Where is your pelvic floor?

The Pelvic Floor is part of our inner core - it is 3 layers of critical muscle that sit in our pelvis and supports our organs, allows control of bowel & bladder, aides in pain free sex, improves erection control and sexual function, supports posture control, stabilizes your hips and trunk, produces productive labor, acts as a sump pump improving blood and lymph flow, and also enhances diaphragmatic range of motion leading to improved breathing.

The pelvic floor is a teachable group of muscles that can be stretched, strengthened, bulked, and trained! It is a dynamic group of muscles that affects our lives all day every day!

Before we dive into what pelvic floor therapy is let’s get you familiar with the anatomy and functions of the pelvic floor:

There are 14+ muscles in the pelvic floor which have 7 main functions including support, sphincteric, sexual, stability, sump pump, posture, and breathing. The muscles run from the pubic symphysis to the tailbone, sit bone to sit bone, and three layers deep into the pelvis - wrapping around the entire interior of the pelvis.

The muscles of the pelvic floor wrap around and control the opening of your bladder and rectum. When there is an increase in abdominal pressure (for example when you cough, sneeze, laugh or jump), these muscles contract around your urethra and anus to prevent leakage. Equally as important, these muscles have to relax and lengthen to allow us to urinate or have bowel movements easily.

The pelvic floor muscles support the pelvis and internal organs. This incredible group of muscles act as a bowl to support our pelvic organs which include the bladder, rectum, and uterus against gravity. Excess strain on the pelvic floor such as coughing, sneezing, or straining with bowel & bladder, or with weakening of the pelvic floor due to age or hormonal changes can cause the pelvic organs to protrude near the vaginal opening. The weakening of the supporting muscles can lead to prolapse of the bladder, uterus, or rectum. But have no fear! Pelvic floor therapy can help bulk, strengthen, and coordinate the pelvic floor to perform their job and keep the internal organs supported! Some patients may require a pessary or surgical solution, but significant improvement can be achieved through pelvic floor therapy.

Sexual health is highly influenced by the pelvic floor. A functioning pelvic floor can help reach and maintain clitoral and penile erection. Healthy tissue allows for pain free intercourse. The muscles of the pelvic floor can become tight, hypertonic, or scared leading to pain during and after intercourse. Sufficient strength and range of motion in the pelvic floor muscles is necessary for orgasm. The pelvic floor muscles are an integral component to healthy, pain free intercourse. A Pelvic floor therapist will assess the tissues, function, strength, and range of motion of these intricate muscles to help their patients reach pliability, coordination, control, and awareness. Improvements in arousal, sensation, and pain symptoms can be reached with pelvic floor therapy.

Stability and postural support are directly affected by the pelvic floor. The pelvic floor muscles have attachments to the pelvis and hips. It is part of the core assisting other abdominal, hip, and back muscles to control movement of the sacroiliac and hip joints. It is our central support that leads to pelvic alignment and back stability.

The pelvic floor muscles are the central part of the core affecting deep abdominal stability and can be critical in the recovery of abdominal splitting known as diastasis recti. A male or female can experience abdominal splitting. Diastasis recti can occur when too much pressure is put on your abdominal muscles causing the central linea alba to stretch. This causes the rectus abdominis muscle to split and separate. Men can experience this due to improper exercise, weightlifting, sudden weight gain, or muscle wasting. Women generally experience diastasis recti during and after pregnancy. The quick expansion of the abdominal region with pregnancy can lead to separation of the abdominal wall during or after pregnancy. The linea alba stretches causing gapping at, below, and above the belly button region. The opening of the abdominal wall can cause a bulge in the middle of the abdomen, back pain, sacroiliac joint pain, weak core, and reduced ability to participate in daily activities. Diastasis Recti can be corrected with pelvic floor exercises, deep core exercises, and body mechanics education. Building structural stability from the deep pelvic floor outward can help return the abdominal region to its appropriate position.

When the pelvic floor muscles are active and functioning properly, they encourage blood and lymph flow through the pelvis. This is important for the venous and lymphatic system to reduce swelling, pain, or congestion in the pelvic region.

Finally, our very breath is affected by the pelvic floor. A strong pelvic floor leads to neutral posturing and improved diaphragmatic range of motion to improve ease with breathing.

The Pelvic floor has many muscles, ligaments, and nerves. A functional pelvic floor leads to healthy bowel and bladder habits, pain free sex, and coordinated body movements. It is an incredible, teachable part of our body! It works hard for us every day, so let’s be sure to keep it healthy and happy!

Pelvic floor therapy is provided by a licensed physical or occupational therapist. An initial evaluation will start with an interview to discuss your symptoms and concerns. An internal examination to assess your musculature will be performed to determine if there are areas of weakness, scarring, tension, discoordination, or hypersensitivity. A specific treatment program will be developed to reach your goals and bring your pelvic floor back into a happy, healthy muscle group that supports your body and responds appropriately with the 7 main functions of support, sphincteric, sexual, stability, sump pump, posture, and breathing.

Treatments are generally 45-60min, 1-2x a week, and may include exercises, biofeedback, education, desensitization or sensitization techniques, neuromuscular re-education, and manual techniques. Treatments will be similar to the initial evaluation discussing your progress, symptoms, concerns, and achievements. At each treatment session your personalized program will adjust to ensure you are progressing forward to reach your goals.

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