The pelvic floor is a group of muscles, ligaments, tendons and connective tissue in the pelvic area. Dysfunction in this area can cause a wide range of symptoms and related conditions. At Absolute Health and Wellness we have a physiotherapist who specializes in pelvic floor dysfunction.
Understanding the pelvic floor and how it functions will assist you in better understanding your case. It’s helpful to visualize the muscles and bones which make up the pelvic floor.
Function of the Pelvic Floor
The pelvic floor has 5 main functions:
- Support: your pelvic floor muscles are a basket of muscles that support your internal organs against gravity, intra-abdominal pressure, and vaginal/rectal walls
- Sphincteric: controls urethral, vaginal, and rectal openings to maintain continence
- Stability: assist sacroiliac joints, pubic symphysis, sacrococcygeal, lumbopelvic, and hip joints; assists in unloading the spine
- Sump-pump: venous and lymphatic pump for pelvis
These functions are carried out by coordinated function between muscles, tendons, bones/joints and the nervous system.
Pelvic Floor Anatomy
We will focus on the bones and muscles involved in the pelvic floor.
The bones of the pelvis, which the pelvic floor muscles attach to are:
- 2 innominate bones made up of ilium, ischium, and pubis
- The sacrum (which the coccyx attaches to).
These bones attach in the front at the pubic symphysis and at the back at the Sacro-iliac joint (SI joint). These joints are secured by various ligaments. Issues with the ligaments or the joints can cause symptoms. Your Pelvic Floor Physiotherapist will be able to assess if you’re having issues with these structures.
The muscles are important as they support the reproductive organs against changes in abdominal pressure. They really keep things in place. Both men and women have these muscles; in some cases, the name of a muscle will be different between men and women.
There are 4 layers of muscle and tissue that make up the pelvic floor:
Layer 1 (Uritogenital Triangle): helps control bladder, bowel, and sexual function .
- Bulbocavernous (Bulbospongiosus in men)
- External anal sphincter
- Superficial transverse perineal muscle
- Perineal body
Layer 2 (Uritogenital Diaphragm):
- External urethral sphincter
- Sphincter urethral vaginalis
- Compressor urethra
- Deep transverse perineal muscle
Layer 3 (Pelvic Diaphragm): deepest muscle layer 
- Levator Ani: pubococcygeus, puborectalis, iliococcygeus
- Arcous Tendinous of Levator Ani (ATLA)
- Obterator Internus
Layer 4 (Endopelvic Fascia)
- Meshwork of smooth muscle fibres, ligaments, blood vessels, and connective tissue that covers all internal organs and anchors them to the pelvis
The pelvic floor is made up of bones, muscles and connective tissue. This article allows you to visualize these important muscles. People with pelvic pain may go to a pelvic floor physiotherapist, who will assess these structures to determine the source of any discomfort or pain. Click here to learn more about conditions which may benefit from a pelvic floor physiotherapist.
|||S. Lawson and A. Sacks, "Pelvic Floor Physical Therapy and Women's Health Promotion.," J Midwifery Womens Health. , vol. 63, no. 4, pp. 410-417, 2018. [https://www.ncbi.nlm.nih.gov/pubmed/29778086].|
About the Author - Sonia Gashgarian
Sonia Gashgarian is a registered physiotherapist who graduated with a Master of Science in Physical Therapy from the University of Toronto. Prior to this she completed her Bachelor of Science in Kinesiology with Honours from the University of Waterloo. Sonia has completed courses in sports taping and basic kinesio-taping, as well as the McKenzie Method of Mechanical Diagnosis and Therapy and Mulligan Concept. She also has her APTEI Acupuncture and Dry Needling Certification.
Sonia uses a variety of treatment techniques to help clients feel better and return to their regular activities as soon as possible. Her individualized treatments may include the following: education, joint mobilizations, exercise prescription, soft tissue release, trigger point release, taping, acupuncture and dry needling, cupping, and Gua Sha.
To book in please call us at (519) 442-2206 or click here.