Understanding Pelvic Floor Anatomy

The pelvic floor is a layer of muscles that lie at the base of your pelvis. Your pelvis is shaped like a bowl, and at the bottom of that bowl are your pelvic floor muscles. In a female, there are 3 holes in these muscles where the urethra, vagina and rectum run through; in a male, there are 2 holes for the urethra and rectum.

The pelvic floor muscles are controlled by nerves that come out of your lower back and have a very unique movement:

• They “close” and “open” around the urethra, vagina and rectum. 

• And they also “lift up” and “drop down”. 

• At rest, they are “flat” and shaped like a dinner plate.

• When they “lift up” they take on the shape of an umbrella. 

• When they “drop down” they take on the shape of a hammock. 

I like to use the idea of an elevator to describe the healthy movement of the pelvic floor muscles. At rest, your pelvic floor muscles should be sitting in the lobby, and when called upon, they are able to go up to the 1st, 2nd, or 3rd floor, or they can drop down to the basement. But they always return to the lobby when they are finished performing a function.

There are 2 very important anatomical characteristics of the pelvic floor that are not often talked about and highly misunderstood, but play a HUGE role in how we can best strengthen and heal these muscles.

The pelvic floor is 70% Fascia, 30% Muscle

This is a surprising fact to learn because we usually think about the pelvic floor as all muscle, but it's not! It's mostly fascia! Fascia is that white connective tissue that covers everything in your body. It keeps our anatomy in place and gives it form. Without fascia, we would just be blobs of tissue. Fascia is non-contractile, meaning it does not contract and relax by itself like muscles do. It follows what muscles and bones do. Muscles support fascial integrity- meaning that if the muscles that the fascia is attached to are not strong and therefore do not absorb a load very well, the load will be taken by the fascia instead of the muscle. So a weak and dysfunctional muscle leads to increased loading of it’s associated fascia. When fascia is chronically loaded and under pressure- it will over stretch, thin out and become weakened.

The fact that the pelvic floor is mostly fascia means that anything that causes chronic or repetitive pressure on it can injure it. Things such as bearing down when you void, chronic coughing, running, jumping, heavy weight-lifting, crunches and sit ups create lots of pressure on the pelvic floor. If the pelvic floor muscles are dysfunctional, this pressure can cause the pelvic fascia to weaken. Weakening of the pelvic fascia can ultimately lead to injury and pelvic floor dysfunction, especially when the pelvic floor muscles them selves are not working properly.

Since our pelvic floor is more fascia than it is muscle, it responds very differently than other muscles in the body to stress and loading. So when it comes to training and healing the pelvic floor, we need to treat it differently than other muscles. When strengthening the pelvic floor, we need to use techniques that unload and take pressure off the pelvic floor, such as hypopressive training, so that the pelvic floor muscles have the opportunity to activate functionally. It is only when the pelvic fascia is unloaded, that the pelvic floor muscles can be properly re-trained to absorb the loading that occurs in our every day lives.

The pelvic floor muscles are 80% involuntary

That means that we have voluntary control over only 20% of our pelvic floor muscle fibers! The rest of the 80% contracts and relaxes in response to spinal reflexes and breathing. In comparison, most skeletal muscles in the body, like the quads, glutes, hamstrings, and biceps, are 90% voluntary and 10% involuntary. Meaning they contract and relax with conscious thought and intention and that’s why sets and repetitions of voluntary contractions work great to strengthen them. 

But the pelvic floor - and also the rest of the core muscles - are only 20% voluntary, and 80% involuntary. Meaning, when you make a conscious intention to voluntarily contract your pelvic floor, you are only accessing 20% of the muscle fibers. The pelvic floor and other core muscles don’t respond as well to sets and reps of voluntary contractions. This is why just doing Kegel exercises doesn’t completely resolve pelvic floor dysfunction. Because Kegels only access 20% of the pelvic floor muscle fibers.

When training your pelvic floor it is important to understand that we don’t have voluntary control over the great majority of it. So in order to train and strengthen 100% of the pelvic floor, a reflex must be triggered that elicits involuntary activation of ALL the muscle fibers of the pelvic floor. And how do you elicit that reflex? Through BREATHING! The breath is our link to the involuntary nervous system (aka “autonomic nervous system”, aka “subconscious”). In order to completely rehabilitate pelvic floor dysfunction, we must harness the power of the breath to train the involuntary muscle fibers of the core. The Core Recovery Method® does just that. In this revolutionary online program, you are taught how to use the breath to train your pelvic floor to function the way it was meant to function.

Pelvic Floor Anatomy is critical concept to understand when healing pelvic floor dysfunction, or any core issues. You’re working with a muscle that is primarily involuntary, and primarily fascia. These unique anatomical characteristics require an approach that involves unloading and reflexive activation of the pelvic floor.