What Is It? Where Is It?

The pelvic floor is a combination of superficial and deep layer muscles, ligaments, connective tissue, and bones. The pelvic bones supported by the pelvic floor include the ilium, ischium, pubis, the sacrum, and coccyx. The bladder, urethra, uterus, vagina, and bowel are supported by the pelvic floor.

What Does It Do?

These tissues and structures support the pelvic organs, spine, and pelvic bones in order to urinate, defecate, engage in sexual intercourse, and birth vaginally. The pelvic floor controls continence (not leaking urine and feces) and is under both voluntary and involuntary muscle control.

How Does It Work?

The pelvic floor works with the breathing diaphragm like a piston system. As you inhale, the diaphragm moves down, pushing the abdominal organs into the pelvic floor, which also moves down. As you exhale, the pelvic floor recoils and goes upwards, just as the diaphragm moves upwards. This combination of movements in conjunction with breathing is referred to as a reflexive exhalation recoil. The pelvic floor muscles are dynamic and consistently in motion.

The pelvic floor should spontaneously respond to the increased abdominal pressure from a cough/laugh/sneeze by a well-timed contraction that will stabilize the urethra and support the pelvic organs.  A normally functioning pelvic floor contracts automatically without the need for conscious voluntary control.

During an effective pelvic floor contraction, the pelvic floor muscles squeeze the urethra against other tissues, resulting in stabilization of the bladder neck and urethra, as well as increased urethral pressure.  This combination holds back urine and results in continence.

What Happens When It’s Not Working?

Breath holding, lordosis posture in pregnancy and postpartum, and sucking in the abs can lead to more complications with the pelvic floor. Physical therapist, Julie Wiebe explains these concepts of dysfunction in the following videos.