Oh… hello there… and welcome to my little discussion about the pelvic floor. In my practice, when I first start talking about the pelvic floor, and the many roles it plays in the body, clients adopt a look of shock and surprise…
“My pelvic floor does what?”
“How did I not know this before?”
“Why has no one ever told me this?!”
Frankly, the pelvic floor has been largely overlooked for a couple of reasons. First, there is still a lot of social stigma, restriction, and discomfort when it comes to speaking openly about our bathing suit parts, and many people prefer to avoid the subject altogether. Second, there is still a lot of misinformation about the pelvic floor. Many health care providers share poor advice about proper pelvic care, and/or ignore dysfunction by saying “it’s normal, get used to it”.
Well, allow me to clear things up a bit. The pelvic floor is the group of muscles lining the base of the abdomen and pelvis. They play several roles in our body’s overall functioning and make up one quarter of our deep core unit. I like to think of the pelvic floor as the body’s muscular foundation upon which everything else is built. Most often, I will develop treatment plans that begin by first optimizing function of the pelvic floor and progress from there. The responsibilities of the pelvic floor muscles can be divided into the following five roles:
The pelvic floor has a role in supporting our internal pelvic organs. Think of the pelvic floor as behaving like a hammock, holding our internal organs up against gravity.
If the pelvic floor muscles are not functioning well in their supportive role, we can develop downward migration of our pelvic organs into areas where they do not belong. This is pelvic organ prolapse and it can be difficult to manage without the proper strengthening exercises in place.
Since the pelvic floor muscles extend between each pelvic bone from the pubis to the tailbone, they play a big role in helping to stabilize the joints of the pelvis. Now, by “stabilize” I do not mean that without the pelvic floor muscles we would be a bunch of easy-to-fall-apart skeletons walking around. Instead what I mean is that the pelvic floor adds a certain robustness to the joints of the pelvis; specifically the sacro-iliac (SI) and pubic joints.
If the pelvic floor muscles are not functioning well in their stability role, we will experience an imbalance of mechanical forces throughout the pelvis. This creates pain, dysfunction, and tenderness in the pelvic girdle ligaments, the pubic joint, and the low back, hip, and sacral regions.
All of the sexual organs are housed in the pelvic region. This means that the pelvic floor muscles inherently play a huge role in helping these organs function properly. Through contraction and relaxation, the pelvic floor muscles help to regulate fluid output by sexual glands, blood flow to genitalia, and lubrication.
If there is congestion or restriction in the pelvic floor muscles and they are not functioning well in their sexual role, we can experience sexual dysfunction. The vagina, for instance, can become too dry, too stiff, or experience spasm, all of which prevent comfortable penetration. The penis can experience premature ejaculation, spontaneous erection, or erectile dysfunction (ED).
The pelvic floor muscles play a huge role in regulating our anal and urethral sphincters. There are specific pelvic floor muscles that wrap around the these sphincters for the purpose of allowing them to open during bowel and bladder movements, and close when voids are complete.
If the pelvic floor muscles are not functioning well in their sphincteric role, we can experience poor control of our sphincters, as well as, urinary and/or fecal incontinence. Additionally, if there is too much restriction in the pelvic floor muscles, we can experience excessive strain or difficulty during bowel and bladder movements, causing retention and/or constipation.
One of my favourite roles of the pelvic floor is how it interacts with the other muscles of the deep core. Essentially, the pelvic floor is designed to work and move in synergy with another deep core muscle, known as the diaphragm (aka the breathing muscle). Together, these deep core muscles help to activate the other two muscles of the deep core, enable proper breathing, normalize pressures throughout our internal body cavities, and create a strong foundation upon which the rest of the body can work. I explore this deep core sump-pump, also known as the Piston, in my article “Are Sit-Ups and Crunches Safe?“.
If the pelvic floor muscles are not functioning properly in their sump-pump role, we can experience everything from prolapse and incontinence, to postural pain, random headaches, gastrointestinal issues, neck pain, etc. We also experience a weaker deep core unit, forcing other muscles of the body to overcompensate during daily activities.
“Wow! Who knew?”
So there you have it folks – the primary roles of the pelvic floor explained! If you have any additional questions or think that you might be experiencing some pelvic floor dysfunction, please do not hesitate to contact me! It never hurts to check and make sure that everything is on the right track… Until next time!
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