The pelvic floor is a group of muscles and tissues that form a supportive “hammock” at the base of the pelvis playing an essential role in maintaining proper bladder, bowel, and sexual functions. 

Understanding and identifying your pelvic floor is essential to maintain good health and prevent issues such as incontinence or pelvic organ prolapse. In this comprehensive guide, we will explore the anatomy of the pelvic floor, how to identify these muscles, and list some exercises to keep them strong and healthy.

Understanding the Anatomy of the Pelvic Floor

Before learning how to identify your pelvic floor, it is essential to understand its anatomy. While anatomical terms are important in differentiating sections of the pelvic floor, what is more important is understanding there are multiple layers. 

The pelvic floor consists of three distinct layers of muscles and connective tissue that stretch from the pubic bone in the front to the tailbone, or coccyx, at the back and from one sit bone to the other. These layers include:

Superficial Muscles

These muscles control the openings of the urethra, vagina, and anus.

Often dysfunctions occur here when there is a grade one (1) tear postpartum and scarring causes the perineum to pull too tight. Symptoms patients complain of in this layer are pain with sex, insertion of tampons, and hemorrhoids. 

This area relies on moisture and patients will come in and complain of vaginal dryness. This is where your OBGYN or urogynecologist will have prescribed pharmaceutical interventions to help maintain the ideal biome in the female vulva.  

Middle Layer

This layer is the vaginal canal. It consists of the urogenital diaphragm which is made up of the deep, transverse perineal muscles and the sphincter urethrae.

Dysfunctions patients complain about in this second layer are most often signs of a UTI, repeated, but not medically diagnosed to have a UTI, pain with sex, specifically describing a “bump, or blocked” feeling when penetration is initiated. This is also where sometimes an organ prolapse will drop down and heaviness is described. 

Deep Layer

The deep layer includes the levator ani muscles (puborectalis, pubococcygeus, and iliococcygeus) and the coccygeus muscle. These muscles form the primary support structure for the pelvic organs.

During an examination, not only is the pelvic floor palpated, but also its prime supports to help the pelvic floor move optimally; the piriformis and obturator internus. These muscles help with stability and can also be treated in orthopedic settings. Thus, myth-busting the idea that the pelvic floor can only be treated internally. 

Dysfunctions of patients are more complex as it addresses the deepest layer of the pelvic floor. However, common complaints in the clinic are heaviness or dropping down, tightness with penetration, bloating, cramping, tailbone pain, SI joint pain, low back pain, abdominal pain, a shift in the pubic bone, constipation, and incontinence.  

Locating Your Pelvic Floor Muscles

We all have a pelvic floor and there is a reason you can’t feel it.  It is mainly composed of 70% slow twitch fibers, which means these are your marathon muscles, muscles you will not feel when they contract; instead, you will feel all the other muscles that help it co-contract. 

To identify your pelvic floor muscles, you can try the following techniques:

Towel Rolls 

Roll up two to three towels and sit as you would on a horse, otherwise known as saddle sitting, on a chair or the ground. It will be a tad uncomfortable because you will directly address the pelvic floor’s first layer. 

As you inhale, the pelvic floor stretches and it will push down on this towel roll with the most pressure. You will likely find that you need to adjust to find your comfort level. As you breathe out, the pelvic floor contracts and there will be a lift and relief from this towel roll. 

You may be thinking, “I feel nothing, just a lot of pressure.” That’s okay! Take a few breaths and come back to it another day and try again.

Putting on Those Tight Jeans 

Ever have those pairs of jeans that were so tight that you would have to lay on your bed and breathe in and out to help button them? I have!

Now, instead of putting on those jeans, lay on your back with your knees up in the bridge position and just breathe. The pelvic floor relies on the pressure system in your abdomen, and fortunately, activating your pelvic floor can be super easy. 

Breathe in, and as you breathe, place your hands on your pelvic bones–the bumps in the front  towards your pubic bones–and feel for a flicker of contraction as you breathe out. That is your pelvic floor. 

Kegels?

Additionally, kegel exercises may not be the answer for everyone. They’re great at helping you lift your pelvic floor, but if you’re not taught how to properly perform them and adapt them to your specific needs, they can be either painful or useless.

So, the next time you hear advice to “Just do kegel exercises,” take a minute to ask yourself:

• What am I feeling?
• Where is the dysfunction?
• How can I alleviate it? 

Pelvic Floor Exercises for Improved Health

Once you have identified your pelvic floor muscles, it is important to perform exercises to maintain their strength and function.

Bear

My favorite way to activate the pelvic floor with its co-supporters is in the hands and knees position. Note that this position is often used in the cat and cow positions in yoga.

• Breathe in for a cat position, and as you breathe out, lift your knees off the ground about 1-2 inches
• Take a breath here to breathe in and out 
• Notice it is easier to hold here as you breathe out 
• Now breathe out and come to the ground 
• To progress, breathe out for the cat position and lift

Squatty Potty 

Improving sitting positions every time you use the bathroom will help the pelvic floor significantly. A supported squat will help both your bowel movements and pelvic floor when using the bathroom. Just make sure that you never strain yourself while in this position.

Additionally, do not sit in this position for more than five to ten minutes even if there is no movement, and adjust your body positions as necessary to improve your relaxation and comfort.

Yoga

Starting yoga will not only benefit your pelvic floor but will also improve organ motility and mobility, and increase mental health–all of which will be drivers towards pelvic floor success. 

Pelvic Floor Muscle Activation During Daily Activities

You can incorporate pelvic floor muscle activation practices into your regular daily activities. For example, if you step up with the same leg every time you use the stairs, try to use the other one. If you wear your purse on one shoulder, switch it to the other side.

Keep in mind that the pelvic floor is a stabilizing and balance muscle too–when you change your balance, the first muscles to engage are your pelvic floor muscles. 

Recognizing Pelvic Floor Dysfunction

It is essential to be aware of signs of pelvic floor dysfunction. If ever have reason to question whether your pelvic function is normal, keep in mind that you probably need to reach out to your pelvic floor providers to help find answers to your concerns. 

Are You Looking to Improve Your Pelvic Floor?

Understanding and identifying your pelvic floor is crucial for maintaining good health and preventing issues and resolving your current issues. Familiarize yourself with the anatomy of the pelvic floor and use these tips to help start your journey. 

Following these guidelines can help you maintain a healthy and strong pelvic floor for years.

Contact me today for more information on identifying and improving your pelvic floor!