Let’s talk basics: what is the pelvic floor?

(and what’s Pelvic Floor Physiotherapy?)

The pelvic floor is the name of the muscles on the bottom of your pelvis. These muscles are responsible for the control of your bladder, bowel and have a crucial role in sexual function.

While in a male designated body (at birth) these muscles are important for sexual arousal, erections and ejaculation, in a female designated body (at birth), the pelvic floor contributes to sexual arousal and assists the birth process and labour as well as supporting the baby during pregnancy. In both genres, the pelvic floor muscles have been also linked to orgasm.

The pelvic floor is like a bowl that support the pelvic organs that are in your pelvic cavity (bladder and rectum and, depending on your anatomy, uterus and vaginal canal or penis and prostate). In normal conditions, when the coordination is ideal, when these muscles relax, they allow urination, bowel movements and, in women, intercourse. When they contract, they close the urethra and the anus, controlling therefore the emptying of urine and faeces.

Anatomically, the pelvic floor can be divided in two layers of muscles: the superficial and the deeper layers. Pelvic floor dysfunctions can result from weakness, over activity or lack of coordination of these muscles as well as trauma that can result from birth but also as a side effect of some surgeries that can affect the local tissues or the muscles, ligaments, nerves and body systems that interact with this region. Due to this multi factorial nature of the pelvic floor dysfunctions, Kegels and strengthening pelvic floor exercises may not be the best intervention for your particular pelvic floor condition. Rule of thumb: When in doubt, find a pelvic floor physiotherapist!

Pelvic floor physiotherapists are trained in several conditions and rehab approaches related to Pelvic Health. While in some cases your pelvic floor muscles may need to be strengthen, often the strength in itself isn’t our main concern. Your pelvic floor muscles may be lacking the control and coordination and / or they may be overactive. This isn’t easy to see only via symptoms because they can be similar to those who have weaker pelvic floor muscles. The treatment for these conditions should widely differ hence, it is crucial that your Pelvic floor physiotherapist checks your pelvic floor in order to verify what your pelvic floor needs.

Additionally, it is important to mention that the pelvic floor is part of a group of muscles that involves the diaphragm and the abdominal muscles and compounds the unit we call the core. Therefore, the pelvic floor should be evaluated together and in relation with the other structures. Moreover, the core activation can also be affected by the other muscles and other body systems such as the digestive system, lymphatic and cardio pulmonary systems so it is important to be evaluated by a pelvic floor physiotherapist. Moreover, the rehab process of the pelvic floor musculature often has to be adjunct to some lifestyle changes in order to improve and accelerate results so, while your symptoms may range from urinary, bowel or sexual, your condition may improve with additional dietary, habit changes and pain/stress management strategies.

To sum up, your pelvic floor is the name we give to the group of muscles that are located at the bottom of your abdomen and are responsible for functions such as control of your sphincters and sexual function as well as support of organs. Due to its relation to the core and viscera, things such as the relation of the pelvic with surrounding musculoskeletal structures, habits and diet will need to be taken into account in regards to pelvic floor dysfunction.

In case you any pelvic floor symptoms such as:

- Leaking while coughing, laughing or during activities

-Urinary urgency, frequency, hesitancy or incomplete emptying of the bladder

- Frequent need to urinate or painful urination.

- Ongoing pain in your pelvic floor region, genitals, or rectum.

- Feeling heaviness or pain in the vaginal region

- Pain in your lower back that cannot be explained by other causes.

- Pain during intercourse or decreased pelvic floor sensitivity post labour

- Feeling that you have several bowel movements during a short period of time or you cannot complete a bowel movement.

- Constipation or straining pain with bowel movements.