What does it mean when we hear pelvic floor/core dysfunction? It sounds pretty ominous, doesn’t it? Well, from a physiotherapy point of view it really means that the muscles aren’t working like they’re supposed to be. So, that could mean that they’re weak, that they’re too tight and are having trouble contracting, or that muscles that should work together aren’t (not really coordinated).
The pelvic floor and deep core
What about the core? The “deep core” is a group of 4 muscles that work together. They are the pelvic floor at the bottom of the pelvis, the transverse abdominus at the front, the diaphragm at the top and the multifidus along the spine. These four muscles should be constantly working. They contract and relax together in response to loads we’re asking our body to do. They help keep our pelvis stable, our pelvic organs up, help control bowel and bladder function and help to regulate pressure in our abdominal cavity. It’s important to realize that the pelvic floor doesn’t work on it’s own.
Weak pelvic floor
A weak muscle is a muscle that doesn’t produce enough force to do it’s job. A muscle that is too lengthened or too tight would fit into that category. So, a weak pelvic floor can be a pelvic floor that’s too long (or “stretched”), or too tight. This is good to know, as how you go about fixing this is different if it’s long or tight.
Coordination or motor patterning
What this refers to with regard to the pelvic floor and core is how well the 4 muscles of the core are working together and the amount of force they’re each producing. A poorly coordinated core can present as a weak pelvic floor and have the same symptoms even if the actual pelvic floor muscle is strong. A well timed core has the pelvic floor and transverse abdominus relaxing as you inhale and the transverse abdominus and pelvic floor contracting as you exhale. How big of a contraction depends on how big the load on the body is.
A “weak” pelvic floor can be long, tight or not working well with it’s partners. It’s important to know what is going on in your body so that it can be treated appropriately. If not, things may not improve and in a worst case situation, get worse.
The second part in this series I’ll be discussing signs of symptoms of pelvic floor/core dysfunction.