March 17, 2021  | By

By: Jeanine Robotti, Physical Therapist

Your pelvic floor – women may know about it through experiences at their gynecologist or through childbirth. Men likely don’t even think they have one (spoiler alert – they do!). So what exactly is the pelvic floor and what does it do?

Anatomy and Function of the Pelvic Floor

The pelvic region of the body includes the bony pelvis, the pelvic cavity (the space enclosed by the bony pelvis), the pelvic floor (below the pelvic cavity), and the perineum (below the pelvic floor). The pelvic floor is made up of a myriad of muscles and ligaments that stretch like a hammock from the pubic bone (at the front) to the coccyx or tail-bone (at the back) and from side to side. It is an integral part of your ‘core’. The pelvic floor has two main functions: it supports the internal organs and contains a passage for the urethra, sex organs, rectum, and birth canal. It has other duties too, including coordination of breath and as a trigger for core engagement for most movements. It also plays an important role in balance and good body posture. Many low-back, hip, and knee problems can be addressed through pelvic floor training. It helps center the body and allows for a sense of lightness when upright.

Diagram of Pelvic Floor muscles in the body. | Physio Logic NYC, Brooklyn, NY

The bony pelvis, which protects the pelvic floor and internal organs, consists of two hipbones called ilium that are connected in the front at the pubic symphysis. There are five joints within the pelvis: each ilium with the pubic symphysis in the front (2), with the sacrum in the back (sacroiliac joints) (2), and between the sacrum and the coccyx (1). The bony pelvis distributes the weight of the upper body, provides a surface for muscle attachments, contains the birth canal, and allows for efficient use of the lower body as a bridge with the upper body.

Goals of a Healthy Pelvic Floor: a good pelvic floor needs to be both strong and solid, yet open and clear.

The pelvic floor requires dynamic training, the goals of which are to build body awareness, flexibility, and strength. Lacking these traits can result in problems giving birth, lack of fitness, and bad posture.

In order to create a flexible pelvic floor and a strong, stable pelvis, we must understand the movements of the pelvis. The pubic symphysis in the front and the sacroiliac joints in the back create the working pelvis. These joints allow for movements of forward and backward tilting, left and right shifting, and rotation. All of these movements of the pelvis involve the condyles or balls of the hip joints and rely on pelvic floor flexibility. The ischial tuberosities, the hip bones, and the pubic bones work antagonistically to allow for the coordination of the legs and spine, and for giving birth. These movements are small, as too much flexibility would cause destabilization; yet too little can severely limit movement in the legs and spine, not allow for cushioning during impact and cause walking to be robotic.

The most effective way to strengthen a muscle is through combined concentric (shortening) and eccentric (lengthening) contractions. By emphasizing the eccentric, one has the advantage to build strength and flexibility. Eccentrically working a muscle elongates the fibers, similar to stretching. An inflexible pelvic floor has little chance to build strength because it only has an isometric (static motion) contraction available. Flexibility must come before strength.

How to Create Flexibility and Strengthen Your Pelvic Floor

The muscles of the pelvic floor create an interlacing sling shaped like a fan to support the internal organs. Visualizing the opening and closing of this fan helps to coordinate the movements of the pelvis. This awareness allows for flexibility in our hips and spine. As you do the below exercises, visualizing the “fan” will ensure you are doing the movement accurately.

Plié Squat:

Starting with a plié squat: Stand with your feet turned out wider than shoulder-distance apart. Place your hands on your thighs to help visualize the movement of the thigh bones as you squat. Start to bend your knees out over your feet and feel the outward rotation of your femurs. As your thigh bones rotate out, your sitz bones widen and your pelvic floor expands. As you straighten up, the reverse happens: thigh bones rotate inward, the sitz bones come together, and the pelvic floor contracts. Repeat this several times to feel these sensations. The same dance of the bones and pelvic floor occur during sitting and standing.

Lumbar Imprint during exercise:

In Pilates, we perform an imprint or lengthening of the lumbar spine for many exercises. This allows for greater support for the low back when lifting both feet off the floor by pre-shortening the abdominal muscles. In order to properly imprint, it is important to understand what is happening to the pelvis. First the pelvic floor contracts with a sense of drawing up toward the center. Then the pubic bone rises, the hip bones widen and sink, and the sitz bones draw closer together. The lumbar spine is now in slight flexion and closer to the floor. In the reverse, tilting past neutral to an extended lumbar spine, the pelvic floor expands, the pubic bone drops, the hip bones shift toward one another and the sitz bones widen. In standing, shifting away from a neutral pelvis to an imprint or posterior pelvic tilt, or into lumbar extension, anterior pelvic tilt, affects the pelvic floor’s ability to be flexible and adaptive to movements of the spine and hips for everyday activities.



 

CatCow:

The same movements of the pelvis and pelvic floor occur during the Cat-Cow exercise.

Try performing these simple pelvic floor exercises focusing just on the pelvic bones and pelvic floor movements. Use your hands to feel these slight bony shifts as you visualize the opening and closing of the pelvic floor fan. Next, take these movements to the catwalk and strut your stuff allowing your pelvis to move side to side and forward and back. Feel how important it is to have flexibility through your hip joints and spine in order to take long strides and feel buoyant on your feet.

Becoming aware of the movements of the pelvic bones and the response of the pelvic floor muscles as you perform these exercises and during everyday activities will help promote flexibility throughout the pelvis and relieve tension in the hips and lumbar spine.

If you feel restricted or experience pain, a consultation with a Physio Logic physical therapist, pelvic floor therapy specialist, or chiropractor can help determine the cause of your discomfort and guide you toward your goal of pain-free movement. Give us a call or start by filling out the form below.


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