The first time I heard of the pelvic floor muscles was during a conversation with my auntie who had just had her first child. She warned me to ‘complete my exercises or I’ll wet myself’ and being the ripe age of thirteen I put that comment in the too hard basket and left it there for just under ten years.
The next time I heard of the pelvic floor was during my undergraduate Physiotherapy degree at university where we briefly touched on the role of the muscles with regards to pelvic health, the postpartum (after childbirth) period and maintaining continence.
However, it wasn’t until I started my career in women’s health physiotherapy, undertaking professional development courses and learning from mentors that I truly understood the importance of the pelvic floor muscles and how they affect both men and women. There is so much more to the pelvic floor muscle than continence, although that is important too!
Where can they be found in the body?
The pelvic floor is comprised of lots of different muscles and together they sit at the base of the pelvis and are positioned like a sling running from the sit bones to the pubic bone and everything in between. The pelvic floor wraps around the urethra, vagina and anus and when contracted helps to close off these passages.
This is why the pelvic floor muscles are so important in maintaining continence. When there is not enough strength or coordination in these muscles, their ability to close off these passages can be reduced. This is why when you sneeze with your muscles squeezed the urethra is closed and supported resulting in no leaking of urine.
When good muscles do bad things
If the muscles are weak and the urethra is not supported and closed during with downward pressure such as a sneeze, leaking can occur. The same effect occurs with the back passage. If you have adequate pelvic floor muscle strength you are unlikely to leak faeces or wind in any unwanted situations. This is not the only role however of this very important muscle group.
Given the position of the pelvic floor, it also provides a lot of support to the pelvic organs (bladder, bowel, uterus) sitting above it. Weak pelvic floor muscles can contribute to the development of something called a pelvic organ prolapse, where the pelvic organs descend down into the onto the vaginal walls resulting in symptoms such as a lump/bulge or dragging sensation in the vagina.
Additionally, pelvic floor muscles play a large role in supporting the abdominal wall and lumbar spine. As physio’s we often talk about something called the abdominal canister. As per the picture, the abdominal canister is made up of the diaphragm at the top, the low belly/transverse abdominis muscle at the front, multifidus at the back and the pelvic floor at the bottom.
Together, these muscles work as a team and provide support to the low back. When these muscles aren’t working together well, it can lead to less support of the low back and result in pain or dysfunction.
One more thing
Lastly, the pelvic floor is heavily involved with sexual function. We know by now that pelvic floor muscles need to be strong and able to contract to support the pelvic organs and maintain continence. However, these muscles also need to be able to coordinated enough to relax and allow movement through them. For example, when having penetrative intercourse. If the muscles haven’t quite got the idea of how to relax this can lead to pelvic pain, painful intercourse and a few other things that I will save for another blog.
As you can see, for such a little-known muscle group that I had parked in my brain for many years, it plays some very important roles in keeping us healthy and functioning as human beings. If you have any concerns with how your pelvic floor may be functioning, please check in with a women’s health physio.