What is the Pelvic Floor?

The pelvic floor can often feel like the lost city of Atlantis; we've all heard of it, many seek to understand it, and when it thrives, it truly is a utopia. 

 

Pelvic Floor Anatomy

Our pelvis consists of two hip bones and our sacrum, which is the triangular bone at the base of our spine. These bones are connected by ligaments and cartilage to create a round, basin-shaped structure. At the front, these bones join to form the pubic symphysis, and at the back, they connect to form our two sacroiliac joints (SIJ).

 

 

Your Pelvic Floor Muscles

The pelvic floor is a complex network of muscles, ligaments, and tissues that extend across the bottom of the pelvis. These muscles provide crucial support to the bladder, uterus, and bowel, helping to maintain continence and control urinary and fecal function. Additionally, the pelvic floor muscles are essential for sexual function, contributing to arousal, sensation, and orgasm. Furthermore, these muscles play a significant role during childbirth, providing support to the pelvic organs and helping to facilitate the birthing process.

 

When you contract your pelvic floor muscles, they lift and squeeze around the openings of your vagina, anus, and bowel. This helps control your urine, feces, and gas. When you release your pelvic floor muscles, these passages open, allowing urine or feces to pass through.

 

Your pelvic floor consists of three different layers, each with distinct functions!

 

Layer 1

The superficial layer is the outermost layer of the body, and it includes the area around the clitoris, the perineal body (the skin between the vagina and anus), and the external anal sphincter.

 

Pros:

- Responsible for arousal and orgasm

- Provides lubrication

- Assists with closing the urethra and anus, aiding with continence

 

Cons:

If these muscles are too tight or overactive, they can contribute to:

  - Difficulty urinating

  - Constipation

  - Pain during sex

  - Susceptibility to tearing during childbirth

 

 

Layer 2

The next layer of the pelvic floor is the muscles that surround your urethra, the tube through which urine passes.

Pros:

• responsible for bladder control by closing the urethra

Cons:

If these muscles are too tight or overactive, they can contribute to:

• difficulty emptying your bladder
• urinary frequency (going to the toilet more often than normal)
• urinary urgency (not getting much warning that you need to go to the toilet)

 

Layer 3

This is the deepest group of muscles, called the 'levator ani'. 

The Pros

• Acts like a hammock and supports the bladder, uterus and bowel
• Act as postural muscles - stabilise trunk and pelvis
• Fast and powerful muslces, assist with sphincter closure

Cons:

• can cause rectal pain

• can cause pain before, during, or after sexual intercourse
• can contribute to needing to urinate often, urgently, or difficulty starting the flow of urine
• bladder pain or pain with urination
• urinary incontinence

 

Pelvic Floor Rehabilitation

The good news is that pelvic floor muscles are muscles. And why is that good news, you ask? Well, if you were to come and see me in the clinic and we assessed that you had weak calf muscles, I would look at your strength, control, and coordination, and set you up with a rehab program to address this. If I assessed that you had tight calf muscles, I would set you up with a treatment program to focus on lengthening your calves.

 

Well.. pelvic floor muscles are muscles. This means that we can rehab them!

 

Pelvic floor rehabilitation will vary for each person. If you have tight or painful pelvic floor muscles, treatment might include relaxation techniques such as breathing, stretching, and mindfulness, as well as internal and/or external muscle release work (massage, myofascial release, and trigger point release), and activity modification. If you have weak pelvic floor muscles, treatment might include strengthening exercises. If you have tight but weak muscles or poor coordination, treatment will likely include a combination of many modalities. It's important to consult a pelvic floor physiotherapist for a personalised assessment to determine your specific needs and create a treatment plan. Just like rehabbing a calf muscle to get back to normal activities, putting in the time and effort to rehabilitate your pelvic floor muscles is definitely worth it.