Pelvic floor muscles

The pelvic floor muscles (PFM) are a group of muscles which sit at the base of the pelvis.

These muscles have a role in:

Most people do not give their PFM a second thought unless their function becomes affected.

Signs that the PFM may not be working well are:

There is thought to be an increased risk of PFM dysfunction with both pregnancy and vaginal delivery, with the risk increasing with each subsequent pregnancy and vaginal delivery.

Women may notice signs and symptoms of PFM dysfunction in the postnatal period as well as with the hormonal changes of menopause, or following any gynaecological surgery.

While men may first experience problems following prostate surgery.

Other people who are at risk are those who:

If you are performing any types of exercise such as these, it is important to know that your PFM are strong enough to withstand the extra strain being put on this region.

If they are not you may be at risk of developing PFM problems. Even Pilates exercises which are too strong, performed incorrectly or are unsuitable may lead to problems.

For this reason, it is important that on commencing Pilates, an initial assessment with a Pilates physiotherapist, involving the use of the real time ultrasound, is performed to ensure appropriate muscle activation.

For more information on this, see our fact sheet on Pilates, will it help me?

The action of a PFM contraction is a squeeze and lift action around the front and back passages.

Often it can be helpful to focus on the action of stopping yourself passing urine or controlling wind. Men may find a contraction easier in standing focusing on the action of lifting the testes up.

The muscles should be able to perform a sustained contraction, plus fast contractions in response to sudden increases in intra-abdominal pressure.

Also important is the ability of the muscles to relax following a contraction.

Possible signs of difficulties in relaxing the PFM may be:

Note that some of the above signs and symptoms may also be associated with other types of PFM dysfunction, which is why an individual assessment is very important.

If you are unsure whether you are activating your PFM correctly, or have difficulty relaxing the muscles after a contraction, or are experiencing any of the above signs or symptoms, then consulting a physiotherapist with postgraduate qualifications in women’s health and continence is recommended.

This will ensure a thorough assessment of your problem and then an appropriate management program can be commenced.

This may also include advice on suitable exercises which do not place excessive force on the PFM.