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Bracing 101: Defining a Brace with Exercise

In any gym you walk in to, you may hear someone yelling "brace!" while someone is lifting, but what does that mean? It's a term that is used in the gym, in physical therapy visits, and in daily life, but oftentimes with unclear definition of WHAT is actually happening during a brace.


In order to understand the brace, we first have to understand the pieces of body that are involve with a brace.


We often conceptualize the core as a 360 degree canister with a top and a bottom.


The Front of the Canister: the anterior abdominal wall makes up the front of the core canister. It's important to understand that this includes not just the transverse abdominals, but all of the layers of the core. Yes, the transverse abdominal muscles, or the circular, deepest fibers of the abs, are a huge important piece of the puzzle, but when we start thinking about lifting heavy, we need ALL the layers of the core firing and not just trying to recruit one layer. The transverse abdominal muscles create a large part of that 360* piece of the canister, attaching in to the thoracolumbar fascia in the back and wrapping around to the front into the linea alba.


The Top of the Canister: the diaphragm makes up the top part of the canister. This large, dome shaped muscle is not under voluntary control, but contracts and relaxes in order to facilitate breathing. On an inhale, the diaphragm pulls downwards in a contraction, and on exhale it returns back to it's resting position (and therefor relatively raises up).

The Back of the Canister: the back of the canister is the spine, and muscles of the spine. It is pretty darn stable, and is a variable that is not manipulated aside from finding a neutral position when lifting.


The Bottom of the Canister: the pelvic floor makes up the bottom of the canister. The pelvic floor is made up of three layers of muscle. It is has several functions, including sphincteric control, support of pelvic organs, sexual functions, and a sump pump to help push fluid out of the pelvic region. The key here is to remember that the pelvic floor is made up of MUSCLES, and MUSCLES need to both be able to contract AND relax, and they respond to load. These key principles are HUGE to really understand and appreciate the necessary treatment strategies for pelvic floor rehab.


To further define the pelvic floor range of motion, we can use the concept of an A Frame house:


The Attic: This is 100% max effort pelvic floor contraction. We need to be able to get here, but we don't need to go to the attic all the time. We need 100% max effort when we are attempting a 1 rep max lift, or when we are helping move a super heavy couch. We don't need to be in the attic to carry a baby. When we are in the attic, we think of "closing" holes

The First Floor: This is where we live daily life. Some degree of contraction, some degree of relaxation throughout the day

The Basement : This is a lengthening of the pelvic floor. When we are in the basement, we are thinking of "opening holes". We are in the basement when we are peeing, pooping, or delivering a baby. With that in mind, we don't want to be in the basement when we are lifting, or we may experience things exiting our body (because the holes are "open" and pressure is downwards).


There are stairs from the first floor to the attic, and from the first floor to the basement. This means there are DEGREES of contraction. When we are lifting say 30% of our one rep max, we aren't necessarily thinking "ok I am going to 30% contract my vagina", but instead we want the engagement of the core and pelvic floor to match the demand of the task at hand. We do this by "calibrating" the system, and working on the coordination of the brace itself.


SO WHAT IS THE BRACE?


The brace is a core TIGHTENING and a pelvic floor either LIFT or STAYING THE SAME. The brace is NOT a drop DOWN of the pelvic floor or a PUSH OUT of the abs.


Cueing bracing looks like this:

"Tighten your core like your dog/baby is about to jump on you"

"Pull your pelvic bones together, and bring your ribcage to your pelvis and your pelvis to your ribcage"

"Tense your abs, but don't PUSH your abs"


On the pelvic floor side, we want AWARENESS of where we are in the house. Are we on the first floor? Attic? Or did we drop down into the basement? Rememeber, we do not want to be in the basement when lifting-because the basement is where leakage happens!

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