The Pelvic Floor (Everyone Has One): Introducing Penelope The Pelvis

To best understand the function of the pelvic floor muscles, we must first understand the anatomy of the pelvis. As we begin, please note that both men and women have pelvises AND pelvic floors! Men also frequently suffer from pelvic health conditions. The information in these blog posts will typically be applicable to both genders, and we will also be offering future posts specifically on men’s pelvic health.

Today I want to begin by introducing you to Penelope the Pelvis.

She is one of my favorite office companions, and we will use her for a very brief exploration of this part of our body. While we are focusing on her physical attributes, it is important that I acknowledge she is much more than this. She enjoys helping people learn, long walks on the beach (socially distanced, of course), and Netflix binges. 

So, what is your ‘pelvic floor’ and what does it do?

Penelope’s bones, often referred to as the hip bones, serve many important functions. These bones help us transmit force throughout the body. They also protect numerous internal organs, and serve as a bridge between the spine and legs. Several joints can be found in the pelvis including the sacroiliac joints (SI joints) and the pubic symphysis. These joints can sometimes become painful, stiff, or hypermobile and make certain activities or movements uncomfortable. 

The bones of the pelvis are lined with the pelvic floor muscles. These muscles are the same type of muscles that we have in our arms and legs, and we can intentionally engage and relax them when we need to (though, a lot of the time, this is easier said than done).

The 4 Fundamental Functions of the Pelvic Floor Muscles

Our pelvic muscles have 4 primary functions:

1. Sphincteric: One important function of the pelvic floor involves its control of the opening of your bladder and rectum. Your pelvic floor muscles are in charge of preventing leakage by contracting during actions such as coughing, laughing, etc. As well, they must relax, to allow you to urinate and have bowel movements.
2. Support: The pelvic floor also acts as a hammock to support pelvic organs, such as the bladder, rectum and uterus. In some instances, these muscles can become strained and/or weak which can contribute to pelvic organ prolapse.
3. Stabilization: Although it’s not what most people think of when they train their “core”, the pelvic floor muscles also make up an important part of our core by assisting other abdominal, hip, and back muscles to help stabilize your SI joint and hip joints.
4. Sexual: The pelvic floor is highly important to sexual function. These muscles contribute to erections for males, and penetration for women (among other things). Excessive tensions in these muscles cause serious symptoms, including pain during or after intercourse.

The 3 Layers of the Pelvic Floor

1. The superficial perineal pouch: These muscles are closest to the outside of our body and form the sphincters responsible for starting and stopping urine, feces, and gas. They also help to support the genitals and aid in lubrication. These muscles have a lot of “quick flick” fibers that can fatigue quickly. 
2. The urogenital diaphragm: This is a small layer of muscle that helps to support the urethra, the structure that we urinate from. 
3. The pelvic diaphragm: This is the deepest layer of pelvic floor muscles and makes up the bulk of the pelvic floor. These muscles help to hold us together, support our pelvic organs, and work to generate posture. They are also involved in sexual function. These muscles are geared toward endurance and are less prone to fatigue compared to their more superficial counterparts. 

The Superficial Perineal Pouch

In addition to these muscle layers, the walls of the pelvis are lined with muscles that help to rotate your hips. Coursing through the pelvic floor muscles are numerous nerves that allow the muscles to function and provide us with valuable information about what is happening in our pelvis. While each layer of muscle has specialized functions, it is important to remember that they work as a unit, often with little input from us; even as we sleep, the pelvic floor muscles are hard at work! 

If the pelvic floor muscles struggle to do their jobs optimally, we can experience any number of concerns including bladder, bowel, and sexual dysfunction. In addition, imbalance of the pelvic muscles can contribute to pain, including genital pain, pain with sex, and abdominal pain.

Common Issues with the Pelvic Floor

• Bladder Dysfunction: Symptoms of bladder dysfunction include urinary incontinence, retention, pain with urinating, and urgency/frequency. 
• Bowel Dysfunction: some bowel challenges may be experienced such as constipation, loose stools, fecal leaking, and/or abdominal pain and bloating. 
• Back & Hip Pain: Additionally, imbalance in the pelvic floor muscles can contribute to orthopedic issues such as hip, back, tailbone, groin, and SI joint pain.

Pelvic floor therapy can be extremely beneficial in addressing not only these concerns, but numerous others. In upcoming posts we will be discussing many of these issues in more detail – so stay tuned! Our next post will explore what a typical pelvic health first visit might look like and address some common questions and concerns people have about coming to pelvic therapy!

Until Next Time,

The Grace PT Team