Pánevní dno, i když není vidět, nezapomínejte na něj!

The pelvic floor, even if it is not visible, do not forget about it!

Do you suffer from pain in the lower back, cross-hip joints, do you have pain during sexual intercourse, leakage of urine or difficulty defecating? If so, it is quite likely that it is all due to the malfunction of the pelvic floor muscles.

What is the pelvic floor?

Anatomically, the pelvic floor is formed by a three-layer group of muscles, going from the coccyx to the pubic bone. We can think of it as a bowl or hammock suspended in our pan. These muscles provide us with the correct position of the organs (they hold them so that they do not sink downwards), help to retain urine and stool.

However, the pelvic floor also has a major impact on the posture of our body, more precisely on strengthening the center of the body. Let’s imagine the position of the pelvic floor and diaphragm. These muscles are stored horizontally above each other and I am constantly communicating with each other. We take a breath through the diaphragm, which pushes down against the pelvic floor. It should be able to withstand the pressure and so the diaphragm can act as a piston, which pressurizes a little, thus strengthening the center of the body. This strengthening is very important for straightening the spine and stabilizing the pelvis and hip joints.

When the pelvic floor is not working as it should…

The pelvic floor should be able to withstand great pressures, e.g. when we cough, jump or lift heavy loads, this function requires its activation. If it is insufficient, there may be leakage of urine called stress urinary incontinence.

On the contrary, with a breath into the lower abdomen, the diaphragm presses into the pelvic floor downwards, at this time the pelvic floor should be able to relax, on the contrary, which is very important. The ability to relax is very often impaired in women and can cause problems often greater than the weakening of the muscles itself (e.g. blockages of the lumbar spine, transferred pain in the hips, buttocks, discomfort during sexual intercourse and others). Very often, however, dysfunction occurs in both of these directions – that is, reduced muscle strength and limited ability to relax.

It often happens that women strengthen and strengthen, but forget about practicing relaxation, which then over time reduces their ability to activate the muscles and muscle coordination occurs.

Who are the most common problems?

Problems with the pelvic floor begin most often during pregnancy and after childbirth. The risk factor is a large and heavy baby, as well as complicated births with postpartum injury, where there may be serious conditions such as uterine or rectal prolapse and related incontinence not only of urine, but also of stool.

Another risk group are women in menopause, in these women the pelvic floor is usually already partially weakened after previous pregnancies and births. In addition, hormonal changes, often increasing weight, play a role here.

In general, problems with urinary incontinence usually worsen with increased demands on the pelvic floor, such as colds, chronic cough or overweight. After a stress episode (cold and cough) everything is normal again, but beware, these episodes with leakage of urine should be a warning signal for us that something is not quite right and the pelvic floor needs to be worked on!

Another separate chapter could be athletes in whom no one would assume dysfunction of these muscles, but the opposite is true. Pelvic floor problems are very common in runners, volleyball players and gymnasts. These athletes usually have difficulty relaxing and becoming aware of the pelvic floor.

Psychological consequences of pelvic floor disorders

At first glance, it would seem that these difficulties are purely physical in nature, but the opposite is true. For women who are plagued by urinary incontinence, for example, this disorder goes far beyond the physical framework and greatly affects the psyche. These women usually do not talk about their problem, they get into social isolation. They often begin to develop psychological and psychosomatic problems such as depression, anxiety and other non-specific disorders, which are very difficult for both health professionals and patients themselves to grasp and treat.

Pelvic floor disorders are successfully treated.

You can read more about the pelvic floor here.