The pelvic floor is a group of muscles that make up the base – or floor – of the pelvis. There are many muscles sitting in different layers in the pelvic floor muscle group.
This side-view of the pelvic area from the Continence Foundation of Australia demonstrates where the pelvic floor muscles sit in relation to the organs housed in the pelvis – the bladder, uterus (for women) and the bowel (side note – yes, men have a pelvic floor too!). You can see the pelvic floor muscles as a red sling stretching from the pubic bone (at the front) to the coccyx (base of your tailbone – at the back).
This picture might trick you into thinking that the pelvic floor is small and thin. However – this is not the case! We prefer these images from the Midwifery Traditions and Associates P.C. group which demonstrate more clearly the complexity and size of the pelvic floor – it really does create the whole floor of the pelvis (the gaps are for the urethra, vagina and anus).
What do the pelvic floor muscles do?
So, as well as having a structural role, the pelvic floor muscle group also has several active roles to play. These include:
- Supporting the organs that live inside the pelvis (the bladder, uterus and bowel) – if the pelvic floor is weak and unable to provide much support, prolapse can result (the descending of one or more of these pelvic organs).
- Providing resting or closing pressure around the urethra and anus to control release of urine, stools or gas – if the pelvic floor is weak or having difficulty with coordination, incontinence can result.
- Supporting the uterus as it expands and holds extra weight during pregnancy
- Pushing a baby out during a vaginal delivery – this is when these muscles work to their maximum effort!
- Providing sensation and muscle endurance during intercourse.
How can I strengthen my pelvic floor?
Physiotherapists can help you strengthen your pelvic floor – after all, it’s another group of muscles! Just as the muscles of the legs and arms can be assessed and trained, so can the pelvic floor muscles. A physiotherapist can do either: an external assessment or with appropriate training, an in internal assessment (only if required) can be completed via the vaginal canal. In this situation, the physio can assess strength, coordination and endurance, as well as assessment of prolapse or muscle avulsions (when a muscle is torn from its attachment during childbirth).
Pelvic floor muscle exercises are an easy, safe and direct way to address any pelvic floor muscle weakness. Most people have heard of pelvic floor muscle exercises and have tried them but stop doing them as they forget, or life gets in the way. However, this is to their detriment – just like brushing your teeth, pelvic floor exercises should be for life! Particularly if you are at risk of prolapse or incontinence, as doing exercises can directly lower your chances of developing these or any worsening of these conditions.
I would encourage you to make an appointment for a pelvic floor assessment if you are:
- unsure of how to do a pelvic floor muscle exercise
- unsure if you are completing a pelvic floor muscle contraction correctly
- wanting some help getting your pelvic floor muscle stronger (especially if you’re completing regular exercise)
- interested in a grading of your strength or coordination
- concerned you may have a muscle avulsion
- experiencing incontinence (no matter how mild!); or
- concerned you may have a prolapse or would like assistance in managing a prolapse
Want to improve your pelvic floor muscles? Make an appointment with our Women’s Health Physiotherapist online or by phoning 6652 7355