7 Things You Didn't Know About Your Pelvic Floor

October 1, 2024

The pelvic floor muscles are located between the tailbone (coccyx) and the pubic bone within the pelvis. They support the bowel and bladder (as well as the uterus and vagina).

1. Everyone Has One A Pelvic Floor

Regardless of age or gender, if you have a pelvis you have a pelvic floor! The pelvic floor muscles act as a hammock inside the pelvis where the bladder, rectum, and uterus/prostate are housed. Additionally there are several ligament attachments surrounding these organs. The pelvic floor’s main jobs are:

Continence - making sure that you are not leaking urine, gas, or stool at inappropriate times
Support - providing support to internal organs (bladder, uterus/prostate, rectum), acting as a responsive “floor” to changes in pressure
Sexual function - the pelvic floor aides in strength and sensation involved with orgasms and sexual function
Core stability - the pelvic floor works to help stabilize your pelvis, hips, low back, and core
Drainage - the pelvic floor muscles help pump blood and lymphatic fluid in and out of the pelvis

2. The Pelvic Floor Works in a System

Your pelvic floor does not function independently, but rather it is a part of the core canister. This core canister is made up of the pelvic floor muscles (at the bottom, between the pelvic bones), deeper core muscles (in the front), back muscles (in the back), and the diaphragm (at the top, between the ribcage). All of the components of this system work together, and if there are any areas that are not functioning appropriately, then other areas of the core canister will start to compensate, possibly leading to dysfunction.

Common symptoms of dysfunction include, but are not limited to:

Chronic Back or Tailbone Pain
Leakage of Any Kind (urinary, gas, stool)
Heaviness/prolapse symptoms (feeling like something is going to fall out of your pelvis)
Diastasis Recti/Abdominal Separation
Hernias
Pelvic and/or Genital Pain
Pain with Intercourse

3. Your Pelvic Floor Functions Involuntarily

Your core canister and pelvic floor mainly function involuntarily, meaning you do not actively have to think about making it function appropriately, it should do it on its own! So contrary to popular belief, “kegels” or voluntarily contracting your pelvic floor several times throughout the day is usually not the answer for any of the above dysfunctions. Your pelvic floor, more often than not, is the victim in the core canister. This means to find relief and resolvement of symptoms we need to look outside the pelvic floor.

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4. The Pelvic Floor Doesn’t Push Your Baby Out During a Vaginal Delivery

When you give birth vaginally, it is a common misconception (usually due to movie depiction) that you need to realllllly bear down to get the baby out, and this sometimes can be equated to needing a “strong pelvic floor”, when in fact your pelvic floor has little to do with helping you deliver a baby. The main thing that is focused on in pelvic floor therapy when pregnant and about to give birth vaginally is making sure the pelvic floor can get out of the way so that the uterus can do the pushing to deliver the baby! Breathing through contractions and breathing with delivery will help manage the pressure in your core canister (discussed above) to decrease chances of prolapse or significant tearing during delivery.

Read: What to expect during pregnancy and postpartum.

5. The Pelvic Floor is still impacted during a C-section

If you have a c-section, whether planned or unplanned, it is important to remember that it is a major abdominal surgery. There are 7-8 layers of tissue that your doctor needs to go through before the baby is delivered, and all of those layers help make up the front wall of your abdomen and connect directly onto the pelvis. In the pregnancy to postpartum transition this can translate to a lot of weakness at the abdominals, which then can cause your pelvic floor to overcompensate and could possibly lead to symptoms of pelvic floor dysfunction such as leakage, heaviness or pressure symptoms, or even pain with intercourse. Working with a pelvic floor therapist post c-section can help you:

Connect with your deep core
Breathe and manage pressure appropriately with activities
Improve wound healing post delivery
Decrease numbness, hypersensitivity, and/or “shelf-ing” at your c-section scar

6. Your Hip Mobility and Foot Mobility Can Impact Your Pelvic Floor Mobility

There is a direct connection between your foot and your pelvis. Oftentimes if you have foot pain or a history of chronic injuries (such as ankle sprains) it can lead to compensation at the foot, which will add to the work your knees, hips, and pelvic floor has to do to control the reaction forces of walking, running, exercising, etc. This can be especially true if you experience pelvic floor dysfunction symptoms during exercise such as leaking while running or jumping!

7. It Is Never Too Late To Fix Pelvic Floor Dysfunction

It does not matter how long you have been dealing with dysfunction, it is never too late to work on regaining your pelvic floor coordination! You could have had a c-section years, or even decades ago, and still regain sensation and mobility. The same goes for leakage, constipation, and intercourse pain!

The body is great at adapting and compensating when it needs to, but given the right resources and tools your pelvic floor can learn to function more appropriately without dysfunction no matter how long you have been dealing with symptoms!

Dr. Megan (she/her) is a pelvic floor physical therapist at Genesis PT & Wellness, a holistic pelvic floor therapy practice including a team of specialty physical therapists, occupational therapists, and birth doulas. Dr. Megan has a passion for treating members of the LGBTQIA+ community, those diagnosed with endometriosis, people experiencing prolapse and pain with sex, and the pregnant and postpartum population. She sees patients in person in Fort Worth, Texas as well as virtually from anywhere in the world!

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