Pelvic Floor Anatomy and Function
written by Crunch RanjaniEveryone has a pelvis and a pelvic floor – that’s why pelvic health is important for everyone, regardless of age or gender. Unfortunately, this part of the human body is not very well-understood, even among general healthcare professionals, physiotherapists, and yoga teachers. This is despite the fact that many people will experience pelvic health issues in their lives.
Understanding the pelvic floor and the essential role it plays in our day-to-day mobility, movement, form and function is one of the keys to better pelvic health. In this article, we explore the anatomy of the pelvic floor, and the variety of functions it performs, as well as some ways yoga can help improve pelvic health.
Special thanks to Marie-Josée Forget for sharing her expertise in the Pelvic Health Professionals Membership site and on The Connected Yoga Teacher Podcast.
Anatomy of the Pelvic Floor
What exactly is the pelvic floor? As its name suggests, it is the floor of the pelvis, and is much larger than most people imagine.
Where is the Pelvic Floor?
The pelvic floor muscles attach from the pubic bone at the front of the pelvis, all along the pubic rami, to the coccyx (tailbone) at the back. This front-to-back attachment is why the pelvic floor is often described as a hammock, bowl or sling.
In addition to this, the pelvic floor muscles come up the sides of the pelvis to laterally attach to the bony pelvis (ischial tuberosities and ischial spine inside the pelvis). On the sides, the pelvic floor is attached through fascia to a muscle called the obturator internus, which is a hip lateral rotator.
Layers of Pelvic Floor Muscles
Sitting over top of the pelvis is the first layer of the pelvic floor muscles called the urogenital triangle. They attach from the ischial tuberosities to either side of the clitoris (in assigned female at birth bodies) or the base of the penis (in assigned male at birth bodies). These muscles are important for sexual function, and also contribute to bladder control. They are on the surface (superficial), which means they can be felt from the outside of the body.
The second layer of the pelvic floor is just underneath the superficial layer, and this is where the voluntary sphincters of the bladder and bowel sit. These muscles are critical for bladder and bowel control, and prevent urinary and fecal incontinence.
The deepest layer of the pelvic floor is the one people are talking about when they talk about doing Kegel exercises. This layer is known as the pelvic diaphragm, or levator ani, and it is a large group of muscles nestled deep within the pelvis. It attaches from the tailbone and sacrum at the back of the pelvis to the front, just behind the pubic bone, and to a muscle on the side of the pelvis called the obturator internus. This set of muscles also play a part in bladder and bowel control, and sexual function, as well as support for the pelvic organs. Pelvic organ prolapse is a common issue that relates to this layer of the pelvic floor.
Functions of the Pelvic Floor
The pelvic floor is responsible for some very major functions. The five functions of the pelvic floor are:
1. Support
The pelvic floor plays a major role in supporting our internal pelvic organs. It acts as a “shelf” to hold up the bladder, rectum, and in some bodies, it also holds up the uterus. Excess strain on the pelvic floor (e.g with pregnancy, childbirth, or constipation) or a weakening of these muscles (e.g with age) can cause the pelvic organs to start to descend or protrude, which is known as pelvic organ prolapse.
2. Sphincteric
The pelvic floor is designed to tighten when we cough, sneeze, laugh or do a quick movement, and this tightening closes around the urethra and rectum to prevent leakage of urine and feces. The pelvic floor also tightens when we experience the urge to go to the bathroom to close off all of our sphincters (openings) to be able to get to the bathroom on time, and relaxes in order to allow for us to expel urine and feces.
3. Sexual Function
Another essential role of the pelvic floor is in sexual function. For penis owners, these muscles contract to allow for penile erection, penetration, and orgasm. For vulva owners, these muscles contract to keep blood in the clitoris, and at the right tension, can allow pain-free orgasms to occur.
4. Stability
As practitioners of yoga, we know that a lot of our stability in various asanas comes from the “core”. But did you know that the pelvic floor is a part of what is sometimes referred to as the “core 4”? The pelvic floor, diaphragm, transversus abdominis and multifidus are a team of deep muscles that work in synergy to control movements in your torso, hips, and legs, providing stability to your body. These muscles also work together to maintain good function of the spine and pelvis.
5. Sump-Pump
It may not seem like it, but the pelvic floor is an essential part of your breath. With each breath, the pelvic floor and the respiratory diaphragm move together to create a sump-pump action, which circulates blood and lymph from the pelvic area. When the pelvic floor is not performing this function correctly, we may experience swelling or pelvic congestion.
Bonus: Guarding and Protecting
In addition to these five key functions, the pelvic floor also protects and guards the body. It can tighten up and hold tension if the body is fighting off a bladder infection, or experiences pain during intercourse. Stress, anxiety and emotional trauma can also manifest as tension in the pelvic floor. Such tension and guarding in the pelvic floor is a sign that something needs our attention in our body (or mind!), and it is necessary to seek professional help in these situations.
Importance of Pelvic Health
With the pelvic floor playing such an important role in our bodies, keeping it healthy and functioning well is of utmost importance. However, many people experience acute or persistent pain in their hip and pelvic area, and/or other pelvic health issues like urirnary incontinence, painful sex, pelvic organ prolapse and more.
For people dealing with pelvic health issues, getting to know the pelvic floor is the first step toward improving pelvic health. Pelvic health education can help tremendously in alleviating symptoms and addressing the underlying causes.
It is also a great idea see a pelvic health PT (phyisotherapist/physical therapist) if you are experiencing specific health issues such as hip pain, pelvic girdle pain, painful bladder syndrome, incontinence, or painful sex. For the full list of podcasts and other resources related to pelvic health, check out the Pelvic Health Resources page.
Interested in learning more about pelvic health, while connecting with other professionals and industry experts?
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Hello,
I have been experiencing pain in the hip and other areas of the pelvic floor. I have back issues, and am doing PT to address those. I’m really interested in learning more about pelvic floor strengthening and pain relief.
Hi Patricia and thanks for your comment. I have also dealt with 20+ years of pain in my low back and pelvis and over the years I have learned from some amazing PTs and movement experts. Here is the summary of what I have learned — https://www.theconnectedyogateacher.com/225-yoga-hip-pain-shannon-crow/
Also, feel free to join us inside of Pelvic Health Professionals if you would like to ask the experts yourself. We have 1-2 live calls a month and a full training on pelvic girdle pain in there.