Pelvic Floor 101

The pelvic floor (PF) is a collection of muscles that line the bottom of the pelvic bowl (ie. the pelvis). Think of it as a trampoline - it remains taut however can stretch as required. The pelvic floor is comprised of separate muscles, all that can act individually and all together - it also provides holes for the passageway of the genitourinary organs. Refer to the diagram which depicts a bird’s eye view of the pelvic floor as it lines the bottom of the pelvis.

Looking into the pelvic bowl, from above. You can see the different fibres of each of the muscles which each contribute to make up the collective ‘pelvic floor’.

The PF has many important functions including:

• Supporting the contents of the pelvic bowl:

  • The contents of the pelvic bowl include the bladder, uterus & vagina (in females), prostate (in men), small bowel, and rectum.

  • When there is a lack of support to the organs of the pelvic bowl there are a number of events that can potentially occur:

    • Rectal prolapse: where the large intestine slips outside of the anus, occurring both in males and females

    • Vaginal prolapse: where the bladder, uterus, or bowel protrude into the vaginal canal. This is quite a common presentation in women post-natally.

    • Bladder leakage: A finding which results in small (or big) leakages from the bladder, particularly with sneezing, coughing, laughing, or jumping. This occurs in both males and females however it is particularly apparent in women who have recently given birth or post-natally, where there was inadequate pelvic floor rehabilitation.

  • Bladder & bowel control

    • In both males and females, having a strong pelvic floor means there is adequate control of both the bladder and bowels.

    • Think of trying to ‘hold on’ when you have to urinate, pass a bowel motion or even fart! This is your pelvic floor doing its thing. 

  • Sexual Function

    • In men, the pelvic floor is vital for erectile function and ejaculation

    • In women, the voluntary contractions contribute towards arousal and sexual sensation.

This often forgotten about area is an important consideration in many cases of lumbo-pelvic pain and injury. In addition to all of the functions above, the pelvic floor actually contributes to the stability of the lumbar spine and pelvis. The strength of the pelvic floor needs strong consideration when it comes to ‘core strength’, as it acts in conjunction with the deepest layer of the abdominal muscles to assist in core stability. This is vital when it comes to rehabilitation and preventative measures towards low back pain, pelvic and hip pain.

It is also important to consider the pelvic floor as any other muscle in the body - it can become tight, strained, weak or inactive. From an Osteopath’s perspective, it is an absolute necessity to consider the potential contribution of a dysfunctional pelvic floor to lower back, pelvic and / or hip pain.

If you believe pelvic floor dysfunction is contributing towards your pain, please do not hesitate to contact the clinic to ask more, or book an appointment online. We would love to hear from you!