The Pelvic Floor:
What is it & why is it important?
The pelvic floor (PF) is part of the deep core system that includes:
pelvic floor muscles
transversus abdominis (core muscles)
multifidus (back muscles)
the diaphragm (breathing muscles)
During life, these muscles all have to work together in coordination- to perform the 5 main functions of the pelvic floor:
Support (of organs)
Sexual function
Sphincters (bowel and bladder)
Stability (muscles)
Sump pump (circulation)
The most important thing is we should always consider the pelvic floor context with the rest of the body - it is never working in isolation. A lot of different muscles and fascia attach to the pelvis. They coordinate with the pelvic floor to complete those 5 main functions mentioned above. At any point, any of these muscles or fascia structures may also be impacting your pelvic health!
What can go wrong with the pelvic floor?
The following are common issues that often come up with the pelvic floor.
Bladder & Bowel Issues
Urgency/frequency with going to the bathroom
Bladder or bowel leakage
Constipation
Struggling to control gas
Pain with urination
Orthopedic Issues
Back/SI joint pain
Hip pain
Pregnancy fitness
Diastatis Recti -a separation of the two vertical muscles that run along the front of the abdomen
Return to fitness post-pregnancy
Sexual or Pelvic Health Issues
Pain with sex
Erectile disfunction
Pelvic organ prolapse
Pelvic pain
Endometriosis
Post-op: hysterectomy, hernia, prostate or other abdominal surgery
What is pelvic floor physical therapy?
Pelvic floor PT is a specialized type of physical therapy that focuses on improving the function of the pelvic floor muscles. Your first visit will be an initial evaluation that should include a comprehensive, individualized assessment that prioritizes you and your body as a whole.
The visit will start with questions about a variety of factors that may be influencing your pelvic floor function on everything from fluid intake, bladder/bowel/sexual function, to pregnancies. Next a physical exam may be performed that can include an external assessment of breathing and hip muscles. If (and only if) you are comfortable, and the PT thinks it may be helpful, an internal exam of the pelvic floor muscles can also be performed. This exam helps provide information about the strength and coordination of the pelvic floor.
The single most important thing to remember in pelvic floor physical therapy is everything patient driven. Nothing is ever done without the patient’s full, complete, and educated consent. Pelvic floor therapists receive advanced thorough training in both internal and external assessment techniques, and are experts on the complex pelvic and abdominal anatomy. Additionally, they receive extensive education on all hormonal and physical factors that can influence the pelvic floor.
The pelvic floor and fitness
Everyone has a pelvis (and a pelvic floor) and the literature tells us that over 80% of women, who participate in high impact exercise, experience some level of pelvic floor dysfunction (leaking urine, pelvic pain, heaviness etc.)
These are incredibly common occurrences, but not something that should be happening. This topic is not openly discussed today. Let’s change that and start the conversation.
Let’s start by talking about all things pelvic floor, including:
Anatomy: how well do you know your own body?
Function: do you understand how it’s supposed to work?
Common GREEN, YELLOW, or RED symptoms
Management Strategies
Exercise & functional bracing strategies: weight lifting belts and special pelvic floor considerations
By viewing the pelvic floor as an integral part of the whole body, we build healthy functional movement patterns and long-term performance success!
