The Pelvic “Floor”

pelvic floor image copyIf you do Pilates you have been told to engage the pelvic floor. Huh?

And if you learned Pilates in a large group class, the concept may have remained a mystery for some time. Instructors of large group classes are loath to be bombarded by oceans of titters. Yep, people get a little silly when genitals are mentioned in public. But it’s impossible not to mention the reproductive and eliminative organs in a discussion about the pelvic floor because one of its main functions is to bear the load of the viscera. These very muscles also control the openings of the rectum and urogenital organs.

The pelvic floor refers to an interweaving group of muscles – none of them very big – that lie deep in the pelvic diaphragm, or cavern. From back to front and from side to side they connect the tailbone, sits bones, and pubic bone to one another.

The shape can be viewed as a pyramid with respect to the bones involved. If you’re sitting down reading this, the bones you are sitting on (underneath that gluteal mass of yours) are the sits bones, or the ischial tuberosities of the pelvis. Drawing a line from them to your pubic symphysis (the center where the two rami, or branches of the pubis meet, forms part of the pyramidal base. Add two more lines from your sits bones to your tailbone (coccyx) and you’ve simulated the bony infrastructure.

Then all the muscular tissue hangs on to those bones and that is often referred to as a basket, hammock, or sling. At the front of the pelvis are the puborectalis, pubococcygeous, and iliococcygeous muscles. The pubococcygeous muscle is the most well known of the group as it was popularized by Dr. Alfred Kegel after whom kegel exercises were named.

Together with the levator ani, coccygeus, and oburator internus muscles located in the posterior pelvis, the tailbone is allowed to draw forward toward the center of the pubic symphysis. You can feel this coming together easily if you are proficient in the pelvic tilt.

We’re not done yet, though. The perineum muscles form a bridge between the two sits bones. For purposes of urination and defecation they need to be relaxed. For purposes of childbirth they need to significantly contract. The perineum is often a site of arousal in both men and women so keeping it optimally functioning can be a benefit in sex. If you are supine on the reformer doing Footwork, it is not at all difficult to perceive the perineum muscles widening (relaxing) as the reformer carriage approaches home and narrowing (contracting) as the carriage extends away.

The pelvic floor muscles are intended to engage. Their actions are (1) to lift up (2) to draw in toward the body’s midline (3) to stretch wide, all toward serving myriad functions in daily life, exercise, and sexuality. Weak pelvic floor muscles can lead to a number of dysfunctions including incontinence and problems in childbirth. Strengthening the pelvic floor muscles have been helpful in allaying erectile dysfunction in men and enhancing sexual response in both men and women.

Pelvic stability is one of the virtues Pilates teaches. This is why our doctors send us to learn it. Accessing these otherwise “abstract” areas of the body will go a long way to building a strong and sustainable foundation.

Did you know?

In Chinese medicine the perineum is thought to be the place where yin and yang meet!