WHAT THE HECK IS THE PELVIC FLOOR?!?

That at first glance is a really easy question to answer. It could simply be answered by listing a handful of muscles that are hard to pronounce and even more difficult to spell. In fact, the names are so ridiculous that we could make them up or string them together and it would sound similar to Mary Poppin’s most well known song, and I’m not talking about “A Spoonful of Sugar”. But on a basic level, the pelvic floor is the real foundation. And most definitely, the real OG. In it’s simplest form, it is a multi-layer funnel made of muscles, that just so happens to have multiple holes. Those holes are kind of important. You should know what I’m talking about by now. And yes, men have them too. Because the pelvic floor is made up of muscles, you can be weak, you can have poor activation, you can be “tight”, you can have increased tone, you can have pain, you can have inflammation AND most importantly you can relax, rebuild and reach better performance of these muscles- just like any other muscle in your body. You can work these muscles by doing a kegel. If you DON’T know what a kegel is, totally fine. We will go over that. IT IS OUR VERY NEXT BLOG TOPIC. Don’t Google it. And don’t do it. If you DO know what a kegel is, totally fine. Don’t Google it. And don’t do it. We will go over why.

Wait; did we just say: “Don’t do kegels.”

YES. But add an asterisk to that statement and stay tuned for that next blog post. If you can’t wait, sorry. If you can wait, *spoiler alert* the post is going to tell you to some hypnotic, funky, fresh ways to learn more about your pelvic floor.

But why is it called the pelvic floor. Well, let’s back up a little and put a little tune in your head. I apologize in advance, it will be there all day. “Ow, she’s a briiiiick hooooouse.” So yes, in a basic way of thinking. It literally is the floor AND foundation of your brick house. And trust, as ladies we are mighty, mighty. BUT those above mentioned holes in the floor, we don’t want to let them all hang out.

So what about those walls of the house. If you picture your beautiful six-pack (or keg), most people have heard of “abs” and can in some form visualize them. They are the front wall. Despite what you may think, we all have them. Some are just a little bit more cozy under some cushioning, and then there is JLo rockin’ them at 50. Go her, am I right?!? But in any case, they are there. So those abs you visualized are great, but aren’t worth a s*** without the deeper layers. The next layer, picture those diagonal V shaped lines leading down to Channing Tatum’s money maker. I’ll give you a minute to regroup. Deep breath. I know I need one. Those are the visible parts of the side walls. You may have heard of these as well, they are collectively called the obliques. Also great, but not without their foundation. The last layer of those abs are the real deal. You likely have never heard of this one and we hate using medical words, but for the sake of education- this is called the transverse abdominus. This muscle is the wind beneath your wings. You can’t see it. There is no oiled up heart throb reference. But you can feel it and lord help ya—if you try to fly, lift weights, have a baby, go for a run, pick up groceries, take a poo and on, and on, and on without it— you are in trouble.

So this trouble we speak of— that doesn’t sound good. But anyone who has ever been a parent and anyone who has ever been a child (so that means you), can tell you that there are different levels of trouble. Sometimes that trouble is plateau in your workouts, sometimes it is peeing your pants, sometimes it is hip pain, sometimes it is back pain, sometimes it inability to touch your toes, sometimes it is constipation, and sometimes it is nothing. So wait, this transverse abdomina-whatcha-ma-call-it does all this?! No. But if it isn’t functioning properly, a whole chain reaction is set off and your pelvic floor has to work a little harder. Just like having a crack in your house foundation, you will start to crumble.

The back walls of your house. Whew, that is a little more complicated, but also important. Why do I keep picturing “The Rock”?! I mean, seriously. What a piece of art that man is. And I’m not talking about his tattoos. You can picture all his curves and all his edges. No further explanation today. But welcome to take a minute to regroup again.

Lastly, there is the roof. But in this case, we definitely don’t want to raise the roof and we for sure hope it is not on fire. That friends, is the diaphragm. No, not that weird contraceptive device that you think doesn’t even exist anymore. BUT- it kind of looks like that in the form of a giant muscle. Say what?! Another muscle?! My bad. That is kind of what us PTs get all giddy about. Prepare for the road ahead. This diaphragm helps control breathing. Also weird, we know. And yes, you guessed it: another blog post to come.

Whew... so all this and we STILL don’t know what a pelvic floor is. Wrong. You know what it is. Now it is time for WHAT IT DOES. That ladies, is the stuff [wet] dreams are made of.

The easiest way to think of the functions of the pelvic floor, is to use a catchy phrase. We love to use little whimsical sayings, analogies, and giggle worthy ways to remember and understand things. Mostly, because I (Allison) have a terrible memory. For learning the pelvic floor, we will refer to the 5 S’s. One of the main functions of the pelvic floor and our first S is STABILITY. Let’s all take a minute to say it again slowly. STA-BIL-I-TY. Anytime we move, our pelvic floor should be some of the first muscles to engage and stabilize our bodies. That’s right, EVERY time we move.  That includes, you guessed it: makin’ whoopie. So just remember, if you are trying to work on that “core” of yours, the pelvic floor should not be forgotten about.

The pelvic floor provides SUPPORT to all the organs it surrounds. Some describe it as “hanging like a hammock” to support the bladder. I don’t know about you, but I don’t want the adjective “hang” anywhere around my va-jay-jay. That strength must also be enough to keep your organs in place and not develop prolapse. THANK every lucky star in your life if you don’t know what this is. And if you haven’t found us too predictable: do not Google it. The pictures are interesting, for lack of wanting to give a visual this time. Trust. Yes, we will post about this individually as well.

