Pelvic Floor Tutorial

Hi, this is Leah Stewart and I am here to give you a little tutorial on the pelvis and the pelvic floor. The pelvic floor is something that is kind of complicated for us to understand because there are muscles that are kind of deep in the body and they're not always easy to feel and they don't necessarily move the bones in a big way that our biceps sue our hamstrings and our quadriceps do. So they're a little bit harder to get in touch with. But we've all had this experience while we're practicing [inaudible] that we will be instructed to Cagle or contract your pelvic floor before you do movement in. You're kind of thinking, okay, I don't really know what that feels like. I don't know. I don't, maybe I don't really understand that.

So that's why I'm here today to kind of help you understand that a little bit more. So this is really not a comprehensive course. Obviously I'm on the public floor. This is more about just getting good imagery and a good basic understanding of what that means for you so that it can help you in your practice. So, first thing I want to do is I have my little model here of the pelvis and you can see it's kind of an odd shape, kind of a little bit of a circle, a little bit of a heart shape. And it's this really beautiful, brilliant design. So the first thing is the pelvis is kind of the bridge between the upper and the lower body. It connects those two elements. You have the thigh bones that connect into up into the pelvis.

You have the spine that connects to the pelvis. So those are gonna play a big role on pelvic floor and pelvic health as well. But we want to kind of look at the structure of the pelvis in and of itself. So it is a bowl and you want to think of that bowl being made up of these two bones on the sides, which are called the iliums. And then in the back you have the sake grim, which is the lower aspect of the spine. And then the coccsyx or the tailbone, which is the lowest aspect of the spine.

So that's where the ilium bones connect to the spine there. And you can see here at the bottom here, these are called the issues in down here, this is called the issial tuberosity or what we know as the fifth bones and the front here there's this piece of cartledge and where those two sides of the alien bones meet, this is called the pubic synthesis or the pubic bone. And then of course in the back we have the tailbone. So those are going to be kind of some of our points of reference. Here we have this two notches in the front that are called the Asi bias.

And in the back we have the two notches in the back that are called the psis. So these are all things that we can feel and manipulate on our own body. And that's what we're going to do really quick. So if you will just join me. So in the front you put your fingers here, those are your ass s if you take your index finger and wrap your thumb around, depending on how big your hands are, you kind of pushed down a little bit. That's your Iliac crest. That's this ridge right here.

The kind of the top of the pelvis, the top of that bowl. And then I want you to go ahead and lean forward a little bit and I want you to put your middle finger right on that sitz bone on the right side. And then put your left one right on the sizzle one on your left side. Yes, I'm telling you to touch your booty here, but that's what I want you to do. And if you can kind of manipulate those, those are your sitz bones. You can even play around with Kinda sitting on them a little bit and you can feel that kind of that boniness down at the bottom.

Those are your issial tuberocities and those will actually move quite a bit when we do certain movements in Palladia. So those become really important as well. And then I want you to just go ahead and place your hand down in between your two sides of your buttocks and that's going to be your sacred down into your coxix so you can actually feel how that Cox is set. Telephone, kind of wraps it down and around. And that's an also really important point to be aware of. So the pelvis there has certain movements that we do, so we can tuck the pelvis or tip it back. We can tip the pelvis forward or archer back.

We can tilt the pelvis up to the side or we call laterally tilt on both sides and we can rotate the pelvis from side to side. So we have front, back, side side, rotate, rotate. So all this wonderful movement happens in that pelvis. So those are the bones, that's the structure. How do the muscles affect that movement? What is the role of the pelvic floor? Well, in order to understand that, you've got to understand that there's a couple of little layers, so to speak, of the pelvic floor we have, and they all kind of happen in this smaller opening here.

So in the pelvis you have this larger opening here at the, in the higher aspects of the aliens. Then you kind of go through the smaller, what we call the lesser pelvis. And that's going to be a little bit more of where the pelvic floor muscles are going to start to attach. And then you have the inferior or the bottom aspect of the palace. And that's going to be where those other layer of the pelvic floor muscles attach. So that's what I want to explain to you a little bit more today if you're up for it. So we have the superficial layer that we're gonna start with first.

And this I'm going to do a little drawing for you. Okay. I'm a mover a dancer, I'm not an artist, so bear with me. This is very rudimentary. So here at the top I'm representing the pubic bone at the bottom here with the little triangle, I'm representing the sacrum. And on the side here I'm representing the right, right?

It shows the recipe rather. And then on the left, the left side. So there we have it. And then what you can see here is it makes this really beautiful diamond shape. Isn't that nice? And then from there you can kind of divide that into do different triangles. So that's what I really like about the looking at the pelvis this way.

