The “squat-sit” is arguably one of our most primitive and natural postures as humans. It involves lowering the body to the ground while staying planted firmly on your feet. If you’ve ever watched a child at play, you may have noticed how naturally they adopt this position.
While in a squat-sit, we have complete freedom of our arms and hands and a significant amount of stability and support on the ground. It’s not hard to imagine that our ancestors likely spent a lot of time in this position.
One of the most common things I see clinically is that adults tend to lose their ability to squat-sit. Some people are surprised to discover they can’t comfortably sit in this position; others don’t even have to try to know they can’t do it. Whether it’s joint stiffness, poor balance, or simply the inability to get back up from a deep squat, the challenge of the squat sit is a common theme among adults I see in physiotherapy – especially those with back or pelvic pain.
Why is it that we can do something as children and lose that ability as adults? It usually boils down to the “use it or lose it” theory. If you don’t flex a muscle, that muscle becomes weaker over time. If you don’t stretch a muscle, that muscle becomes tighter over time. (We can apply this theory to not only muscles, but also things like joint mobility and even nerve conduction in the body!) The reality is that most adults simply don’t have much of a reason to spend time in a squat-sit through the day. Unlike our earliest ancestors, we have chairs to sit on and stoves to cook at. The argument could be made that one of the side effects of modern human living has been stiffer joints and more limited ranges of motion. Stated simply, if we don’t make a point of squat-sitting, we lose the ability to squat-sit.
So who cares? If we have chairs to sit on and stoves to cook at, why should we continue even trying to squat into adulthood? As a pelvic health physiotherapist I have 3 good reasons:
1. For pelvic floor muscle flexibility. Squatting pulls our pelvic bones into a very “open” position, which lengthens and stretches the muscles of the pelvic floor. Like most muscles of the body, the pelvic floor muscles require a certain amount of flexibility to function properly. If we aren’t putting them into this lengthened position as a part of daily life – and are instead spending more time sitting in chairs or standing – the pelvic floor can become short, tight and stiff. This is one of the biggest contributors to things like urinary urgency, urinary incontinence (aka bladder leakage), pain with intercourse, and persistent pelvic/rectal/perineal/genital pain. Maintaining good pelvic floor muscle mobility and flexibility can actually help treat or prevent a lot of these issues.
2. For optimal bladder and bowel function. The muscles of the pelvic floor have a huge role in continence. The muscles form physical closures (aka “sphincters”) around the rectum and the urethra to keep them closed. The deeper we move into a squat position, the more these muscles are able to relax and release, which is crucial if we want to empty the bladder or the rectum fully. This is why products like the “squatty potty” are so helpful for constipation. Having a stool under your feet while you sit on a toilet helps your body assume a deeper squat-like position which helps the rectum open more fully.
3. For core function. Did you know that the pelvic floor muscles are one of our most important core muscles? Many people who struggle with core strengthening (especially after pregnancy/childbirth, or after sustaining a significant back injury) don’t know that their pelvic floor isn’t functioning properly, which leaves the core ineffective. Although most people assume the pelvic floor needs strengthening to optimize core function (think: kegels), very often the problem is pelvic floor tension and stiffness. Deep squatting can help restore mobility and flexibility, which a crucial component to muscle function.
Hopefully by now you’re on board with the idea of including some simple squat-sitting in your day as a part of your pelvic health. Here’s all you need to do:
Start with your feet nice and wide apart – a little bit wider than your hips. You can point your toes straight forward or feel free to let them point out slightly if that’s more comfortable.
Now squat down and let yourself “sit” suspended between your feet. You can use your elbows to keep your knees apart, with your hands clasped in front of you for support if you like.
Now become aware of your pelvic floor and give a little contract-relax to make sure you’re not tensing up. Squeeze gently around the anal sphincter like you’re trying not to pass gas… then let it go as if you are allowing yourself to pass gas. You have to fully relax these muscles to get the full benefit of the stretch, and this is easier said than done for many!
Finally, take some good deep diaphragmatic breaths and imagine inflating a balloon in your pelvis and belly. As you breathe in, your pelvic floor should lengthen and let go even more. As you breathe out just try to maintain this release in the pelvis. Try 10 breaths like this, and don’t worry if you don’t feel anything the first time. This is difficult and often people need a lot of practice on this part!
*Modifications:
1. If you feel like you can’t get your heels on the floor, you can try putting a thick rolled up towel under your heels.
2. If your balance feels too challenged, you can either hold onto something stable in front of you (i.e. a door jam) or lean your back against a wall. Alternatively, sit on a low stool and progress towards taking the stool away over time.
More questions? Feel free to contact me at cmacmillanpt@gmail.com with your questions about pelvic health physiotherapy. If you’re interested in a pelvic health assessment, call Cooper Physiotherapy Clinic in Greely at 613 821-1662.
