The Pelvic Floor

Despite the pelvic floor being SO vital to our functioning as human beings, it continues to be a taboo topic of conversation. In this post, I hope to shed some light on the importance of understanding and taking care of our pelvic floor.

 

What is the Pelvic Floor?

The anatomy of the pelvic floor, regardless of one’s sex, is more similar than it is different. Both the female and male pelvic floor have a urethra and rectum, the female pelvic floor also has an additional opening called the vagina. Another key difference is that the female pelvis is wider than the male pelvis. Other than that, anatomically, the female and male pelvic floor look and function in very similar ways.

The pelvic floor can most simply be defined as a group of muscles (12 to be exact) layered on top of one another that help our bodies:

• Pee and poop (and have control over when that happens)
• Experience sexual arousal & orgasm
• Have babies
• Stabilize / support our internal organs and the spine

The pelvic floor muscles are layered from superficial to deep, with the deepest layers being the largest and most powerful. The deep muscles of the pelvic floor can also give us the most problems if they are not functioning correctly! Just like any other muscle in your body, the pelvic floor muscles can become strained or injured. Thus, we enter in, pelvic floor muscle dysfunction. The pelvic floor has a difficult balancing act to play between providing mobility and stability to the pelvis. If the pelvis is too mobile, incontinence and pelvic organ prolapse can occur. If the pelvis is too stable or tight, pelvic pain or neuralgia can occur.

Pelvic Floor Mobility  and Stability

Incontinence occurs when the body has lost control of bladder functioning causing leaking. This can occur due to pressure like a cough or sneeze. This is called stress incontinence. Loss of control of the bladder can also occur when the need to go outweighs the body’s ability to hold the bladder. This “gotta go, gotta go” feeling causing leaking is called urge incontinence. Incontinence can occur in both females and males. Pelvic organ prolapse occurs most notably in the female pelvic floor when the pelvic organs (bladder, uterus, or rectum) herniate through the vagina. This downward movement of the organs can cause pain, fullness, heaviness that can affect the body’s ability to move and function.
Pelvic pain can range from superficial burning to deeper, sharper discomfort that can affect intimacy, penetrative sexual intercourse, and functioning of sexual organs that allow for pleasure in both females and males. Neuralgia is a type of pain that is driven by nerves in the lower spine and pelvis that can become irritated due to compression, adhesion, or stretching. This can cause superficial to deep pain in various places around the pelvis and can also affect sexual functioning and pleasure.

Pelvic Floor Physical Therapy

Physical Therapy can be a game changer when it comes to pelvic floor muscle dysfunction. Through physical therapy, our goal is to identify if the pelvic floor muscles are too mobile or too stable, and how that influences bowel and bladder function, sexual health, and pelvic pain. This is done through a combination of manual therapy, therapeutic exercise, biofeedback, education, and functional re-training. So, if you have questions or concerns about the pelvic floor….or peeing, pooping, painful sex, let’s talk about it!

Written by Kerry DeGaetani, PT, DPT, SCS. Kerry has a Certificate of Achievement in Obstetrics Physical Therapy and is the proud mama of two, spirited kiddos.