Una vez que tenemos claro lo que es el suelo pélvico, dónde se encuentra y cuáles son sus funciones, el siguiente paso es aprender a cuidar de él. ¿ Por qué? Pues por ese refrán tan popular que dice así: MÁS VALE PREVENIR QUE CURAR. Y porque, como os dije en mi entrada anterior, uno, en este caso una, no se da cuenta de que tiene suelo pélvico hasta que le empieza a dar la lata.
En otras culturas, el suelo pélvico sí existe. Las niñas aprender a entrenar su musculatura desde que son pequeñas. Entre las orientales, son raras este tipo de patologías. ¿Por qué? Pues porque el yoga es una filosofía de vida. Lo practican durante toda su vida, y eso les hace tener un tremendo control postural. Lo mismo ocurre en muchos lugares de África, donde las mujeres son porteadoras natas. Eso significa que se pasan toda la vida porteando: los cántaros donde llevan el agua cuando son pequeñas y a sus propios hijos cuando son madres. Todo esto obliga a llevar una posición ERGUIDA. Así que la primera prevención es esa: CUIDAR LA POSTURA.
Una postura erguida, en la que la columna está elongada, hace que los multífidos, esos músculos que se extienden del sacro a las cervicales trabajen. Obliga a nuestra faja abdominal a activarse y quita presión al maltratado suelo pélvico. Haced la prueba: sentaos en una silla y “dejaos caer” sobre vuestra propia musculatura. Los hombros se enrollan hacia delante, la cabeza cae y aparece la papada, el abdomen se arruga … alargad ahora la columna hacia arriba, como si os tirasen del pelo hacia el techo. Dirigid la mirada al frente. Voilá! vuestra faja abdominal se ha activado, y el suelo pélvico no tiene que soportar tanto peso. Cuando aprendemos a integrar esto, y reeducamos a nuestro cuerpo, los beneficios que obtenemos son múltiples. Acordaos cuántas veces hemos escuchado eso de: “ponte derecho”. Pues por algo sería.
La segunda máxima a tener en cuenta es el estreñimiento. Es el enemigo número uno del periné. El número uno. Las mujeres suelen padecer estreñimiento mucho más que los hombres. Pero no os engañéis, una mujer estreñida no es la que va a defecar una vez cada cinco días. La verdadera estreñida, la que lo sufre de verdad, es la que toooodos los días tienes ganas de hacer caca, tooodos los días va al baño y tooooodos, absolutamente tooodos los días de su vida se tira diez minutos empujando sin conseguir nada. A lo mejor lo consigue una vez de cada cinco. Con suerte, una de cada tres. Pero con cada pujo machaca su suelo pélvico…Todos los días de su vida!!! Así que, aprendamos a combatir el estreñimiento. Con una alimentación sana, fundamental. Con una dieta rica en fibra. Bebiendo agua. Evitando el sedentarismo. Y si nada de eso funciona, por favor, no machaquéis vuestro suelo pélvico. Si no toca, no toca.
Otra de las cosas a tener en cuenta es el peso. El nuestro, y el que cargamos. Como en todo, los kilos de más no favorecen nada a nuestro periné. Cuanto más peso tengamos, más tendrá que sostener y le someteremos a mayor esfuerzo. Lo mismo ocurre con el peso que cargamos. Si no tenemos una faja abdominal competente y una espalda sana, al coger peso la presión irá hacia abajo, hacia el suelo pélvico. Así que ojo con esto, especialmente en el postparto, cuando el suelo pélvico está tan debilitado.
También aquí toca hablar de los deportes de impacto. Os tengo que decir que no son los ideales para un periné que no está lo suficientemente fuerte. Muchas veces, aparecen patologías como la incontinencia o los prolapsos tras empezar a correr, saltar, hacer zumba, etc. Por otra parte, siempre les digo a mis pacientes que no dejen de hacer lo que les hace feliz. No se trata de abandonar el deporte, sino de reeducar la musculatura del suelo pélvico, entrenarla igual que entrenáis el resto de vuestro cuerpo. Es cierto que no siempre se consigue, y entonces habrá que buscar otro tipo de deporte que no sea tan lesivo. Pero para eso hay tiempo. Lo principal es no ignorar los problemas una vez que han aparecido.
Para terminar, deciros que hay múltiples maneras de ejercitar este grupo de músculos, pero que normalmente no se hace de forma aislada, sino que se entrenan junto con la musculatura abdominal, el diafragma, etc. Para que sea efectivo, ha de ser un entrenamiento GLOBAL. Está muy bien hacer ejercicios de Kegel, los más conocidos, pero no es suficiente. El suelo pelvico forma parte de un todo, y así es como hay que reeducarlo. En próximas entradas os enseñaré cómo.
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