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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.
What is the pelvic floor?
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
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 & 3
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 2 large bones (Innominates) that connect in the back via the sacrum.
The Innominates
Each Innominate has an Ilium, Pubis, and Ischium.
The 2 Innominate's join together in the front of the pelvis to make the Pubic Bone.
In the back, each Innominate connects to the sacrum forming the SI (SacroIliac) joint.
The bottom of each Innominate 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 physical therapy, the abdomen, and the low back:
Above the pelvic floor muscles is 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 lower back. Remember... the abdomen is just the front of the lower back while the lumbar spine (lower back) is the back of the abdomen! It's all connected.
How is it all connected?
Our bodies are three dimensional and interconnected through nerve and connective tissue pathways. All the nerves that leave the lumbar spine (lower back) travel through the abdomen, innervating and controlling both the movement and sensation of the lower back, abdomen, hips, and pelvic floor. So... a complete 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.