by Molly Gittings PT, DPT, OCS
The muscles of the pelvic floor (the hammock of muscle that attaches to the pelvis and makes up the perineum) are critical to one’s health and happiness, though most of us give it little attention. Ignoring potential deficits in this area can cause multiple issues and the effects of poor pelvic floor performance can be wide reaching.
Roles of the pelvic floor:
- Support: The bladder, uterus, rectum, prostate, and intestines all sit on top of the pelvic floor and are actively supported by the stability and integrity of these muscles. A dysfunction and lack of support in the pelvic floor combined with increased intraabdominal pressure (such as pregnancy or pressure increase during exercise) can result in a prolapse these organs.
- Stabilization: The muscles of the pelvic floor work in conjunction with the abdominal muscles, spinal stabilizers, and diaphragm to create stability of the trunk and spine during everyday movements. An important component of any core stabilization program includes training of the pelvic floor musculature.
- Sphincter control: Muscles of the pelvic floor include the muscles that surround the opening of the urethra and the rectum. The ability of these muscles to function properly will determine your ability to control the passage of urine, feces, and gas, supporting continence.
- Sexual function and satisfaction: The pelvic floor muscles assist in gaining/sustaining erection in males and assist in achieving orgasm in all genders. Conversely, tissue tightness and increased sensitivity can lead to pain, which may limit a sexual experience.
- Lymphatic drainage: The activation and relaxation of the pelvic floor musculature creates a pumping effect that assists in proper drainage of lymphatic fluid away from the pelvis and back towards the heart. This ensures that we do not get an accumulation of swelling into our groin.
A healthy pelvic floor is the key to all of these functions, but any breakdown in the system can lead to dysfunction. A physical therapist with advanced training can perform an assessment that includes assessment of pelvic floor muscle function in addition to a comprehensive look at the posture and movement patterns of the trunk in order to fully evaluate the interplay between systems and determine drivers of dysfunction. They can also treat these dysfunctions—or prevent them from occurring—by helping you in balancing strength, relaxation, posture, and motor control of pelvic floor muscles, leading to a greatly improved quality of life.