Pelvic Floor- what it is and why we need it.

Okay, I’m going to let in on a little secret. I am kinda obsessed with the pelvic floor. SHOCKER, I know, I know….but yes- I think the pelvic floor is amazing. I am it’s biggest cheerleader- I actually have on my YEAY PELVIC FLOOR! t-shirt as I am writing this. So I want to convert everyone to pelvic floor believers…as a lot of what I teach stems directly from (both figuratively and literally) this musculature.

So the first question that needs to be answered before you can get on the believer train to pelvic floorville, is to know  what the pelvic floor actually is.  (Disclaimer: I’m about to get real up in here and use words like clitoris and anus, so if hearing anatomical words for your body makes you feel a little hysterical, stop reading NOW. You can still keep referring to to these parts as “the things that do that stuff”sssssshhhhh don’t get upset, you’re okay) So the pelvic floor (known from now on as the PF) consists  of three group of muscles:

1. Superficial perineal layer: innervated by the pudendal nerve
   • Bulbocavernosus
   • Ischiocavernosus
   • Superficial transverse perineal
   • External anal sphincter (EAS)
2. Deep urogenital diaphragm layer: innervated by pudendal nerve (for women this is the layer that contains the tendons that hold the clitoris in place)
   • Compressor urethera
   • Uretrovaginal sphincter
   • Deep transverse perineal
3. Pelvic diaphragm: innervated by sacral nerve roots S3-S5
   • Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus
   • Coccygeus/ischiococcygeus
   • Piriformis
   • Obturator internus

When you work on the PF, you will almost exclusively be focusing on the deepest layer, known as the Pelvic diaphragm, even more specifically the Levator Ani. However, it is good to know the way the muscles work. The superficial layer is just that, superficial. It’s main function is to contract and relax the orifices present (so for all of us the the anus and urethra and the vagina 50% of the time). It covers the next two layers which form two overlapping diamond shaped sheathes of muscle that connect at the pubic bone in the front, the sits bones on the side, and the tailbone in the back.

You can watch a really cool video with a model (don’t stress, it’s plastic) of the pelvic floor here 

Now that you have muscled (oy- no pun intended) through all of the anatomical aspects of the pelvic floor, lets now get to the good stuff, what does it DO? First, it holds up and cushions the organs in the pelvis and lower abdomen. Second, the pelvic floor controls the urge to urinate or defecate by sending signals to the bladder and colon and opening and closing the urethra and anal canal. Third, the pelvic floor is the mechanism of sexual function, contracting muscles to respond to arousal and to enhance enjoyment.

First it holds up and cushions the organs in the pelvis and lower abdomen. This is a pretty big statement….so Ill say it again It HOLDS up the organs. Woah! that’s a pretty big task. So basically the PF is the foundation of the body. For women this is even more profound, because when they are pregnant this is the group of muscles that holds the baby in the body and keeps the cervix intact. Second the the pelvic floor controls the urge to urinate or defecate by sending signals to the bladder and colon opening and closing the urethra and anal canal. This is why there is a direct link between incontinence and a weak pelvic floor. Third, the pelvic floor is the mechanism of sexual function,contracting muscles to respond to arousal and enhance enjoyment. Conversely, when the pelvic floor is weak, there is a dulling of sexual arousal in women (remember where the clitoris  is connected?) as well as erectile dysfunction in men.

SO! I feel like I made a pretty convincing case on why we should all pick up our pom poms and start cheering for our pelvic floor. However, though pompoms are fun….they don’t strengthen the pelvic floor. In my next post I will talk about how to strengthen this part of the body. (ps ladies, Kegels are NOT a very effective way to do so….)