing. 


Breathwork is foundational to most, if not all dysfunctions I see in the clinic setting. If you’d like to learn more about the importance of proper breath mechanics, read the blog post here.

Training the Deep Core

Now that you understand the importance of the transverse abdominus muscle and its role in preventing urinary leakage, we’re going to talk through how to properly engage this muscle. 


For starters, we want to engage this muscle from the bottom up rather than top down. If we choose to do the opposite, engaging it from the top down, it is going to result in downward pressure further contributing to our issues with urinary leakage. Engaging the muscle from the bottom up supports upward pressure dispersion, helping you to improve breath control during exhalation.

Starting with the Basics

To start with, a key concept to remember is that the transverse abdominus has to engage with a “forced exhale,'' or forced breath outward. This takes us back once again to proper breath mechanics, focusing on inhalation and exhalation. Diaphragmatic breathing with a forced exhale is just one way that I help clients to retrain their deep core muscles and start to make brain to body connection.


Once a person has mastered diaphragmatic breathing, the next step is to work on training the transverse abdominus muscle to engage from the bottom up, as we talked about before, during the forced exhale of breathing. Here are the steps I recommend:

  • Lay on your back

  • Take a deep breath in, expanding your ribs outward

  • On exhale, visualize the air leaving from the bottom of your core moving up

  • During the last bit of breathing out, feel your deep core muscles engage


As you become more successful with deep core activation on your back, you can transition to trying this same breathing technique but in different positions. These positions could include sidelying, sitting upright, standing, on hands and knees, etc. Each position helps to further train your transverse abdominus to properly coordinate its activation no matter what position you’re in.

Moving Towards Strengthening 

After you have become confident with transverse abdominus activation, especially in various positions, it is possible to start strengthening this muscle. To do this, just like with any other muscle, placing load on it via resistance of duration of activation starts to challenge this muscle. 


Start by engaging the muscle during walking activities and gently progress to transitional movements such as getting off the floor, getting in or out of your car, or rolling over in bed. These functional movements focusing on deep core stabilization can be especially helpful for pregnant and postpartum women. Practicing transverse abdominus activation with lifting your baby, loading the car seat, or getting out of the bathtub can reduce the risk of urinary incontinence, diastasis recti, hernia, or pelvic prolapse. You can learn more about the functional core of the postpartum body in the blog post here.

Conclusion

Learning to properly engage the transverse abdominus muscle during simple daily activities all the way up to power movements involved in CrossFit will significantly help women everywhere reduce their risk of urinary leakage. The key is to take pressure off of the pelvic floor by ensuring proper pressure management in everything we do. Afterall, the transverse abdominus is often the missing link that results in a reduction of various issues in pregnant, postpartum, and active females. 


If you’re a postpartum mom and looking for guidance on postpartum exercise recovery, check out the blog post here.


If you or someone you know is struggling with urinary leakage during exercise, coughing, sneezing, getting out of bed, or any other activity, get in touch with us! We’d love to help point your or your friend the right direction to a leakage free life. You can contact us at 502-939-8564 or book a free consultation here.


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