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Pelvic Health Explained
What is pelvic health physical therapy?
Pelvic health physical therapy is a speciality within the field of Physical Therapy primarily focusing on the function and health of the pelvis and pelvic floor muscles.
The functions of the pelvic floor are to: support the pelvic organs, withstand increased pressure in the abdominal cavity (like coughing), and provide sphincter control for bladder and bowel function
What is the pelvic floor?
I do not own the rights to this image. Source: https://totalpelvichealth.ca/
The muscles of the pelvic floor
You can think of the pelvis like a bowl, where the bottom of the bowl is made up of your pelvic floor muscles. These muscles attach to the bony part of the pelvis and are interwoven with arteries, nerves, veins, connective tissue, ligaments, fatty tissue, and lymph nodes.
There are 3 layers to the pelvic floor:
Layer 1
The most superficial (outer) layer of muscles
These muscles live right underneath the skin
Layer 2
This layer of muscle sits between layers 1 & 2
Your external urethral sphincter lives in this space which helps you voluntarily control the flow of urine.
Layer 3
The final and deepest layer of the pelvic floor
This layer includes muscles that help support pelvic organs and even assist with moving your hip.
The bones connected to the pelvic floor
The pelvis is constructed of a 2 large bones (Inominates) that connect in the back via the sacrum.
The Inominates
Each Inominate has an Ilium, Pubis, and Ischium.
The 2 Inominates join together in the front of the pelvis to make the Pubic Bone.
In the back, each Inominate connects to the sacrum forming the SI (SacroIliac) joint
The bottom of each Inominate is called the Ischial Tuberosity also known as the Sitz Bones.
The sacrum
A flat and fused bone at the base of the spine.
At the very base of the sacrum lives the Coccyx also known as the Tail Bone.
Pelvic Health Physiotherapy, the Abdomen, and Low Back
Above the pelvic floor muscles lives the supra-pubic region of the body. Just as the name explains, the supra-pubic area is anything above the pubic bone including the muscles, nerves, organs, and connective tissue of the abdomen and low back.
Remember... the abdomen is just the front of the low back while the Lumbar Spine (low back) is the back of the abdomen! It's all connected.
Major anatomical parts of the abdomen and low back:
The abdomen is divided into four quadrants
The Muscles
4 layers of the abdominal wall: create the outter shield of the abdomen
Psoas muscle: lives deep inside the belly and connectes to the low back
Quadratous lumborous muscle: creates the back wall of the abdomen connecting the lumbar spine to the pelvis
The Nerves
The Lumbar Plexus: All of the nerves that travel from the lumbar spine into the abdomen, hips, and pelvic floor.
I do now own the rights to this image. Source: http://humananatomybody.com/four-quadrants-of-abdominal-organs/
I do not own the rights to this image. Source: https://www.earthslab.com/anatomy/nerves-of-the-abdomen/
How is it all connected?
Our bodies are three dimensional and interconnected through nerve and connective tissue pathways. All of the nerves that leave the lumbar spine (lower back) travel through the abdomen, innervating and controlling both the movement and sensation of the low back, abdomen, hips, and pelvic floor. So... a holistic pelvic health physical therapy session will focus on the treatment of the abdomen, low back, and pelvic floor to manage and treat pain symptoms in the entire pelvic girdle region.
I hope this information helped you understand the anatomy, function, and interwoven connections within the pelvic girdle.
I will continue to add more information to this page so make sure to check back in soon!
I'm here for you if you have any questions.
- Dana