The pelvic floor is a dome-shaped structure made up of muscles and other connective tissues which stretch like a hammock from the pubic bone to the coccyx and across the ischial tuberosities (sitting bones). The muscles and connective tissue structures which make up the pelvic floor, form the base of the core muscles and separate the pelvic cavity above from the perineal region below.
The function of the pelvic floor:
- Control the release of urine, faeces, and flatus
- Delay emptying (voiding)
- Sexual activity
- Pregnancy and childbirth
- Support the abdominal and pelvic viscera (bladder, urethra, prostate (males), vagina and uterus (females), anus, and rectum, along with the general support of the intra-abdominal contents)
So many daily activities that we do place extra force on our pelvic floor, for example when we lift objects, laugh, sneeze, cough, and even laugh!
Dysfunction of the pelvic floor
Pelvic floor dysfunction is used to describe numerous symptoms and anatomical changes which can be associated with abnormal function of the pelvic floor musculature. The muscles may be overactive (hypertonic) or underactive (hypotonic) or have inappropriate coordination.
Dysfunction in this part of the body can result in the following:
- The inability to void urine and faeces (incontinence)
- Pelvic organ prolapse
- Pelvic pain -chronic pain lasting more than three to six months, unrelated to other defined conditions
- Sexual dysfunction
What is incontinence?
Incontinence is a problem experienced by both males and females, of different races and cultures across the world. Incontinence refers to the involuntary release of urine and/or faeces. When the pelvic floor muscles contract, the urethra, anus, and vagina contract. The contraction is important in preventing the involuntary loss of urine or rectal contents. The pelvic floor muscles must also relax in order to void. A hypotonic or underactive pelvic floor can cause incontinence.
What is Pelvic organ prolapse?
This refers to when pelvic organs descend into or outside of the vaginal canal or anus. Risk factors include but are not limited to age, obesity, history of a hysterectomy, pregnancy/ labor, etc. There are varying degrees of pelvic organ prolapse.
Some symptoms include:
- Seeing or feeling a bulge or “something coming out” of the vagina
- A feeling of pressure, discomfort, aching, or fullness in the pelvis
- Pelvic pressure that gets worse with standing or coughing or as the day goes on
- Incontinence or problems having a bowel movement
- Difficulty or pain inserting tampons
If you suspect that you are experiencing any pelvic floor dysfunction, it is important that you contact an experienced physiotherapist. Physiotherapists with a special interest in pelvic floor dysfunctions are able to assess, diagnose and treat the above-mentioned conditions and give appropriate advice to aid in your recovery.
A healthily functioning pelvic floor makes all the difference with regard to your quality of life. A dysfunctional pelvic floor may affect your confidence when doing actions that exert pressure on your pelvic floor such as coughing, sneezing, running, and jumping. Please refrain from self-diagnosing and self-treatment and seek guidance from a medical professional for any pelvic floor-related conditions. The pelvic floor is after all a wonderful part of our body.