What is the pelvic floor?

The pelvic floor is a group of muscles that spans up the underside of your pelvis. The muscles attach to your pubic bone at the front, your tailbone at the back, and your sit bones on the sides. The pelvic floor moves up and down like a trampoline to perform many important functions (see below).

What does the pelvic floor do?

The pelvic floor:

  • Supports the pelvic and abdominal organs, including a growing baby when pregnant
  • Plays an important role in stabilizing the pelvis, low back and hips
  • Helps to maintain continence of urine and feces (prevents leaking of urine, stool and gas)
  • Allows voiding (peeing) and defecation (pooping)
  • Plays a role in sexual function
  • Acts like a sump pump to help circulate blood and lymph fluid around the pelvis
  • Is an integral part of the inner core system which is the foundation of our bodies and of all our movements
  • Allows for the passage of a baby during childbirth

What happens when the pelvic floor is injured or not working properly?

Pelvic floor dysfunction is the term used to describe a pelvic floor that is not working properly. Pelvic floor (PF) dysfunction can involve:

  • PF muscle weakness
  • PF muscle tightness
  • High or low PF muscle tone
  • Poor endurance of PF muscles
  • Poor timing of PF muscle contractions
  • Poor coordination of PF muscles with the rest of the inner core system and/or body

What are the signs and symptoms of pelvic floor dysfunction?

Signs and symptoms of pelvic floor dysfunction include:

  • Constipation or straining to pass bowels
  • Accidental leaking urine or feces
  • Accidentally passing gas
  • Strong urge to use the bathroom, or not making it in time
  • Frequent need to urinate
  • Difficulty emptying your bladder and/or bowels
  • Feelings of discomfort, heaviness, pressure, bulging, draging or dropping sensations in the vaginal area
  • Seeing a lump or bulge in or coming out of your vagina
  • Painful sex
  • Numbness during sex
  • Pelvic girdle pain (including sacroiliac joint pain, pubic symphysis pain, tailbone pain)
  • Pain in the genital or rectal area
  • Hip and/or low back pain

What causes pelvic floor dysfunction?

Pelvic floor dysfunction can be caused by direct injury to the muscles (e.g. during a vaginal birth or a fall on the groin). Other factors associated with pelvic floor problems include:

  • Female sex
  • Older age
  • Pregnancy
  • Birth factors - prolonged labour, instrumental delivery (forceps or vacuum), episiotomy
  • Baby factors - large head circumference, increased number of babies and births (parity)
  • Genetics
  • Increased intra-abdominal pressure (from chronic coughing, abdominal gripping, etc.)
  • Constipation
  • Heavy lifting
  • High impact sports (e.g. trampolining, running, ggymnastics)
  • Obesity / Increased BMI (above 25)
  • History of low back pain
  • History of pelvic or abdominal surgeries (e.g. cesaerian, hysterectomy)
  • Low socioeconomic status

What conditions are associated with pelvic floor dysfunction?

Pelvic floor dysfunction is associated with the following conditions:

  • Urinary Incontinence
    • Stress urinary incontinence (SUI)
    • Urge incontinence (UI)
    • Mixed urinary incontinence (a combination of SUI & UI)
    • Urinary frequency
  • Fecal Incontinence (FI)
  • Difficulty urinating
  • Bladder retention (difficulty emptying the bladder)
  • Constipation or straining to pass stool
  • Pelvic Organ Prolapse (POP)
    • Cystocele (bladder prolapse)
    • Urethrocoele (urethra prolapse)
    • Uterine Prolapse
    • Rectocele (rectum/bowel prolapse)
  • Dyspareunia - painful sex
  • Pelvic girdle pain (including sacroiliac joint pain, pubic symphysis pain, tailbone pain)
  • Hip and/or low back pain
  • Sexual Pain & Dysfunction
    • Vaginismus - tightening of the vagina (pelvic floor) muslces
    • Reduced sensation or ability to orgasm
    • Vestibulodynia - sensitivity or pain around the vulva
    • Pain with penetration
    • Pain with orgasm or after sex
  • Vulvodynia - chronic pain in the vulva