Let’s Talk Anatomy: Pelvic Floor

A huge thank you to Jeanette Knill, PT for guest blogging for us on this important topic!

I am a Physical Therapist that specializes in treating women with pelvic floor disorders (PFD) which means most of the women I see in the clinic have UI or pain in the pelvis, especially during intercourse.

Here are some research findings related to UI:

  •    Nearly 30% of the female population in the US has a problem with urinary incontinence.
  •    It takes the average woman up to 7 years before she tells her healthcare provider that she has a problem. Why? She is embarrassed or thinks it isn’t a problem because many of the women she knows also pee in their pants.
  •    Kegel exercises are only part of the solution to help you regain continence.

Let’s talk anatomy: The pelvic floor muscle is the bottom of the body. In a female, it is the muscle structure that supports the uterus, vagina, bladder and rectum. It controls when we use the toilet and is important in sexual satisfaction. This muscle is like a hammock. It attaches in the front to the pubic bone and in the back at the tail bone. The sides attach to part of the hip bone and a hip muscle (obturator internus) on each side of the body. Other hip muscles that attach near the pelvic floor muscle are the gluteal muscles (your butt) and the piriformis muscles. The low abdominal muscles attach to the pubic bone, just above where the pelvic floor muscles attach. Your low abdominal muscles and hip muscles are very important in the function of the pelvic floor.

Usually, the first recommendation for women who report UI is to do Kegel exercises, tightening the pelvic floor muscles like you are trying to stop pee or gas from escaping. Why gas? Remember I said the pelvic floor is a hammock from front to back. When you tighten the muscle in the front-around the urethra (where pee comes out) you also tighten the muscles in back around the anus (where gas and poop come out). The person next to you knows when you pass gas but you can hide pee in a pad! Thinking about stopping gas can send a stronger signal to the brain and gets a better contraction. Do not tighten your butt cheeks when doing a Kegel exercise.

Some other Kegel tips for success: When you tighten your pelvic floor it is a squeeze and lift. Imagine you are sitting on a grape and you want to pull it up into your vagina. Silly, right? I bet you just did it!

But…it isn’t just about Kegel exercises. Strength at the low abdominal and hip muscles are also important. Crunches are not an effective way to strengthen the low abdominal muscles. Planks and challenging the muscles with leg movements are more effective. Hip exercises that work your “butt cheeks” are beneficial. Stay tuned for future blogs that will highlight the best way to strengthen your abs and butt.

-Jeanette Knill, PT, works at Bellin Health Generations clinic as a physical therapist specializing in the treatment of pelvic floor dysfunction.