A pelvic floor is a group of muscles, ligaments and fascia that sit like a hammock on the floor of the pelvis. It attaches to the coccyx, at the base of your spine, to the pubic bone and the front of your pelvis, and to each ischial tuberosity (also known as your sit bones).
Both men and women have a pelvic floor. In women, the pelvic floor has three openings in it for passages to pass through, the urethra, vagina and anus. Imagine the pelvic floor like a trampoline – it should be made from firm muscle and be able to move up and down.
The pelvic floor is an extremely important group of muscles for several reasons:
– it holds all our internal organs in place
– it assists in controlling our bladder and bowel
– it’s important for sexual function, contributing to sexual arousal and sensation
– it contributes to the stability of our pelvis and spine
Both men and women can suffer from pelvic floor problems. The pelvic floor can become too weak or too tight. Both can be a very distressing problem to experience, however, in most cases, it can be resolved with the correct treatment and management.
Pelvic floor weakness can happen for several reasons, with one of the most common being pregnancy and childbirth. Evidence suggests that problems can start during pregnancy, not just after birth. The weight of the baby and extra weight gained during pregnancy puts a greater strain on the pelvic floor. Therefore, even if you had a C-section, it is still just as important to address and strengthen your pelvic floor after pregnancy. Women who have had multiple births, instrumental births (with forceps or ventouse), severe perineal tearing or large babies (birth weight over 4kg) are at greater risk of pelvic floor muscle damage.
The condition of your pelvic floor before your pregnancy and childbirth can also contribute to how it recovers following these events. Other factors which can contribute to a damaged pelvic floor are:
– constipation and/or straining with a bowel motion
– persistent heavy lifting (this may include activities such gym work, lifting children, lifting items at work or just around the house
– high impact exercise
– gaining body weight
– repetitive coughing and straining, or even vomiting with severe morning sickness
– age and changes in hormones
Pelvic floor tightness is a complex issue. Sometimes pelvic floor muscles can fail to relax properly (often due to pain), causing the pelvic floor muscles to tighten up protectively. This can lead to issues such as difficult or impossible intercourse. It can also cause the bladder and bowel not to empty properly.
If you are unsure of whether you are exercising your pelvic floor muscles correctly or you have urinary problems, you should make an appointment with a Women’s Health Physiotherapist.