PELVIC FLOOR 

MUSLCES

The name gives it away; these muscles are very much the floor of the pelvis! They attach together and form a hammock in between the pubis bones at the front and the coccyx bone at the back, and then from each sitting bone either side.  There are two passages for men (urethra and anus), and three for women (urethra, vagina and anus.) Some of the pelvic floor muscular layers which are more superficial than deep (closer to the skin) are called the urethra sphincter and the anal sphincter. These muscles are much like a figure of eight around front and back passage and their role is to tighten closed during any change in intra-abdominal pressure or ‘stress’ to the pelvic floor. If these muscles are weak, the muscles are unable to efficiently tighten, resulting in incontinence.  If this muscle is too tight, this can result in pain and/or sexual dysfunction

What are the roles of the pelvic floor muscles?

Support

The Pelvic Floor Muscles (PFM) act as a hammock to support the bladder, rectum and uterus/womb against gravity and when there is an increase in intra-abdominal pressure. If the PFM are weaker or have undergone specific strain (such as pregnancy and childbirth, excess heavy lifting or high impact exercise,) or through weakening of the pelvic floor ( through age or menopause) the pelvic organs have less support from the pelvic floor which can result in movement internally, also known as pelvic organ prolapse.

Stability

The pelvic floor makes up our ‘core muscles.’ The muscles in our pelvic floor attach closely to the sacro-illiac joint (SIJ), lumbar spine and hips, which means strengthening the PFM can help with the rehabilitation of the above issues too!

Sexual

Sexual intercourse can be uncomfortable for a lot of women. Dryness is one of the most reported side effects of going through the menopause which can result in pain during intercourse. Also, if our pelvic floor muscles are weak, men may be unable to sustain an erection and women may be unable to achieve orgasm, or complain of a weak orgasm. If our pelvic floor muscles are too strong, penetration may be difficult and pain can be experienced during or after penetrative intercourse (dyspareunia).

Spontaneous sphincter contractions

We have some sphincter muscles around the opening/closing of the bowel and bladder. Their role is to automatically tighten with any increase of abdominal pressure such as coughing, sneezing, laughing, running or lifting. The functional muscles here would then contract quickly and involuntary to tighten closed and prevent leakage. If these muscles are weak, symptoms of urinary or bowel incontinence can be reported. The sphincter muscles also have a role to relax and lengthen for timely and appropriate emptying of the bladder and bowel. 

 

What can weaken the pelvic floor muscles?

  • Pregnancy and Childbirth

  • Straining on the toilet ( constipation)

  • Chronic coughing ( medication side effects/smoking/chest conditions)

  • Persistent heavy lifting

  • Obesity / weight gain

  • Going through the menopause / increase age (oestrogen withdrawal) 

  • High impact exercise