The pelvic floor is a series of muscles that are situated between the pubic bone and the tailbone lengthwise and between the sit bones side to side. The pelvic floor has many functions, including:
- Support for your bladder and bowel as well as supporting the uterus in women
- It gives you the ability to control pee, poo and gas.
- Playing an important role in erection and ejaculation in men.
- Playing an important role in sexual pleasure and sensation in women.
- Helping move lymphatic fluid from the legs back to the heart.
- It adds stability through the pelvis and back.
Anatomy of the pelvic floor
In examining the anatomy of the pelvic basin, let’s look at both the bone structure and muscles.
Pelvic Floor Bones
The pelvic bone consists of three main parts, the ilium, the ischium and the pubis. Most people associate the illium with the most prominent part of that bone which is the iliac crest (see the video below). The ischium is the lower part of our pelvis and are often associated or referred to as the sits bones. Finally, there is the pubis, which is the front portion of your hip bones. Obviously this is simplified but these are the important parts to be aware of.
Pelvic Floor Muscles
Now that we’ve discussed the pelvic bones, lets look at how the pelvic floor muscles tie into the picture. Your pelvic floor muscles attach along the bottom of your tailbone and the side of your pelvic basin. There are three layers of muscles within the pelvic floor. The most common layer is called the pelvic diaphragm. This is the layer of muscles we think about most often when referring to Kegel exercises. Watch the video below for a brief visual overview!
How do the pelvic floor muscles move?
When we are performing pelvic floor exercises, you’ll notice that we place a large emphasis on breathing. That’s because when we inhale our diaphragm muscle lowers as do our pelvic floor muscles. The lowering of the muscles causes them to lengthen. When we exhale, our diaphragm moves back up along with our pelvic floor muscles which results in contraction (or shortening) of the pelvic floor muscles.
The male pelvic floor
More often than not, when we discuss the pelvic floor, people assume that we’re talking about women. But men suffer from pelvic floor dysfunction as well — it’s just less talked about. There are some obvious and some not-so-obvious differences in the male pelvic floor. Below is a summary and you can also find a more in-depth article that I wrote here.
The male pelvic floor anatomy
The male pelvic floor has just one access point, the rectum. Whereas the female pelvic floor has two access points, the vagina and the rectum.
Cues used to strengthen the male pelvic floor muscles.
Learning to engage, strengthen or lengthen the pelvic floor is different for men. Also, when you think about addressing both front and back pelvic floor, you will generally achieve a stronger contraction Some helpful words or phrases often used to cue men to engage their pelvic floor muscles are:
- Stopping the flow of pee/shortening the penis
- Drawing the scrotum up/draw the boys up
- Stop passing gas
Reasons why male pelvic floor muscle dysfunction may happen
There are a wide variety of reasons why men may experience pelvic floor problems. We can usually divide these reasons in two categories, pathological and non-pathological
Common pathological causes of male pelvic floor dysfunction
- Prostate enlargement (BPH – benign protastic hyperplasia)
- Removal of the prostate (radical prostatectomy)
- Chemotherapy treatment
- Radiation treatment
- Androgen therapy
Non (or less) pathological causes of male pelvic floor dysfunction:
- Stress
- Excessive time riding a bike or on a trainer
- Being constipated
- Excessive coughing
- Repeated heavy lifting for example deadlifting or squatting
- Pelvic trauma
The Female Pelvic Floor
While there are some similarities between women and men when assessing and treating pelvic floor issues, there are also plenty of unique aspects that need to be considered including cues, causes and symptoms.
The female pelvic floor anatomy
The female pelvic floor can be considered unique in that it is also designed to facilitate childbirth and we can access the female pelvic floor from both vagina and rectum.
Cues used to strengthen the female pelvic floor muscles.
When I work with women there are several verbal cues that I find to be helpful in teaching women how to contract their pelvic floor muscles. These include phrases like:
- Try to top passing gas/stop the flow of pee
- Close your rear elevator door, close the front and take the elevator up to floor three
- Draw the tampon up
- Drink a milkshake with your vagina
- Zip the clit
Reasons why female pelvic floor muscle dysfunction may happen
There are many reasons why PFD might occur in women. The most common is having a vaginal birth but there are are also other potential causes including:
- C-section
- Constipation
- Stress
- Heavy lifting without proper core engagement
- Falling on the tailbone
- Menopause
Common pathological causes of female pelvic floor dysfunction:
- Endometriosis
- Interstitial cystitis
- Polycystic ovary syndrome
- Uterine cancers
The pelvic floor muscles not only need strength, they also need length so be sure to check my other blogs showing you how to release those pelvic floor muscles.