Pelvic Floor Muscles

What are pelvic floor muscles?

Your pelvic floor muscles support organs in your pelvis. These include your bladder, bowel and internal reproductive organs. You can think of your pelvic floor muscles like a bowl or sling that holds these organs in place. The muscles also assist with bodily functions like peeing, pooping and sex.

You may not think twice about the muscles in your pelvis until you face issues with pee and poop control. That’s because these muscles often do their job automatically. The good news is that specialized physical therapy (like Kegels) can help restore your pelvic floor muscle function.

What do pelvic floor muscles do?

Your pelvic floor muscles:

• Keep your pelvic organs in place
• Allow you to control when you pee, poop and fart
• Support your posture alongside your abdominal muscles and diaphragm
• Allow you to cough, laugh and sneeze without releasing waste
• Help with vaginal contractions during sex and orgasm
• Support the weight of a growing fetus during pregnancy
• Support vaginal delivery during childbirth
• Help with erections and ejaculation

Your pelvic floor muscles hold the major organs in your pelvis in place and protect them. Pelvic floor muscles support your:

• Bladder (the organ that holds your pee)
• Urethra (the tube that carries pee out of your body)
• Bowel, or large intestine (the organ that turns food waste into solid poop)
• Rectum (where poop collects before it’s ready to come out)
• Anus, or butthole (where poop and gas come out of your body)

In females, they also support the vagina and uterus. In males, they also hold the prostate in place.

Squeezing your pelvic muscles narrows your urethra and anus so waste material can’t escape. Relaxing these muscles widens these passages so you can pee, poop or fart.

Healthy pelvic floor muscles can squeeze and relax automatically. You can also control these muscles deliberately, much like flexing a bicep.

Where are your pelvic floor muscles located?

Your pelvic floor muscles stretch from your pubic bone in the front of your body to your tailbone in the back. The muscles extend outward on both sitting bones on the right and left sides of your pelvis. Several pelvic floor muscles intertwine to form a single sheet of layered muscle with openings.

You can feel where your pelvic floor muscles are by squeezing these three openings:

• Anus: Squeeze your anus as if you were preventing yourself from farting.
• Urethra: Imagine that you’re peeing. Squeeze as if you were stopping the flow midstream.
• Vaginal opening: Insert a finger or two inside your vagina and try to squeeze them.

In each case, you should feel muscles inside your pelvis pull inward and upward. These are your pelvic floor muscles.

Your pelvic floor muscles form the base of a group of muscles known as your core. Your core muscles include your:

• Abdominal muscles
• Back muscles
• Diaphragm (the muscle that controls breathing)
• Pelvic floor muscles

Together, these muscles attach to your pelvis and spine. They create stability throughout your body’s center. This allows you to maintain your posture and balance and move effectively.

How many muscles make up the pelvic floor?

You have 14 pelvic floor muscles that intertwine and layer together to form a sheet of muscle.

The two main pelvic floor muscles include:

• Levator ani: The levator ani is the bulk of your pelvic floor muscles. It consists of three separate muscle components: pubococcygeus, puborectalis and iliococcygeus. The levator ani wraps around your whole pelvis.
• Coccygeus: Your coccygeus is the smaller muscle component. It’s located toward the back of your pelvis.

What conditions affect your pelvic floor muscles?

Pelvic floor dysfunction is a group of conditions in which you can’t properly relax and/or use your pelvic floor muscles. The muscles may be too loose and weak or too tight.

Pelvic floor muscles can weaken from injury or trauma, including childbirth and surgery. They can also weaken during pregnancy or from overuse (like repeated heavy lifting or chronic coughing).

Weak pelvic floor muscles can lead to conditions like:

• Fecal incontinence (uncontrollably leaking poop)
• Flatulence incontinence (inability to control when you fart)
• Pelvic organ prolapse (one or more of your pelvic organs sags)
• Sexual dysfunction (like decreased sensitivity and erectile dysfunction)
• Urinary incontinence (uncontrollably leaking pee)

When these muscles are too tight, healthcare providers call it hypertonic pelvic floor. Researchers haven’t studied hypertonic pelvic floor as much as weakened pelvic muscles. But having tight pelvic muscles may lead to issues like:

• Back, hip or leg pain
• Constipation or difficulty pooping
• Difficulty peeing
• Painful sex
• Pelvic pain

How do I know if my pelvic floor muscles are strong?

If you can control when you release pee, poop and gas, there’s a good chance that your pelvic floor muscles are strong and healthy. But certain things, like pregnancy or prostate surgery, can affect previously strong pelvic floor muscles.

It’s a good idea to talk to a healthcare provider if you’re concerned about your pelvic floor muscles. They can walk you through pelvic floor exercises.

Remember that the goal is balance. Your pelvic floor muscles should be strong enough to stabilize your core and secure your organs. But they also need to be flexible enough to stretch and relax.