Introducing Your Pelvic Floor

Hello, I’m Phillipa Butler, a Chartered Physiotherapist and Certified Pilates and Yoga Teacher.

My philosophy in my own life is that prevention is better than cure and I believe that a regular programme of appropriate exercise is the key to a fitter, healthier future. Bladder weakness is no different, but it can be a bit trickier to get right. I love to understand what is happening inside the body and, if we have a problem, understanding what is happening can really make a difference when it comes to fixing it.

What is the pelvic floor and what does it do?

The pelvic floor is a group of muscles, like a sling or hammock, that forms the floor of the abdominopelvic cavity. The muscles are attached between the pubic bone at the front and the coccyx at the back and from one side of the pelvis to the other. 

The two main functions of the pelvic floor are:

To hold up the abdominal and pelvic organs.
To help to control the bladder and bowels.

The Pelvic Floor Muscles

The most important muscles for us to understand are the brightly coloured muscles that surround the openings in the pelvic floor and help us to maintain continence. These muscles are grouped together and called Levator Ani.

Watch a demonstration of the anatomy of the pelvic floor in my video: Pelvic Floor Anatomy for Beginners.

Pelvic Floor Muscles: What goes wrong and why

There are many disorders affecting the pelvic floor, but they can be broadly grouped into disorders of support (e.g. pelvic organ prolapse) and problems associated with constrictor function (e.g. urinary and faecal incontinence). Furthermore, these disorders can be further divided into dysfunctions of pelvic floor contraction (faecal and urinary incontinence) and relaxation (constipation and urinary retention).

There are many factors that can contribute to pelvic floor problems; a common contributory factor for females is pregnancy and childbirth.

Possible Effects of Pregnancy and Childbirth

If you delivered a baby vaginally you have an increased risk of pelvic floor dysfunction. A study in 2013 found that having a baby delivered vaginally is associated with a 67% increased risk of urinary incontinence (UI), and the risk of having UI that lasts for more than ten years was increased by 275% compared with a caesarean section.

Having three babies or more increases your risk or pelvic floor dysfunction as does obstetric trauma when pelvic floor muscles, nerves or fascia can be damaged. 

Causes of trauma include:

  • Delivering a baby with a large head overstretching pelvic floor muscles
  • An instrumental delivery (forceps or ventouse)
  • Perineal tears (2nd, 3rd or 4th degree tears)
  • Being cut (episiotomy)
  • A long second stage of labour. 

  • Other contributing factors include:

Hormonal status
Exercise levels

Having a chronic respiratory condition.

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