Okay, so we’ve all probably heard of the pelvic floor before. But what exactly is this mysterious group of muscles and what the heck does it do?

What is it?

The pelvic floor (PF) is a group of muscles and connective tissues that support important organs in the pelvis, including bladder, bowel, and internal reproductive organs. The PF muscles help stabilize the core and hold these organs in place, while assisting with bodily functions like bowel and bladder control (continence), and sexual intercourse. When the PF muscles are contracted, they lift internal organs in the pelvis and tighten the openings around the vagina, anus, and urethra. When the PF muscles are relaxed, it allows for the passage of urine and feces. These muscles also help the body absorb outside pressure, from coughing or lifting something, to help protect the spine and organs.

The PF muscles, particularly in females, have a few very important functions:

  • Provide support for the bladder, urethra, vagina, uterus, bowel, rectum, and anus
  • Squeeze and relax to control urination, bowel movements, and passing gas
  • Help with blood flow and vaginal contractions during sex and orgasm
  • Support vaginal delivery during childbirth

Where is the PF Located?

The PF muscles form the base of a group of muscles known as the core. The core includes the muscles in your pelvic floor, lower back, hips, and stomach (abdominal muscles). The PF muscles stretch like a hammock from the pubic bone in the front of your body to the coccyx, or tailbone, in the back of your body.  They extend outward to both sitting bones on each side of the pelvis. The PF muscles come together to form a sheet of layered muscle with openings for the vagina, urethra, and anus. 

How do I know if my pelvic floor muscles are functioning properly?

Many pelvic floor disorders can come from the PF muscles being too relaxed and weak, or from the muscles being too tight. The key to a functioning pelvic floor is for the muscles to be strong enough to support the internal organs and stabilize the core, but flexible enough to stretch and relax.

A weak pelvic floor can lead to conditions like

  • Incontinence
  • Pelvic organ prolapse

A tight pelvic floor can lead to conditions like

  • Constipation
  • Pelvic pain
  • Back or hip/leg pain
  • Painful intercourse
  • Difficulty urinating
  • Urinary urgency or frequency

The good thing is that the pelvic floor muscles can be trained with exercise with the help of a pelvic floor physical therapist!

Exercises for the PF muscles can help with improving bowel and bladder control, reducing the risk of prolapse, improving sexual function, allowing for better recovery following childbirth or surgery and overall increasing the quality of life and social confidence.

Signs it may be time to see a physical therapist include:

  • Experiencing urinary leakage when running, jumping, coughing, sneezing, laughing, etc
  • Having a frequent or urgent need to pee (or poop)
  • Having a pelvic organ prolapse or feeling a heaviness in your pelvis and like something is falling out of your vagina
  • Pelvic pain or discomfort
  • Pain with sexual activities
  • Chronic constipation
  • Postpartum
  • Currently pregnant or planning to become pregnant
  • Having a cesarean section or abdominal or pelvic surgery

What to Expect from Your Pelvic Floor PT

If any of the above signs resonate with you, you may be wondering what PFPT looks like. Since each treatment plan is completely individualized and tailored to your specific needs, we spend the first visit getting to know you! Some things you can expect to discuss are your history, what brought you in, your concerns, discomforts, and your goals for treatment. We will also spend time educating you on your condition and how your treatment plan will proceed. We may evaluate your posture and assess your movement through your hips and back. Once we have gathered all of your history, we will develop a treatment plan with you to help get you back to doing what you love.

A typical treatment plan includes a combination of hands-on manual techniques, exercises, and movement coordination to retrain or strengthen your pelvic floor. Some of the modalities and treatment techniques a pelvic floor specialist will use include:

  • Strengthening and flexibility exercises
  • Breathing techniques
  • Myofascial release
  • Soft tissue massage
  • Visceral mobilization
  • Pain education
  • Scar tissue mobilization
  • Biofeedback
  • Taping
  • Functional movement and postural coaching
  • Relaxation techniques
  • Meditation

Let’s work together!

As you can see, PFPT goes way beyond simply performing kegels and can be a useful resource for many different conditions. We focus on treating the entire individual and offer a myriad of techniques and practices to help you achieve your goals. Our pelvic floor physical therapists are here to support you on your journey back to pelvic health so you can get back to doing what you love!

Click here to schedule an appointment with Trudy, or learn more about our Women’s Health Services!

Meet the Expert

Trudy Roth, PT, DPT
Montvale Physical Therapist

Trudy has worked with a variety of patient populations, including oncological, post-surgical, trauma, orthopedic and pelvic floor patients. She enjoys treating orthopedic conditions, but also has a special interest in women’s health physical therapy. Trudy is currently completing a pelvic health residency through Ivy Rehab. Her goal is to earn her pelvic rehabilitation practitioner certification. Learn more about Trudy here.