When patients come to see me for the first time about their pelvic floor functions, they are often confused about why their provider has referred them to pelvic floor physical therapy— and it’s not surprising! Due to a lack of general knowledge on the topic, it can often be a stressful experience for many people to make sense of what is going on when referred to a pelvic floor physical therapist.
When I have a new patient, I always begin by asking, “Do you know what the pelvic floor is? Have you ever heard of it before? Do you know the pelvic floor functions?”
The answers I’ve gotten run the spectrum from yes to no— and everything in between. I have had a number of people who also think that only people with vulvas have a pelvic floor, and individuals with a phallus do not. Some people think their pelvic floor was removed when they delivered a child. Others know what the pelvic floor is but don’t know the pelvic floor functions that are important in their daily lives.
I share these stories with you not to shame those individuals, but instead to demonstrate how widespread and common misconceptions about the pelvic floor and pelvic floor functions really are. If you are not sure what a pelvic floor is or what it really does, you are not alone.
DEMYSTIFYING THE PELVIC FLOOR FUNCTIONS
First things first, it is important to note that everyone has a pelvic floor— men, women, trans men, trans women, nonbinary people, moms, babies, and people who have had hysterectomies! The major difference is that the pelvic floor may be oriented differently based on the person’s individual genitalia and life experiences.
Your pelvic floor is comprised of the 26 muscles that attach behind the front of your pubic bone and run like a sling or hammock back to the bottom part of your spine (the sacrum and tailbone). Your pelvic floor functions in four major ways and works in conjunction with many other very important areas of your body.
4 MAJOR PELVIC FLOOR FUNCTIONS
These 26 muscles in your pelvic floor are a busy group, and even though they are internal, they can be treated and trained. Your pelvic floor functions can affect of many major areas of your body, including your spine, hips, diaphragm, back muscles, core, and abdominal muscles. You might find it surprising that it is also important for blood and lymph fluid circulation!
The first of the major pelvic floor functions is pelvic organ support. Naturally, organs tend to move towards the area of least resistance. Your stomach region creates a great deal of pressure which can push on pelvic organs. The pelvic organs include the bladder, uterus, ovaries, vagina (if you have these), small bowel, and rectum.
If you are constantly straining during urination or bowel movements your organs move constantly towards the ground. If you hold your breath when you lift heavy objects it can cause the same issue. Without the counter-effort from your pelvic floor, your organs will just head right on out of your body and plop on the ground. I feel confident in guessing that you do not want that happening. Typically individuals will have a sense of something falling out, however, even if you do not have this sense, I would not recommend frequent straining as this can lead to a prolapse.
The second of the major pelvic floor functions is to support your spine, pelvis, and hips. Because the pelvic floor is literally the base, or floor, of our core canister, it works to aid stability in these areas. Your core canister is the cylinder, or pillar-shaped, of muscles reaching across your pelvic floor, up through and including your abdominal and back muscles, and reaching its top at your diaphragm.
You can imagine how the stability of your spine, pelvis, and hips would be important to this canister. I personally feel that this is one of the most important functions that the pelvic floor performs because it requires not sheer strength but overwhelming coordination with a multitude of other muscle groups to get the job done right. Patients will often be treated for hip and back pain for years with no success, and they discover that the issue the whole time was with their pelvic floor.
The third of the major pelvic floor functions is bladder and bowel continence. Your pelvic floor has to be able to contract and relax when you want it to, so you are able to maintain continence but also empty when you choose. Many people come to me and report, “Everything is fine until I pull out my keys to open the door, and instantly it’s like, ‘Get out of the way! I HAVE to pee!’”
Conversely, I also hear, “No, I am not constipated! But I take all these medications every day, and if I don’t then, well, I only go once a week…” I promise you, THAT IS NOT NORMAL! If this is your experience, I can not encourage you enough to seek out a healthcare individual about your symptoms.
The fourth of the major pelvic floor functions is sexual appreciation. Common issues people report having in this area are any number of things: pain, a change in your arousal level, changes in the strength of orgasm, difficulty getting into, or pain with certain positions, you once loved. Listen, sex isn’t all 50 shades of grey for everyone, but we can get you to a place to meet your goals and achieve your fantasies!
DIAGNOSING ISSUES WITH PELVIC FLOOR FUNCTIONS
The way one’s pelvic floor functions is a major key to lifetime health, but it is often left out of the conversation when dealing with any primary care physicians. It performs so many key functions and works in conjunction with other core areas of your body to perform innumerable other functions across your body. Just because the pelvic floor is internal doesn’t mean it can’t be exercised and even stretched just like any other muscle in your body.
The first thing you need to do if you notice pelvic floor dysfunction-related issues is to identify which of the muscles within the group you need to give some attention to. Finding a pelvic floor physical therapist can help you with this identification and get you started on the journey to healing.
Once you have a pelvic floor physical therapist, they should help you to better understand your own pelvic floor by identifying your various areas of concern, through a thorough history and physical exam, then they will outline a comprehensive treatment plan to help you achieve your goals.
I have gained experience with a variety of cases through years of patient care, as well as during my education and research while earning my doctorate at the Mayo Clinic in Minnesota.
I offer inclusive patient care, treating all gender identities and conditions relating to the pelvic floor; and work to create a safe space to discuss and learn about common pelvic floor conditions. I always work to ensure a professional but accessible experience for all of my patients; challenging the status quo to diminish shame and instead create courage and vulnerability in topics that are typically considered taboo.
I am passionate about creating accessible resources, education, and products for individuals suffering from pelvic floor conditions in order to help them work towards a better quality of life.
If you feel that would benefit from pelvic floor physical therapy or think you are experiencing symptoms that may require diagnosis, you can book a FREE 20-minute consultation with me any time!
Or, if you’d like to learn more about all things pelvic floor health, head over to Instagram! You can always reach out in the DMs if you have any questions!
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