The pelvic floor is clearly a key player every time you sit on the throne. The SPHINCTERIC function pairs with the support function. The pelvic floor must not only engage or contract, but also relax properly to let go of your number one and two- WHEN YOU WANT TO. That is the key. WHEN you want to. So, the answer to your undying question is NO. It is in no way shape or form normal to leak on yourself before having children, after having babies, as you “go through the change” into menopause, or really ever; but YES it is common. This same thought can be applied to pain, weakness, and many other things. Throw the word normal “to the left, to the left” and get to replacing it with COMMON. Told you I like Bey.

So let’s get even more personal. SEX. The pelvic floor is essential in its contributions to sexual function for both males and females. For men, it aides in sustaining erections, full penetration and then ejaculation whereas in women, it contributes to desire AND functional sensation towards the Big O. And we don’t really know anything about Oprah. So get ready, let’s do it. Ride this out, and say it again. A stronger pelvic floor in females leads to more satisfaction for you and your partner and a pelvic floor that is “tight” does NOT mean what you think it does. A “tight” pelvic floor can lead to pain during or after intercourse. Ladies, it is COMMON to have pain or decreased sensation with sex after babies, gynecological procedures, inflammatory diagnoses or other trauma but it is NOT normal. Normal would indicate that it is acceptable and we should settle for this. We HATE the word normal. Have we said this enough?!

Experiencing any of this?!? You are not alone. Maybe you should talk to your medical provider about this. THEY ARE THERE TO HELP. Still don’t know what to do?! Find a Pelvic Health Physical Therapist in your area. And be prepared to talk. A lot. If you aren’t ready for this either, then stay tuned. We have too much to share for just this one blog post.

Lastly, the unsung hero, the SUMP PUMP function. So many blood vessels and lymph vessels pass through this area, that the pelvic floor helps act as a pumping mechanism to transfer fluids back towards your heart. Kind of important (sense our sarcasm), this is VERY important but not as often talked about.

So let’s put all this into a few practical applications, and then we promise we will wrap up. This one goes out to all the (soon to be) baby’s mommas. Any pregnant mommas out there?!? Your pelvic floor is working hard for you and your baby right now. It is important to have adequate strength to support that bundle of joy. And by bundle, we mean shoving the Thanksgiving turkey out an opening you think is only meant for the baster. Don’t worry, it will be fine. During labor we want the pelvic floor to relax so your baby can make his or her grand entrance smoothly. You have to both be STRONG enough to withstand the load and then able to CONTROL the relaxation to avoid reflexive tension. And if you have a c-section, guess what- they cut all up on these layers of muscles we spent visualizing before. Stay tuned, because we will be going over simple techniques to keep you strong during pregnancy and relaxed for the marathon that is childbirth, regardless of how that little turkey makes their appearance.

This one goes out to the ladies who pee their pants. It can be a small drop or a gully washer. But if you are weak, your muscles aren’t strong enough so they can’t function all of the 5 S’s properly and you can have leakage. On the other hand, if you are “tight”, any additional strain such as a sneaky sneeze makes those muscles tighten up more and can also cause leakage. Ugh. So unfair.

Last, but certainly not least: those of you ladies looking to become pregnant or just simply looking to enjoy the act of baby makin’ a little more. Before you get your freak on, there are more things you should know. Often, your Pelvic Floor Dysfunction is rather a royal pain in your a**. Literally and figuratively. It can occur as a result of an inflammatory process such as endometriosis, ovarian cysts, chronic UTIs, trauma and the list goes on. It can cause painful sex or other issues, which make it more difficult to conceive or even enjoy sex. So trust this, if you are trying to get pregnant and you already have a weak pelvic floor: you bet that bundle we were referring to earlier, is going to seem a little more hefty. If you are in the category of “too tight”, overdoing pelvic floor exercises can make childbirth, sex, and even other close by anatomy, more painful.

Thoroughly confused yet? You should, without properly knowing which category you fall in (weak or “tight”) it will be difficult to know how to improve. Because another *spoiler alert*... it is often both and it can be quite the “chicken or the egg” debate. Which is why we said, “Don’t do kegels” with an asterisk. And why it is so important that we want to go into more detail. We hope in this journey we can help you learn a little about yourself and your pelvic floor. And if you are left wanting more, we sincerely appreciate your need to find a Pelvic Health Physical Therapist in your area who can help push you in the right direction!

So, does ANYTHING we covered sound like something you have experienced?!? It should, or else your freak of nature, non-bathroom using self has a whole lot of problems going on. But in all seriousness, if you have not had any issues, great! We are certainly both so jealous! Pelvic Floor Dysfunction is something that is estimated to effect 50% of all women during their lifetime, including the two of us. Guilty; but working on it. We want you to know, you are NOT alone. We hope to share along in this Oregon Trail adventure some educational pieces to aid you navigate your lady bits- but not to be direct medical advice. You need to see a provider for that and we would certainly not know what to do about dysentery! We want to push you to seek help from those providers. They want to know what you are concerned about. We want to celebrate in your successes, we certainly want to help create them. We want to comfort you in your set backs, we have all been there and learned from them. We want to empower your to take control of COMMON issues and welcome you into your new and improved normal. And we hope to specifically encourage you to seek out a Pelvic Health Physical Therapist when needed, because we think there are some awesome vagina whisperers out there. But, until next time and our next post: Don’t freak out. Don’t Google everything. Don’t do kegels.* Don’t lose hope. And go ‘head girl, go ‘head get down.