What is the Pelvic Floor?!

The pelvic floor is a group of muscles that sit at the base of your pelvis acting like a sling or hammock. The pelvic floor muscles cover the area from your pubic bone to your tailbone and from sitz bone to sitz bone. These muscles surround all of your openings (urethra, vaginal, rectal openings). Some people may think just women have a pelvic floor, but ALL HUMANS have a pelvic floor (men and women) and anyone at any age can have dysfunction related to the function of the pelvic floor muscles. It is not just because of pregnancy or childbirth or old age. Studies have shown a high prevalence of stress incontinence (involuntary leakage of urine at unwanted times) in female athletes.

The pelvic floor muscles have several important functions:

1. Support -- support abdominal contents (bladder, uterus, rectum)

2. Stability -- play a role in your deep core and help stabilize your spine and pelvis

3. Sexual -- play a role in sexual function including pleasure and reproduction

4. Sump-pump -- play a role in circulation of fluid throughout the pelvic region

5. Sphincteric -- the pelvic floor muscles control the opening of your bladder and rectum; they must relax to allow you to urinate or have a bowel movement and they must contract to prevent unwanted leakage of urine or feces

Why is the pelvic floor important to me??

Most people consider only the abdominals and back muscles as a part of your core. However, the diaphragm and pelvic floor also make up part of your 'core canister.' Thus, your core is made up of the diaphragm, abdominals, back muscles, and pelvic floor muscles. All of these must be coordinated and working together properly to provide proper stability to your spine and pelvis!

Dysfunction in this core canister can manifest itself in many ways, including: low back pain, pain in the pelvis/pelvic region, urinary or fecal incontinence (unwanted leakage of urine or feces), unresolved hip pain, tailbone pain, difficulty sitting for prolonged periods, difficulty squatting, or inability to run/perform high impact exercise due to your symptoms.

The pelvic floor muscles need strength, endurance, flexibility, and proper motor control to function properly (just like all other muscles in our body)!

Your pelvic floor muscles may be very strong, but if they relax at the wrong time such as during a cough or sneeze and allow urine to leak out then we have a motor control problem! These muscles are not working properly when they are needed! Or, maybe you are experiencing painful intercourse, and a potential issue could be that your muscles are holding too much tension and are not able to relax properly to allow pain-free intercourse. We must look at all aspects and symptoms to figure out what is going on in the pelvic floor and to determine the appropriate treatment!

See a physical therapist for a full assessment to determine an individualized, specific treatment plan for your needs! As physical therapists, we are movement experts with a depth of knowledge of the musculoskeletal system allowing us to break down movement patterns, assess, and determine the root cause of your symptoms!

What can I do for my Pelvic Floor??

One of the most basic exercises, yet SO undervalued, for pelvic floor health is diaphragmatic breathing. In this day and age, with increased stress levels and lots of sitting and using electronics, we often fall into a 'shallow' breathing pattern. This means we breath more through our chest/neck/shoulders rather than actually using our diaphragm (our main breathing muscle)!

Proper diaphragmatic breathing:

Inhale: when we inhale, our diaphragm contracts and descends; in turn, this should allow our entire rib cage (think belly, sides, and back) to gently expand or rise and fill with air; our pelvic floor should also gently descend and lengthen

Exhale: with a passive exhale, our diaphragm will naturally recoil and come back up to its resting position as will our pelvic floor muscles; our ribs will naturally come back down and in

*You can also practice actively contracting your deep abdominals and pelvic floor muscles as you exhale during diaphragmatic breathing.

*As you exhale, you will want to gently lift your pelvic floor muscles up and in as if you were stopping the flow of urine AND holding in gas simultaneously! You can also focus on tightening the area between your hip bones by imagining you are trying to 'pull your hip bones together.'

If you are in the Columbus, OH area I offer in-person, one-on-one physical therapy sessions! I also do virtual consultations online if you prefer to stay in the comfort of your own home while receiving education, advice, assessment, and programming from a physical therapist and prenatal/postpartum corrective exercise specialist!

Email me at restore.physicaltherapy614@gmail.com with more questions or for scheduling!

Here's to a happy pelvic floor!

Kaitlin Hartley, PT, DPT, PPCES