So you can imagine that you're looking up on the pelvis from underneath. That might be a good way to think about it because the first layer we're going to talk about is the most superficial layer of the pelvic floor or the parent Niamh. And this is really interesting because this is, um, the muscles that will help kind of control the orifices, meaning the openings that we have on women. We have the urethra, the vagina and the anus. So these muscles are going to help to control that and what's going on there. So the first we want to look at is the deep, um, excuse me. We want to look at the superficial transverse peritoneal muscle and that is going to be a muscle that connects from those [inaudible] initial tuberosities. There's a tendon that runs down the middle here, but it's going to connect from the sides horizontally.

So that's a really wonderful, um, muscle there that kind of keeps that idea of coming in a member muscle fibers. Will they pool in the direction that the muscle fibers are going. And then from there we had, this is what becomes really important about this superficial layer of the parent. Ian, you have this wonderful muscle that's a figure eight. And again, my drawing is, I'm just trying to represent it in a really rudimentary way. You have this awesome muscle, so think of the openings here, the vagina, the urethra, and the and the anus all there. So it kind of wraps around those openings and you have these two different muscles that connect there. And I'm going, I'm not going to give you very many names, I just want you to see the visual more importantly here.

And then from there on the superficial, there's a muscle that runs along the two, is she in bones here that connect to the pubic bone there? And then those will help kind of keep that sense of that triangle pulling in. And then you have that figure eight there. So this is really important because those sphincter muscles of those openings are gonna need help from the superficial layer to help control those bodily functions that we have. When these muscles get slack or they get over worn or they get too tight or they get weak, that control starts to diminish and it starts to dissipate.

And that's when we have urinary incontinence to feces incontinence into the worst being prolapse of the organs that come out through the opening. Sarah. And that certainly what we don't want. So is that pretty clear there? Are we good on that? Now I'm going to show you a picture of the deeper layer of the n pair name or the pelvic floor muscles. The one we did before, the superficial layer that was kind of at the inferior aspect of the pelvis. That was kind of the figure eight that surrounds those openings that are gonna help support that.

This next layer called the [inaudible] deep pelvic floor muscles or the pelvic tire from those that kind of a couple of different terms that people use to describe this. This is going to be a little bit more on the, um, the, the middle aspect of that lesser pelvis of that inner pelvis and they're really beautiful and they're described as kind of like, um, like a whole of a boat. I know, imagine like within this of the pelvis there's another bowl that occurs there. Um, sometimes it's referred to as a fan, that kind of fans across that pelvis kind of fan. So it's parallel to the ground kind of fans across the pelvis or you'll also see from my drawing, there'll be an element that's kind of a horseshoe shape. So basically the function of these deep muscles are, they provide that whole, that fan, that support and basically all of the, our contents of our torso, our abdominals, our intestines, our uterus.

If you're a woman, everything is kind of stacked on top of that. And so there needs to be muscles that are there to help support that adequately. Um, in evolution when we were walking on all fours, domino muscles and the front of the tour. So they were the support mechanism as they became bipedal and became upright evolutionary and development or progress, the pelvic floor muscles started to develop and the tailbone, the coccsyx instead of being flipped up like an animal kind of came down underneath to give a little bit of that a bony support as well, that little, that structural support. So that's really important, the amount of support that that pelvic floor can provide. That deep pelvic floor in particular is really gonna be dependent on the contractile ability of those muscles, which I'm going to refer to in a little bit.

And also the pelvic floor for women giving birth. The other function is that as it serves as a passage way for that baby to travel down through the pelvis. So let's go ahead and draw a little bit of a picture here for you for that deep layer of the pelvic floor. So again, we have the pubic bone. The left is shell tuberosity, the right is she'll tuberosity and the sake ground. And I'll go ahead and draw that diamond shape for you.

So again, these are going to be kind of a horseshoe shaped muscle group that levator Amy or I mean however you want to say it, it's going to be the first one that we're going to direct here. So if we have those openings of, again I'm not going to drop them completely the scale, but if we have the anus here, the vagina and the urethra there, we have to have these muscles that kind of support that. So we have the first one, which is the pupil rector rallies, which is going to connect at the pubic bone and it's gonna wrap around all the way here. So I'm going to try to draw this as dark as I can for you. So you can see that that's the first one here.

And then we have the pupil Cox, the g is muscle, which is going to connect a little bit more over to the side of it is she comes here and that's going to connect here. So you can kind of see how I'm starting to create that horseshoe. Yes. And then we have the Elio Cox, the g s muscle, which is more of a lateral muscle, more on the outside. And that one is gonna come all the way here. And it's going to connect here so you can see how I continue to make this horseshoe, this fan that comes all the way.

And please forgive my lack of absolute precision here in my drawing. Again, it's just more of a visual for you so you can see how beautiful that fan is, right? And it connects all it down here towards the coccsyx. Okay. And then last but not least, of course we have another little group of muscles called the Cox, the GF muscle. And they kind of comes down here and they're kind of just going to add that extra support where the sacrum is. So that is the deepest layer. So you can see that four shoe quality, you can see that whole of a boat, you can see that fan that kind of comes across there isn't that knife.

