PowerPoint Presentation

THE PELVIC FLOOR AND THE ABDOMINAL CORE

1 THE BONY BOUNDARIES OF THE ABDOMINAL CORE Netter 2006

The ribs, low back and pelvis form the bony boundariesof the abdominal core

This is a picture of the rib cage, low back, pelvis and hips. The diaphragm attaches to the inside of the rib cage and separates the chest cavity from the abdominal cavity below. The low back is made up of the 5 lumbar vertebra. The pelvis is made up of the sacrum and the 2 pelvic bones. The sacrum is the triangular bone that is wedged in between the pelvic bones. The sacrum joins the pelvic bones to form the sacroiliac joint on each side. At the end of the sacrum is the tailbone, where the pelvic floor muscles attach. At the front, the pelvic bones join at the pubic symphysis. The pelvic bones have a socket for each of the hip joints. 2 THE ABDOMINAL CORE

Lee 1999A strong and coordinated abdominal core helps to:

control the rises in intra- abdominal pressuresupport the pelvic organssupport the low back

Now lets look at the muscles that make up the abdominal core. Think of a box. The diaphragm forms the roof, the pelvic floor makes up the floor, and the deepest abdominal muscle, called transversus abdominus, wraps around from the front of the abdomen to the back. Inside the box is where the intraabdominal pressure is generated when you cough and sneeze, for example . All of these muscles normally work in a coordinated way to help control the rises in pressure, to assist in stabilizing the abdominopelvic organs and to help support the low back. You can see how it makes sense to look at all of the muscles of the abdominal core when there is a pelvic floor problem rather than looking at the pelvic floor in isolation.3

THE FEMALE PELVIC ORGANSPetros 2004

4This is a picture of the female pelvic organs- the bladder, the uterus, vagina and rectum. THE PELVIC FLOOR MUSCLES

Petros 2004The pelvic floor is the primary support for the pelvic organs

This picture shows the pelvic floor muscles forming the bottom part of the abdominal core. They form a hammock-like support for the pelvic organs. The pelvic floor is actually a multi-layered muscle complex comprising a superficial layer, a middle layer and a deep layer, seen above, formed by the levator ani muscles.5 THE LEVATOR ANI MUSCLESNetter 2006U urethraV vaginaR rectumC coccyxPR puborectalisPC pubococcygeusIC iliococcygeusCG coccygeus

PCICCVRUPRCG

6This picture is looking down and into the pelvis. The front of the pelvis is at the top of the picture. You can see the urethra, vagina and rectum in the midline. The levator ani muscles include the PR, PC and IC muscles, seen as PR, PC and IC above. The coccygeus muscles are seen posteriorly. Note how these muscles make up the entire floor of the pelvis. They form a muscular plate that is constantly working to help support the pelvic organs against the downward forces of intraabdominal pressure.

THE PELVIC FLOOR MUSCLES- An extraordinary multi-tasker!sexual function pelvic organ supportlow back stabilitypelvic stabilityurinary continencebreathingfecal continencevoidingchildbirth

7The pelvic floor muscles are truly extraordinary because they play an important role in all of the functions above. There are so many reasons why it is worth being proactive about the pelvic floor!

NOW IS A GOOD TIME TO START TRAINING YOUR PELVIC FLOOR