Whether you are male, female, or non binary, we as human beings all have a pelvis. Males or XY chromosomes have a slightly smaller space between the two iliac crests, while females or XX chromosomes tend to have a wider girth in order to support the load of bearing a child. Regardless of gender, pelvic floor health is incredibly important and symptoms of dysfunction are so much more common than people realize or tend to think about. Have you ever had increased urgency or frequency in urination, been unable to control the bowel or bladder, or felt like you can barely make it to the bathroom? Have you ever been to an exercise class that incorporated jumping or hopping movements and noticed you wet yourself slightly? Is sex painful or uncomfortable? Has your sex drive been lower than usual, experienced difficulties getting or maintaining an erection, trouble lasting during sex, or unable to climax? Do you have chronic low back, hip, or saddle area pain? These are all various signs and symptoms of pelvic floor dysfunction.
The pelvic floor has 3 layers and divisions including the urogenital and anorectal triangles. It is innervated by the parasympathetic plexus from our autonomic nervous system (meaning should happen automatically) as well as somatically from our sacral plexus (which contributes to the low back and saddle area pain). The main functions of the pelvic floor include the 5 S’s:
- Sump pump – A major area of lymphatic and venous drainage.
- Sexual functioning – Responds according to the human sexual functions of the brain.
- Sincterix – Causes opening and closing of the Sphincters.
- Stability – The pelvic floor stabilizes the coccyx, the sacrum, and the pelvis in space.
- Support – Supports the abdominal organs.
Three additional functions that we are not in control of and the pelvic floor does (or SHOULD!) do automatically are:
- Tonic contraction with sustained load (stabilizing when lifting something heavy).
- Anticipatory contraction (tensing preemptively to prepare for load or control bowel/bladder).
- Breathing and pressure management of the abdominal cavity.
Our core is why we can stand up straight, and the pelvic floor is the base of our core. It SHOULD be a pliable surface that lifts as it contracts and descends as it lengthens. Dysfunction can occur when the pelvic floor is overly active and tense, or underactivated. There needs to be a happy balance! One way to improve pelvic floor function and awareness is exhaling with retention (holding the breath at the very end of an exhale), which leads to engagement of the deep abdominals without pushing pressure down into the pelvic floor and heart. Work to engage this area by imagining drawing your sits bones together and zippering up or pulling up from the pubic bone DURING EXHALATION in various movement patterns and positions. Relaxation of this area is just as important; work on relaxing this area when diaphragmatically breathing. When inhaling feel the belly rise BUT ALSO the rib cage expelling laterally (out to the side) and front to back, which are equally as important. Other ways to relax this area include the use of a “Cooch/Gooch Ball” which is like a foam roller specifically designed for your pelvic floor to allow for myofascial release just as you would use on other tissues of the body.
EVERYONE can benefit from these simple techniques to bring awareness to this area of the body that is so important for our sexual health and overall well being. We practice many of these deep abdominal and pelvic floor contractions with breath retention methods in our LYT yoga practice. Join me on Wednesdays at Roper PT Yoga Studio or online at my website MYWINPT.com to become a member and gain access to a new class every week. I hope this helps with any of the symptoms above you might be experiencing!
Your Physical Therapist,
Dr. Sarah Kingsley PT, DPT, RYT
This information is generalized and intended for educational purposes only. Due to potential individual contraindications, please see your primary care provider before implementing any strategies in these posts.