So those two layers are going to work together in order to provide that support that you have. So I just want to give you that little image. I'm going to draw over this. I'm going to try this. So that image of, if you had a fan here connected at the sake ground, do you want a nickname? Me Picasso, you can, I know I'm really antic my drawing. So there you can see that fan that comes across there. So think about that on a contract dial level. If you have that image of that fan fans out and contracts here and that's really what's going on are contracts that you can see how those muscle fibers would pull in is really beautiful and it's really brilliant to kind of look at.

Now here's what I want you to think about why we work in a neutral pelvis. When we do pull out these versus kind of some of the traditional way of working in a flat back or in a posterior tilt, we would work here when we work here and our pelvis is in the posterior tilt. This is really fascinating to think about. Those muscle fibers are shortened. They are, um, you can think of it kind of in a, um, concentrate contracted state. And then we hold it there. We're holding that in a [inaudible] metro colds.

So what that does is it pushes the bottom of the public together. The initial tuberosity discovered to other Cox's comes together. You have that tight sense of that, uh, those paraniem and those deep pelvic floor muscles, they become very tight and very weak. But when we reach the tailbone back and we lift the coccsyx up, the issue tuberosities will widen and those muscles will go into a linkedin state and they'll kind of stretch. Now we need to release those tight muscles before we can strengthen them.

So we need to lengthen them back to their proper resting length before we can go back in and strengthen them. So we have to find that sense of mobility and length before we can go in and strengthen. Because we all think that we have a big problem with over tight pelvic floors. And that may be true, but more often it's a sense of weak pelvic floors either for some people in a shortened state and they're weak or some people are in a linkedin state and they're weak. So think about this from another perspective. Women, particularly after they give birth or during pregnancy or just women in general or people who are dealing with obesity and being overweight, they generally are here, right in an anterior tilt to their Pulis, their pelvis flops forward, their abdominals are weak. Well, what I just described to you is that pelvic floor is lengthening. It's in a lengthened state, is an overstretch state.

You have these muscles that are overlaying, do you have those figure eight muscles that are over linkedin? So what happens here is the muscles of the lower back are also contracted back problems instantaneously. So we talk about, oh, strengthen the abdominal, strengthen the abdominal strength and mcdonalds, mobilize the back, mobilized the back. That's one part of the equation. If you do pelvic floor therapy and pelvic floor work and you really think about contracting those pelvic floors, getting a good sense of understanding how to contract. The pelvic floor musculature, along with those other elements of work, we can pull the pelvis back into a neutral position. All of a sudden people's back pain start to dissipate because their pelvic floor health starts to improve.

So it really is such a crucial aspect of our work because even when we move our legs, all the quadriceps, the hip abductors, the hip abductors, the hip extensors, the rotators, they all play a crucial role in those little tiny movements and manipulations of the pelvis of the bones, which are going to have a profound effect on the pelvic floor musculature. Um, I don't know if I have a great representation of this, but I do want to show you if I want to try and, because we talk about lifting the pelvic floor, lifting it up, and I think this is kind of, it's a good image, but I think we need to understand what's actually happening. And I think by having this image of the fan, you'll be able to understand that a little bit more. So when we have our hands, I'm going to use my hands as my muscles here. When I have my hands in that fan state, so I'm inside my palace, I'm tipping it forward so you guys can see it. When I contract those muscles, this, this a fan, this whole of this boat, when I contract those muscles, what happens is there's an element of narrowing inside the pelvis and basically that provides that support and that sensation is that everything is lifting up. I'm not sure if you can see it here, but let's say I had these, this was like my intestines and my stomach.

This are all the contents of my torso. If my muscles are in a stretch state, my pelvic floor muscles, when I contract them, what happens to my book here? It lifts up, right? You can kind of see elevate up. So essentially that's a good image for, you can kind feel that sensation. You kind of provide that support.

So it's kind of like the gates are closing and then we'd go into abdominal contraction where all that content of the diaphragm and the abdominals and all that content comes down toward the pelvis. So we're not putting that bad kind of pressure on the pelvic floor, which sometimes abdominal, where it gets a bad rap for on our pelvic floor and said we can contract and feel that support before we can check those other muscles so that we're in that protective mode. And that's what you are thinking of when you're being cued of contracting the pelvic floor prior to movement or feeling that sensation of support. I want you to have that image again. So hearing in the fan of my hands, just see my book here represents the contents of your pelvis and your abdomen. And so here I contract and I feel that support boom.

Then from there that's really solid. It's really constructed, it's really steady. So I hope that gives you a little bit more of a visual here for the pelvic floor. So again, this was just a really basic introduction to some of the muscles of the pelvic floor, why pelvic floor health becomes really important [inaudible] the structure of the pelvis and again, just to give you that little bit of that understanding. So hopefully when you go into your practice, you can practice all that much more better and have a little deeper understanding. And I hope in the future I can provide a little bit longer and more detailed explanation for you. Thank you so much for joining me today, and if you have any questions, please leave them in the comments below and I will definitely make sure that I get to answering them. Thank you so much for joining me.