What's your pelvic floor? A brief guide from pelvic floor physical therapists
Learn the key functions of your pelvic floor, including bladder control, support, and sexual function, and how exercise can keep it strong and healthy.
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Biceps, hamstrings, glutes: These may be familiar muscle names. You flex your arm muscles to lift a heavy box or stretch your leg muscles after a long car ride. But there’s an important group of muscles nestled deep inside your body that you use all day long, without ever giving it much thought: your pelvic floor.
Here, learn the key functions of your pelvic floor, including bladder control, support, and sexual function, and how to keep it strong and healthy — especially with exercises from our Hinge Health physical therapists.
Fully Covered Pelvic Care
Reviewed by our clinical and medical experts
Jacquelyn White, PT, DPT
Bijal Toprani, PT, DPT
What’s the pelvic floor?
Picture a group of muscles shaped like a bowl at the bottom of your torso, stretching from the pubic bone in the front to your tailbone in the back. This is your pelvic floor.
Pelvic floor functions
Like the foundation of a house, your pelvic floor supports everything above it. That includes all your major organs — your bladder, intestines, stomach, uterus, and more. The muscles and tissues of your pelvic floor are flexible, which allows them to stretch and move, ensuring proper function and support.
Just like any other muscle, the pelvic floor can develop pain or weakness. When this happens, it can cause many different health issues — leaking urine, constipation, pelvic and vaginal pain, pelvic organ prolapse, and more — because the pelvic floor plays a role in so many different body functions. Knowing more about pelvic floor functions may help you understand what could be causing a host of symptoms, which can range from mildly annoying to disruptive.
Continence
Continence is the ability to control your bladder and bowel movements. Your pelvic floor muscles help control when you go to the bathroom. They contract or close around the urethra and rectum to hold in urine, feces, and gas. They relax (or open) when you need to urinate or have a bowel movement.
Support
Pelvic floor muscles act like a hammock that holds up your internal organs. If the hammock becomes weak (sometimes due to age or hormonal changes) or undergoes a lot of strain (e.g., during pregnancy or delivery) organs might shift down, creating a bulge or sense of pressure in the vagina. This is known as pelvic organ prolapse.
Stabilization
Your pelvic floor muscles are a part of your core. Most people associate “core” with abdominal muscles. But your core is actually a larger group of muscles, made up of your abdominal, back, diaphragm, and pelvic floor muscles. Physical therapist and researcher Mary Massery, DPT, DSc, compares the core to a container — not unlike a soda can — with the surfaces of the can representing different structures.
Diaphragm muscles (top of the can): contract rhythmically as you breathe
Abdominal muscles (front and sides of the can): support your trunk and hold your organs in place
Spinal muscles (back and sides of the can): support your spine and help you maintain your posture
Pelvic floor muscles (bottom of the can): support your organs and play a role in urination, bowel movements, sexual function, pregnancy, childbirth, and more
Your pelvic floor muscles work together with other core muscles to help with balance and stability during movements that use your trunk, like bracing, bending, and lifting.
Sex
Pelvic floor muscles play a role in arousal and orgasm in both men and women. And in women specifically, these muscles need to relax to allow for comfort during sex and during vaginal childbirth.
Circulation
Pelvic floor muscles help pump blood and lymphatic fluid (clear fluid that carries infection-fighting cells through your body) from your legs and abdomen back to your heart.
Pelvic floor physical therapy is more than just kegel exercises. Various exercises tailored to your symptoms and needs are key to getting relief. Pelvic floor PT can relieve many different pelvic issues, such as pelvic pain, painful sex, and urinary incontinence.
Members of the Hinge Health pelvic health program experience an average 67% reduction in pelvic pain and 54% reduction in urinary incontinence within the first 12 weeks. Learn more*.
What is pelvic floor dysfunction?
Pelvic floor dysfunction happens when pelvic floor muscles are too tight (hypertonic), too weak, or have coordination problems, says Jacquelyn White, PT, DPT, a Hinge Health pelvic floor physical therapist. This can contribute to urinary incontinence, constipation, painful sexual intercourse, and other symptoms.
Physical therapy and exercise for pelvic floor health
Physical therapy and exercise can help improve muscle coordination, strength and flexibility, pelvic floor function, and symptoms, says Dr. White. Exercise for pelvic health is much more than just Kegels (exercises that contract pelvic floor muscles).
“Kegels can be helpful for some pelvic floor issues, but they’re not for everyone,” Dr. White explains. Trying to strengthen tense or overly tight pelvic floor muscles can exacerbate symptoms. Instead, you may need exercises and stretches to relax and lengthen the muscles before strengthening them.
Pelvic floor physical therapy is a comprehensive treatment that can include education, behavioral and lifestyle strategies, movement and exercise, and manual therapy.
You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
How Hinge Health can help you
If you have pelvic pain or symptoms that are affecting your quality of life, you can get the relief you've been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
References
Hodes, P., Sapsford, R., & Pengel, L. (2007). Postural and respiratory functions of the pelvic floor muscles. Neurourology and Urodynamics, 26(3), 362-371. doi: 10.1002/nau.20232
Massery, M (2013. Soda pop can model [Video]. YouTube. https://www.youtube.com/watch?v=IeiKhMmjDGc
Netter, F. (2018). Atlas of human anatomy (8th ed). New Jersey: Novartis.