When people think about their “core” they often focus solely on the abdominals. Functionally, the core consists of muscles that form the canister from your rib cage to your pelvis and surround the abdominal and pelvic organs. The top of the canister is the diaphragm, the front and sides are the abdominal muscles, the back is the multifidi, and the bottom is the pelvic floor. It is important for all of these muscles to work together to create support for the skeleton of the trunk as well as the viscera within.
The pelvic floor muscles form a diamond from the pubic bone to the coccyx and from one ischial tuberosity to the other. They are responsible for supporting the undercarriage of the trunk and its contents, regulating the passage of urine, feces, and gas, maintaining appropriate intraabdominal pressure, and allowing for the passage of a baby during child birth. In order to perform all of these functions, the pelvic floor must be both strong and supple. When the pelvic floor is not performing optimally, it can lead to back and hip pain, urinary/fecal incontinence, constipation, painful sex, and sexual dysfunction.
Pelvic floor health is often reduced to one word: Kegels. However, it is not always appropriate to continuously tighten the muscles of the pelvic floor. As with any other muscle group, excess tension in the pelvic floor is problematic and can lead to musculoskeletal pain, urge incontinence, constipation, and sexual dysfunction. The muscles of the pelvic floor must be able to fully relax and fully contract with control in order to function optimally. Imagine your elbow is already bent 90º and then you try to do bicep curls – likely you will get a muscle cramp and an overly tight biceps. This is similar to performing Kegels on top of already tensioned pelvic floor muscles. In order to perform pelvic floor strengthening exercises correctly, allow for the full relaxation of the pelvic floor muscles, you should feel a gentle “dropping” of the perineal area towards the floor, and then try to lift the perineal area up towards your head. Always return to a relaxed state following the contraction. Ideally, you can control the strength and duration of the contraction as well. If you have concerns regarding pelvic floor health or experience symptoms discussed above share your concerns with your provider, they can help you decide the best course of treatment.