The pelvic floor. When you hear that term, do you know what it means? Can you get a mental image of what is being talked about or do you think to yourself “I know I have heard that before but I don’t really know what it means?” I hope to get you into that first category today. Just like the floor of your home acts as an indicator of the health of its foundation and function, so too is your body’s pelvic floor. You can get really good clues as to how your foundation is functioning by learning to pay attention to your pelvic floor.
Your pelvic floor is a group of muscles and fascial (connective tissue) layers that spans across the basin of your pelvis. Let’s define your bony pelvis first, to give context. The front of the pelvis is the hard bony joint just in front of the bladder. This is called the pubic symphysis. The bottom of your bony pelvis can be thought of as your sit bones. At the back, you have your sacrum wedged in between your flared hip bones (ilium).
Attaching to the bottom of the pelvic bones, are muscles and connective tissue that work to support your organs in the pelvic cavity above. They also help to maintain bladder and bowel control (continence), aid in sexual appreciation, and promote stability in the nearby joints.
This crucial area of the body is rarely thought of until it begins to break down and not do its job as easily as it always has. When we begin to have leaking with a cough or sneeze or suddenly have trouble getting to the restroom in time, then we start to take notice of our pelvic floor. When we feel an unusual heaviness in the abdomen or around the vagina after being on our feet all day, then we may take notice of our pelvic floor. When sex is of no interest anymore, or it hurts to be intimate, then we might take notice of our pelvic floor.
I am grateful that my area of specialization in physical therapy is working with pelvic floor disorders, because honestly I had very little knowledge of this area until my professional interest led me to it. I wish that women everywhere could be better educated on their bodies at an early age so they could be in tune with the messages it was giving them. Doing so would likely mean that we would begin paying more attention to our pelvic floor before and during pregnancy and really taking good care to heal after delivery. We would not be so caught off guard as to the things that seem to suddenly change after becoming a mother or as we enter perimenopause. Because I promise, as sudden as it may seem, there are warning signs that things are changing, long before most of us recognize it.
What does this education look like? It starts by being able to find your pelvic floor and make the muscles tighten and relax. It means learning to use the muscles in the right way during daily tasks and functional or sport activity. It means knowing that leaking isn’t normal, even if you have had kids. And that it shouldn’t hurt to be intimate. Just because leaking and discomfort may be more common as we age, it doesn’t make it normal. Those are symptoms of a pelvic floor that is not working as well as it should be. It is giving us clues to a cracking foundation.
When you are sitting upright in your chair, can you gently squeeze the muscles around your vagina or rectum and feel the tension and upward lift? Good. Now can you do it without holding your breath? If not, it will take some practice. Can you gently push down as if you are blowing up a balloon in your belly and feel the pressure slightly fill out around the rectum? I hope so. If not, you may have trouble relaxing your pelvic floor appropriately. If you struggle with feeling either the tightening or the relaxing of the pelvic floor, it might be a good idea to consider a consult with a pelvic health physical therapist. Especially if you are getting signals from your body that your pelvic floor is struggling to do its job. You wouldn’t ignore cracks in your floor at home, so don’t ignore the “cracks” in your body’s floor.