All your pelvic floor FAQ answered

Key Points

• The pelvic floor is a deep layer of muscle that attaches from the pubic bone to the tailbone.
• A healthy pelvic floor is super important for the prevention of incontinence and prolapse.
• Pelvic floor issues may be related to lower back pain.

Everyone has a pelvic floor. Did you know that? We don’t often associate the term pelvic floor with men, but all humans have this handy group of muscles. 

Concerningly though, if we’re judging by what people are searching online about, it’s clear there’s a little bit of confusion about the whole thing. 

So, we decided to address some frequently asked questions, starting with what is a pelvic floor? We asked Physiotherapist Brad McIntosh to help us get to the bottom of it all. 

What is the pelvic floor? 

Brad explains that the pelvic floor is a deep layer of muscle that attaches from the pubic bone to the tailbone and forms a sling or hammock-like formation. This muscle layer provides support for your bladder and bowel. 

“Imagine the pelvic floor as a muscular elastic trampoline. As we contract and relax the muscle, it moves up and down in a dome-like shape,” says Brad. 

Your pelvic floor supports your bowel, bladder and uterus – it also prevents problems like incontinence and prolapse. So, it’s kind of a big deal. 

Your pelvic floor supports your bowel, bladder and uterus.

Why is it so important? 

As we said above, having a healthy pelvic floor is super important for the prevention of incontinence and prolapse, which are more common than you may think. 

For women, 38% experience some sort of pelvic floor incontinence in Australia. And it’s believed that by the age of 80, there’s an 11.1% chance they may have to undergo surgical correction for a pelvic floor issue. 

For men, the number is lower, but 10% still report issues. A history of prostate surgery could double the chance of urinary incontinence.  

For trans people who have undergone gender reassignment surgery, the numbers are pretty concerning. 50% of female to male patients and 19% of male to female patients reported urinary incontinence. 

But it’s not just incontinence that’s caused by pelvic floor dysfunction. Brad explains that as the pelvic floor is also part of the stability system for the lower back and pelvis, it may also be associated with pain. 

All pregnancies cause changes to the pelvic floor, no matter if you have a vaginal birth or a c-section.

Pelvic floor and lower back pain 

Because it has attachments onto the pelvis and the lower back, pelvic floor issues may be related to lower back pain.     

Brad explains, “The pelvic floor is a stabilising support structure for the body. So, it may affect how people transfer loads and use their abdominal muscles during structured and incidental exercise, both of which may cause and effect back pain.” 

“Some people may have trigger points or tight spots in their pelvic floor which could refer pain into the lower back,” he adds. 

So, the good news is you may have more options than just ice or heat for lower back pain – working on your pelvic floor might also help the problem. 

Pilates could help to strengthen the pelvic floor and surrounding muscles.

How important pelvic floor exercises are after birth?

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When it comes to the importance of pelvic floor exercises in pregnancy and beyond, Brad says, “All pregnancies cause changes to the pelvic floor, no matter if you have a vaginal birth or a c-section. A postnatal check with a pelvic health physiotherapist may help determine what changes have occurred. And then they’ll let you know what individualised strategies you could use to help achieve your goals. This should help prevent or reduce pelvic floor symptoms in the future.”

It’s also a good idea to ease into an exercise routine with the advice of a health professional, before returning to functional sports training after birth. They should be able to advise you what to do at the gym, how to exercise at home, how much exercise to do and when it’s safe to do so. 

How to relax pelvic floor muscles

The act of relaxing your pelvic floor muscles is called ‘down training’ and Brad says, “It’s a common tool that is used in pelvic floor physiotherapy to relieve tight pelvic floor muscle symptoms.”

“Deep breathing exercises, stretching, mobilisation and strengthening around the pelvic floor may allow individuals to relax the pelvic floor,” he explains. 

Is yoga good for the pelvic floor?

Brad says that it could be. “Some types of yoga are great for relaxation of the pelvic floor, increasing hip flexibility and promoting a range of motion with deep breathing and body awareness. Other types of yoga may also help to strengthen the pelvic floor through the practice of challenging postural positions.”

While we’re chatting about yoga, why not also read about why yoga is different from other exercises, the benefits of stretching and the best yoga poses for digestion. 

Is pilates good for pelvic floor muscles?

Pilates could help to strengthen the pelvic floor and surrounding muscles while providing a low impact option for exercise. 

“We use it a lot in our practice, but it needs to be dosed correctly and performed with good control and technique,” says Brad. 

Is swimming good for pelvic floor muscles?

There appears to be limited scientific research on the impacts of swimming on pelvic floor muscles. However, aqua exercise (different from swimming) may be a more pelvic floor friendly workout because the body is more buoyant in water, potentially reducing the load on the pelvic floor.

What pelvic floor exercise equipment should I use?

There is a range of pelvic floor trainers and machines on the market in Australia, but it’s best to ask this question of your GP or physio. Different problems require different solutions, so you probably shouldn’t run out and buy a pelvic floor exercise machine without professional advice.  

Aqua exercise workouts may be a more pelvic floor friendly workout than swimming.

All about your pelvic floor

It’s really unfortunate so many Australians suffer from pelvic floor related issues when there are many ways to address the issue. 

It might be a good idea to ask your GP to recommend a local pelvic floor physio who specialises in this area and have a check-up. Or you could check out the Continence Foundation Australia for more information. 

Related:

• What is a barre class?
• Is running a good fitness option for me?

Brad McIntosh is a highly-trained and well-regarded physiotherapist with a particular clinical and research interest in knee rehabilitation. 

Reviewed by the healthylife Advisory Board February 2022.