written by Kejal Macdonald

Body Banter

On The Floor

The biggest thing we've learned about the pelvic floor is how little we all actually know. 

I've learned a lot about human anatomy in my 32 years. I know each of my feet has 26 bones, 33 joints, 107 ligaments, and 19 muscles and tendons. I learned the average life of a tastebud is 10 days. I'm aware the pancreas produces Insulin. But somehow, the only thing I knew about my pelvic floor (even after having a baby!) is that maybe I should be doing Kegels? Unfortunately, I'm not an outlier, and for so many women this extremely important part of our core is a blackhole of information.

This is the first of many posts in an ongoing series, written with the help of our resident Pelvic Protector, Lindsey Vestal. Lindsey is a Pelvic Floor Therapist and runs the Functional Pelvis here in New York. She makes house calls to work with women in the comfort of their own homes to help restore and strengthen their pelvic floor muscles.

Lindsey is a delightfully hilarious woman, mother of two, and an all-around majestic healer. 

Ok, let’s start at the very beginning. What exactly is the Pelvic Floor and what does it do?

The pelvic floor is a set of muscles that extend from our pubic bone back to our tailbone, and sit in a bowl shape at the bottom of our pelvis. The pelvic floor actually has 3 main functions:

1) The Elimination of Waste (controlling the closure and opening of bowel and bladder),

2) Organ Support, (holding up all the essential organs like an awesome support base)

3) Sexual Appreciation

Yes! Sexual appreciation! So that pulsing feeling that you get with an orgasm, is that the pelvic floor?

Exactly! An orgasm is basically a kegel - a series of little contractions. But the other reason I say sexual appreciation is because these muscles are sphincters --  they need to both contract and relax, just like any other muscle in the body. So in order to be able to enjoy intercourse, we need those muscles to be able to relax and open and then of course to contract.

That’s so interesting, because when people talk about a strong pelvic floor, for me it conjures up images of being perpetually clenched or flexed. I guess I always thought my pelvic floor should be tight, clenched and always kegeling, but you’re saying it’s equally important for floor muscles to relax?

Absolutely, it needs to be able to move, we never want a muscle to be stuck or to be stagnate. Just like any other muscle in our body, we need to be able to contract it - a kegel in pelvic floor terminology - and we need to be able to relax and elongate it. The muscles need to move through that range of motion and if we’re stuck in a clenched kegel position, or stuck in an elongated position, you’re not going to be able to access that true source of strength and function that a muscle should have.

Think about it like any other muscle. If you wanted to strengthen your bicep, you wouldn’t want to walk around all day with your bicep flexed. Anyone who has held a baby for 10 minutes knows what a strain that is. A truly strong muscle is one that can move easily through elongation and flection. If a muscle is only able to be elongated, it’s weak. If a muscle is only flexed, it’s weak. We want a muscle that can very easily move through all these positions.

The other thing that’s pretty amazing is that there’s part of the pelvic floor muscles that are actually deep hip muscles, so sometimes things that we feel in our body that our pelvic floor is affecting isn’t felt directly in the pelvic floor, like lower back pain, and hip pain. These muscles go directly into the intimate muscles of the pelvic floor. So, relaxing and strengthening the muscles in our pelvic floor can also help your hips and your back. Amazing, right?!

That makes so much sense. When I was pregnant, especially in the final month, I had really bad hip pain in my sciatic joint, so it sounds like that was probably directly related to the pressure my pelvic floor was under?

Absolutely! That and hormones play a role. The hormone Relaxin comes out in spades when you’re preparing for labor. The good news is that we’re able to relax and release some of those muscles from the outside. Doing some hip, butt, and inner thigh stretches can have a positive impact on your pelvic floor.

I know exactly what you mean! My hips get so tight from walking around New York every day that I roll around on a tennis ball to help release that tension and loosen them up.

That’s perfect. Releasing that area feels so good! Remember that next time you’re rolling on the ball or foam roller that you’re likely helping your pelvic floor as well!

What’s one thing you wish every woman knew about her pelvic floor?

I think the most important thing to know is that the pelvic floor is at the center of the body, making it the center of our strength and resilience as women.

Next up: How every single thing you do (including breathing!) impacts your pelvic floor.