Your pelvic floor is a bowl-shaped group of muscles that live at the base of your pelvis and essentially span the range of all the areas on which you sit. They attach to the pubic bone in the front, the tailbone in the back, and the sit bones on each side. They act like a floor (thus the name), holding up and in all of your internal organs. The pelvic floor activates at a low level throughout the day and coordinates with your abdominal musculature and deep muscles around your spine to serve as your “core” and keeps your back stable during movement. They also are the gatekeepers for your pelvis, regulating what goes in and out. That means that you tell your pelvic floor to squeeze when you don’t want to let out urine, gas, or fecal matter. You also have to know how to tell your muscles to relax enough to effectively allow these elements to pass when you want them to.
A person with difficulty starting their urine stream or with constipation may likely have tension in the pelvic floor. Conversely, poor control or weakness of pelvic floor musculature can result in incontinence, or loss, of stool, gas, or urine during activities like coughing, sneezing, or exercising. A lengthened and weak pelvic floor may also lead to prolapse, or a lowering of the pelvic organs. The pelvic floor additionally serves as the gatekeeper for the vaginal opening. Individuals with painful tampon use, exams, or penetration during sexual activity very often are experiencing their symptoms because of musculature that is contracting, instead of relaxing and gently stretching with attempted insertion. Other symptoms of tension in the pelvic floor are painful sitting, tailbone, rectal, or vulvar pain, even sometimes pain into the abdomen or hips, as well as bladder frequency and urgency. Individuals that have painful periods, IBS, endometriosis, chronic bladder or vaginal infections, and interstitial cystitis will also frequency exhibit pelvic floor tension, as their body tries to guard the area from further irritation and dysfunction.
Who has a pelvic floor? You! And you over there! People of all genders and ages have pelvic floors and all can be afflicted with symptoms when those muscles aren’t working properly. These muscles are so important that there’s even an entire specialty of physical therapy dedicated to getting them as healthy as possible and addressing some of the symptoms mentioned above. If you or someone you know are experiencing something that might be pelvic floor dysfunction, seek out evaluation by a pelvic floor physical therapist.
Resources for pelvic floor physical therapists:
Christina McGee PT, DPT
Christina McGee is a physical therapist at Sullivan Physical Therapy, a pelvic floor specialty clinic in Austin, Texas. She received a bachelor of science in Athletic Training from University of Iowa and a Doctorate of Physical Therapy from University of Delaware. Christina treats men and women with bladder, bowel, and sexual dysfunction, as well as abdominal and pelvic pain. She has specific interests in pregnancy and postpartum care and is additionally the head of Sullivan Physical Therapy's pediatric bladder and bowel program and the Center Coordinator of Clinical Education. Christina also partners with Austin Area Birthing Center to provide pregnancy and postpartum physical therapy care and provide education to AABC clients on site. She is on the medical advisory board of ReCore Fitness.