Pelvic Floor and Your Core!

By Kate Textores, B.S. PTA

Sexual health, urinary health, and ‘women's issues’ are all things that are commonly thought of as (looks around suspiciously) Pelvic Floor problems. But it is nothing to be whispered about like a secret password. Your PELVIC FLOOR also has to do with core stability and creates, with your diaphragm, a unique pressure relationship to increase stability. Shout it from the rooftops, people! Everyone should be paying attention to their pelvic floor and I mean EVERYONE.

We have talked at great length about breathing, and if you have ever come to our office for physical therapy, you are going to know exactly what we are talking about in this month’s blog post when it comes to the pelvic floor. For those of you who aren’t so familiar, your pelvic floor is the bottom of the canister that is your abdomen (if you think about the top of it as your diaphragm). This muscle attaches from your pubic bone to your tailbone and across to the edges of your pelvic to create a hammock-like structure to keep your organs from falling out of you. Totally kidding about that last part, but it does directly support the bladder, bowels, prostate, and female reproductive organs.

Ideally, the Pelvic floor muscles work together with the other muscles of breathing to stabilize the trunk. During inhalation, the pelvic floor muscles are most relaxed but retain enough tension to protect the internal organs when the internal abdominal pressure (IAP) increases. These same muscles also contract during exhalation, further increasing IAP, to help bring the diaphragm back up. The pelvic floor muscles work together with the abdominal muscles and diaphragm to help control internal pressure which results in activation of the transverse abdominis and internal obliques but this is not always the case.

The contraction of the diaphragm and pelvic floor should happen together on its own without any thought from us. Things like poor posture, stiffness and/or weakness of the pelvic floor muscles, damage to the pelvic floor, and overactive fight or flight response can dramatically alter this process. Our pelvic floor muscles need to be flexible and retain the ability to relax as well as contract. When they are stiff and weak together, it can result in urinary urgency and leakage. On the other hand, if these muscles are stiff and too strong they can lead to pelvic pain, pain with intercourse, and difficulty emptying the bladder. By holding our breath and ‘bracing’ to perform exercises we contribute to these dysfunctions greatly which is why we always yell at people to breathe!

Sources:

http://www.pelvicfloorfirst.org.au/pages/the-pelvic-floor-and-core.html
Park, Hankyu, and Dongwook Han. “The effect of the correlation between the contraction of the pelvic floor muscles and diaphragmatic motion during breathing.” Journal of physical therapy science vol. 27,7 (2015): 2113-5. doi:10.1589/jpts.27.2113