Written by Lisa Flanders, Physiotherapist and Co-Founder of Bloom Integrative Health and Movement Centre
Your pelvic floor is likely not something you think about often; however, it is an integral part of your deep core system (more about that later). Your pelvic floor is a powerful group of muscles located within your pelvis. They play a critical role in bowel, bladder, and sexual function. Not only do these muscles support your internal organs, they also act as a pump, helping move fluids from the lower half of the body back up toward your heart.
Unfortunately, many people do not realize the significance of the pelvic floor muscles until they start to experience an issue. Common problems related to pelvic floor health includes urinary or fecal incontinence, pelvic organ prolapse, and painful intercourse. Even low back pain has been linked to pelvic floor dysfunction.
So, what exactly is the pelvic floor? Think of it like a trampoline with its anchor points being your pubic bone, tailbone, and sit bones. It consists of three layers of muscles, with the deepest layer, the pelvic diaphragm, responsible for bowel, bladder, and sexual function, as well as support and pumping actions. The intermediate layer, the urogenital diaphragm, plays a crucial role in sphincter control, while the superficial layer, also known as the urogenital triangle, is primarily responsible for sexual function.
But did you know that your pelvic floor also makes up part of your core? Many people mistake their abdominal muscles for their core, but the truth is that your core is a stabilizer, while the abdominals are movers. Your core is made up of four structures: the pelvic floor (bottom), the respiratory diaphragm (your primary breathing muscle) on the top, the transversus abdominis (the deepest abdominal muscle) in the front, and the multifidus (a muscle in your back that runs from the sacrum to each individual vertebra) in the back.
All these structures work together through breath. When you inhale, your diaphragm contracts and lowers, increasing pressure in your core, while the other three structures lengthen. When you exhale, your diaphragm relaxes, and the other three structures shorten and reflexively contract. To visualize this, think of a balloon: as the air pressure increases, the balloon stretches and as the pressure lowers, the balloon recoils.
If you're experiencing issues with your pelvic floor, it might be time to start pelvic floor exercises like Kegels. A Kegel is a very basic pelvic floor muscle contraction and is a great way to start connecting to your pelvic floor muscles. And like all muscles, the pelvic floor should be able to contract AND relax.
To do a Kegel, lie on your back with your knees bent, inhale deeply, and imagine your breath going all the way into your pelvis; this is the relaxation phase. As you exhale, engage your pelvic floor muscles as if you're stopping the flow of urine; this is the contraction phase. Practice and notice if you feel the difference between the muscle contracting and relaxing. Repeat this basic Kegel exercise, remembering that contracting the muscle is equally important as relaxing the muscle.
But don’t stop with just Kegels and think that is all you need to do. To truly strengthen your pelvic floor, you need to incorporate exercises into your daily routine. This is how you’ll retrain your pelvic floor to act without thinking about it. For example, try doing Kegels while lifting weights, picking up a bag of groceries, or standing up from a chair. A simple way to remember this is the three E’s; EXHALE, ENGAGE (contract) the muscles, and then do your EFFORTFUL task.
Of course, if you suspect you have pelvic floor issues, it's important to consult with a healthcare provider or a pelvic floor physiotherapist. By learning to connect with your body and taking care of your pelvic floor and core, you can take control of your bladder, bowel, and sexual health, and become a stronger, healthier you.
To learn more, please check out Lisa Flanders YouTube channel:
'Bloom Integrative Health and Movement'.