What the heck is the “pelvic floor”?

and why should you care?

The “pelvic floor” is a group of muscles, ligaments and connective tissues which line the pelvis. These muscles surround the openings to our bladder, bowel, vagina, and penis. They are like a sling, or a hammock, that attaches to our pubic bone in the front and our coccyx (tailbone) and pelvic bones in the back.

So many attachments….

Your pelvic floor muscles are connected to many other surrounding structures - either directly or indirectly through fascial attachments. Therefore, your pelvic floor muscles are also connected to your inner thighs, outer thighs, lower abdominals, glute muscles, low back muscles, and even your diaphragm! That means when you move - walk, run, jump, twist, bend, and when you breathe, your pelvic floor muscles contract, relax, pull, release, lift and lower.

So, even though the main job of the pelvic floor muscles are to support your organs and stabilize your pelvis, they are involved in many other functions. Here are some examples:

• They are more like a trampoline than a “floor” - they move, pull, stretch

• Maintain storage of waste from the bowel and bladder

• Relax to allow elimination of waste

• Play a big part in sexual function

• Provide a passage for the birth of a fetus

• Support abdominal and pelvic organs

• Part of your “core” along with the diaphragm, deep abdominals, and deep back muscles

• Control abdominal pressure along with the diaphragm

Muscle Awareness:

“I’ve tried squeezing my pelvic floor muscles, but I don’t know if I’m doing it right?”

First of all, not everyone needs to do “kegals”, and there are quite a few people who should not do them. However, because they move and function with your body, it’s always a good idea to get to know them if you don’t already. For people with vaginas, here are some tips and tricks.

Tips & Tricks:

• Get to know your body: get a small, hand-held mirror, sit on a toilet or get in a reclined position (bathtub or bed) with your legs opened and relaxed. While looking, note the area of skin between the anus and vaginal opening - that is called the perineum. If you try to do a kegal, do you see any closure of your vaginal opening? Do you see the perineum lifting upward? Look to see if the muscles are able to contract (squeeze) and also relax (release).

• Here’s some cuing to think of when trying to contract your pelvic floor muscles:

  -Try squeezing like you are trying to stop urination (the phone rang mid-pee and you have to answer it!)

  -Squeeze your muscles as if holding a marble inside your vagina and you don’t want it to fall out

  -Think of an elevator: if you squeeze the pelvic floor muscles the elevator goes up and if you relax, it goes back down

  -Squeeze like you are trying to prevent passing gas (more muscle activated in the back but this may help - they are all connected)

• You can also insert a (clean) finger inside your vaginal opening and try to pinch your finger and then try “pinch, squeeze, lift” (the lift part is you trying to pull your finger deeper inside using your pelvic floor muscles) and see what you feel.

• Now, try the same thing but do with an exhale of breath.

• Keeping your finger inside, try exhaling as you draw in you lower abdominals muscles slightly, do you feel anything happening with your pelvic floor muscles?

So, that’s it! The big mystery is over. Now you have better body awareness and you can teach your friends! ;)

Remember, the more you get to know your body and how it functions, the better you will be at keeping it functioning at it’s best, and have a better idea of when it’s not, so you can get some help if and when you need it!

People with penises have a pelvic floor too. You can have a visual of the superficial pelvic floor muscles between the anus and the base of the penis if you lift up the scrotum. Here are some cues for contracting the pelvic floor:

• Squeeze your muscles as if you are trying to move your penis

• Squeeze as if you are trying to stop the urine stream or get the last bit of urine out

• Squeeze your muscles as if you are walking into a cold lake

• Squeeze like you are trying to lift your perineum up and off of a golf ball if you are sitting on it

• Think of an elevator, squeeze and the elevator goes up, relax an it goes down (same as before)

• Prevent passing gas (same as before)

Place your fingers on your perineum and feel what it feels like to squeeze and let go. What’s happening if you try these cues while looking with a mirror?