What the Heck is My Pelvic Floor? And Why Should I Care About it?
Information on slcpt.com is meant for educational purposes only. The information provided is not meant to be diagnostic and does not replace thorough evaluation and treatment by a medical professional, including that of a physical therapist.
What is the pelvic floor and what does it do?
Your pelvic floor (yes, you have a pelvic floor, no matter the genitalia you were born with or have now) is a group of muscles that sits like a bowl or a sling in the bottom of your pelvis, from your pubic bone to your tail bone and out to the sides deep to your hips. These muscles are quite intimate with your hip muscles, glutes (butt muscles), inner thighs and your core. In fact, the pelvic floor is actually part of your core… did you know that?? Your “core” is not the abs you can see (6-pack abs). The “core” is actually a system that comprises the pelvic floor, deep abs (that you can’t see), deep back muscles along your spine, the diaphragm (yeah, your breathing muscle!), and we are even considering the glottis (up in your throat/airways, whaaaat?) to be part of this system. This system as a whole works to regulate pressure and tension and stabilize the trunk as we move throughout the day or in our favorite activities.
Functions of a Healthy Pelvic Floor
The functions of a healthy pelvic floor have to do with continence (pee, poop and gas), sexual health (arousal, climax), pelvic/spine stability during movement and keeping the pelvic organs (bladder, uterus (females), bowels, prostate (males), etc) inside where we want them.
The pelvic floor muscles (PFM) in conjunction with the other parts of the “core system” form an awesome system that regulates pressure inside the trunk/abdomen when we move- from breathing to walking to running to lifting a barbell or our kids. This is what a healthy core/PF system does for us, but…
What happens when this system, or parts of the system, are not functioning properly or are not well coordinated?
If you are asking, “Do I need to know this? “Does this happen often??” “Is this happening to me???” The answers are probably, totally, and MAYBE!! Think about where babies come from…literally. Think that could have an affect on the pelvic floor muscles? BUT, even folks who have not had babies have dysfunction in the core/pelvic floor system.
So, what is NOT normal?
Peeing, pooping or passing gas..
anytime you don't want to, in ANY amount, no matter what your age or whether you have had a baby or not.
Common examples include peeing (even small drops!) when running, jumping, laughing, coughing, sneezing, lifting; passing gas/ queefing during yoga class; or worse.
Not being able to hold pee/poop for very long
Peeing too frequently
Example: can’t go on a car ride more than an hour or so without stopping
Feeling like something is falling out of your vagina
or like you have a tampon in when you don’t, or pressure/heaviness in the vagina in certain positions, with or without activity. This is Pelvic Organ Prolapse and you do not have to live in fear of these symptoms!
Pain/discomfort with sex or unable to orgasm
Constipation
Pelvic pain or back/hip pain that has gone unresolved
But my doc said…
“Once you have had babies/get older, leaking/prolapse is just part of life.”
This is completely untrue, irresponsible and lazy.
“Not enjoying sex is all in your head, you just need to relax, have a glass of wine!”
old sexist bullshit, see also female hysteria
“Just do Kegels.”
RANT TIME😎: If a doc has told you this without putting his or her finger into your vagina to check your pelvic floor muscles and assess whether you a) even need Kegels (lots of times they will make symptoms worse more than help) and b) if you do need them, are even doing them right (around ½ women are not, studies show), then they have no business prescribing this over- & irresponsibly-prescribed exercise. In fact, they could be doing you a complete disservice if you, in fact, have tight PFM’s. Imagine if your elbow was stuck in a bent position and your doc said, “oh, just do biceps curls.”
Wait, if my doc isn’t helping, who can help me?
Some people need a team approach
Some issues like chronic pelvic pain, issues stemming from trauma- physical sexual, etc, are multifaceted and require a team approach. For example, someone who has faced trauma and deals with resulting chronic pain might benefit from the help of a team of specialists such as a urogynecologist, a mental health professional, a pelvic floor physical therapist and possibly others. If this is you, speak to a healthcare professional that you trust or seek out a pelvic floor physical therapist (we tend to be able to spend a lot more time with you than some other healthcare providers), and they will help you find the right team for you.
Pelvic Floor Physical Therapist
For ALL of the issues listed above, a pelvic floor physical therapist (PFPT) should be the first professional you seek out. You do not need a referral in most states to see a PFPT, but you might want to check your insurance to make sure they don’t require a referral. If a referral is needed... Even if it isn’t, PLEASE advocate for yourself and tell your doctor that you WANT to see a PFPT. More doctors need to be aware of the help that we can provide and should be referring more people to PFPT.
This leads me to an unfortunate truth…
Many people will not have access to a PFPT depending on where they live. In this case, my advice would be to reach out to myself or any provider you can find who will help you find a PFPT. Many of us will do virtual consults and I would bet ALL of us will help you find care that you need and deserve.
Please feel free to comment or reach out! I want to help!
xoxo,
Natasha
Are you a woman who wants to do the things you love with confidence?
I’m Natasha Fett, Doctor of Physical Therapy. I help active women continue or return to doing what they love, and do it for the long term! I treat you one-on-one by looking at your body/mind/lifestyle as a whole and listening to your goals and expectations to give you the care you want and deserve that fits into your busy life. My mission is to help guide you and ultimately empower you to be in tune with your body and manage your symptoms to do what you love with confidence.
