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Demystifying the Pelvic Floor: Understanding Its Anatomy and Function

  • stephanytritt
  • Feb 20
  • 4 min read



You may have already heard of the pelvic floor in your exercise class, among friends or on social media - but if you don’t have a clear picture of what it actually is, keep reading! 

The pelvic floor is a group of muscles that lie at the bottom of the pelvis of both women and men. They create a “hammock” in your saddle area surrounding your genitals and anal area. Often, women will hear these muscles referred to as their Kegel muscles and have been told to do Kegel exercises. They are named after the gynecologist Arnold Kegel (1894-1972) who created a device to measure the strength of the pelvic floor muscles and was one of the first to suggest the contraction of these muscles as a conservative approach for urinary incontinence.


What do these muscles do? 


They do quite a lot!  We use them to control when we will empty our bowel and bladder. A simple explanation would be that we contract them when we don’t want to eliminate our bowel or bladder, and relax these muscles when we do. So if we start having unexpected leaks, no matter how small and regardless of your pregnancy history, it’s a sign that these muscles aren’t quite doing their job. On the contrary, if we’re constipated or having trouble initiating urination, or have the feeling that we can’t fully empty our bladder, the pelvic floor may still be a source of this dysfunction.

Our pelvic floor muscles help in supporting our internal organs and manage our intra-abdominal pressure while helping us maintain ideal posture. They are part of our “core” and work with our abdominal muscles and diaphragm (primary breathing muscle) to support our low back and manage pressure with activities. Performing a small forced expiration alone can contract our pelvic floor muscles. This is why exhaling while performing a task, instead of holding your breath, is one way to help recruit your pelvic floor muscles and support your internal organs - as well as help with any leaks. When pelvic floor muscles aren’t providing the support you need, you may feel a heaviness in the pelvis or suffer from prolapse. 

Reproductive function is also supported by the pelvic floor muscles. They allow for intimacy in both males and females, and aid in pregnancy and delivery of a baby. When pelvic floor muscles are weak, it may limit erectile capabilities in males and limit pleasure in women. These muscles may also be in spasm and a source of pain - leading to dyspareunia, or painful sex that can significantly impact one’s quality of life. The pelvic floor muscles have a significant role to play in pregnancy, regardless of a pregnancy carried to term or method of delivery. 


Over active or Under active?

A pelvic health physical therapist can help you understand if your symptoms are due to an over active (tight and in spasm) pelvic floor muscle, or one that is under active and weak. Like other muscles of the body, the pelvic floor muscles need strength, coordination, endurance and flexibility. Additionally, the pelvic floor muscles need to work with other large groups of muscles to be most effective.


Because of these three global functions of the pelvic floor muscles, symptoms often may overlap. If you’re suffering from symptoms related to the bowel/bladder, pelvic organ prolapse (POP), sexual dysfunction or pain with intimacy - even persistent back, pelvic or hip pain, come in for an evaluation to see how we can get you relief from your symptoms. 


Follow us on Instagram @foothillphysicaltherapy and keep up with our blog for more detail into the Pelvic Floor. 


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References:

  1.  https://en.wikipedia.org/wiki/Arnold_Kegel

  2.   Ghoniem, G., Stanford, E., Kenton, K. et al. Evaluation and outcome measures in the treatment of female urinary stress incontinence: International Urogynecological Association (IUGA) guidelines for research and clinical practice. Int Urogynecol J 19, 5–33 (2008). https://doi.org/10.1007/s00192-007-0495-5

  3. Bannister, Tami MSPT. Physical Therapy Management of Pelvic Floor Dyssynergia. Journal of Women's Health Physical Therapy 33(3):p 16-21, Winter 2009.

  4. Kitani, Lenore J. PT, ScD1; Apte, Gail G. PT, ScD2; Dedrick, Gregory S. PT, ScD3; Sizer, Phillip S. PT, PhD1; Brismée, Jean-Michel PT, ScD1. Effect of Variations in Forced Expiration Effort on Pelvic Floor Activation in Asymptomatic Women. Journal of Women's Health Physical Therapy 38(1):p 19-27, January/April 2014. | DOI: 10.1097/JWH.0000000000000005 

  5. .Pierre Lavoisier, Pascal Roy, Emmanuelle Dantony, Antoine Watrelot, Jean Ruggeri, Sébastien Dumoulin, Pelvic-Floor Muscle Rehabilitation in Erectile Dysfunction and Premature Ejaculation, Physical Therapy, Volume 94, Issue 12, 1 December 2014, Pages 1731–1743, https://doi.org/10.2522/ptj.20130354

  6. Trahan, Jennifer SPT1; Leger, Erin SPT1; Allen, Marlena SPT1; Koebele, Rachel SPT1; Yoffe, Mary Brian SPT1; Simon, Corey DPT, PhD1; Alappattu, Meryl DPT, PhD2; Figuers, Carol PT, EdD, MS1. The Efficacy of Manual Therapy for Treatment of Dyspareunia in Females: A Systematic Review. Journal of Women's Health Physical Therapy 43(1):p 28-35, January/March 2019. | DOI: 10.1097/JWH.0000000000000117 

  7.  Simonds, Adrienne H. PT, PhD1; Abraham, Karen PT, PhD2; Spitznagle, Theresa PT, DPT, WCS3. Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population. Journal of Women's Health Physical Therapy 46(1):p E1-E38, January/March 2022. | DOI: 10.1097/JWH.0000000000000236 



 
 
 

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