We talk a lot about the pelvic floor muscles.  We’re all advised to do our Kegels and work on our pelvic floor strength.  But like much of the pelvis, these muscles are a little bit of a mystery to many of us.  Where are your pelvic floor muscles?

The pelvic floor muscles are technically divided into two groups: the superficial pelvic floor muscles, which are closest to the skin, and the deep pelvic floor muscles.  Generally, when someone is talking about the pelvic floor muscles, they are talking about the deep muscles.  The superficial muscles are much smaller and are difficult to strengthen.  I am just going to focus on the deep pelvic floor muscles here.

The deep pelvic floor muscles include the following muscles: the coccygeus, puborectalis, pubococcygeus, and iliococcygeus.  These muscles form a bowl of support in the pelvis.

I always describe these muscles the same way.  These muscles are shaped like a bowl deep in the pelvis.  They extend from the left hip to the right hip.  They start at your pubic bone and stretch back to your tail bone.  These muscles hold up all of your pelvic organs and are attached to your sphincters.  They are always working to support you and keep you clean and dry.  And there are three holes in these muscles- one for the urethra, one for the vagina, and one for the rectum.

These muscles are tucked behind the bones in your pelvis and can’t be seen.  They are attached to your hip, leg, and abdominal muscles.  Any injuries in these muscle groups can also impact how the pelvic floor muscles work (and feel).  So if the muscles

are behind the bone, how do you assess them?

When you contract these muscles, the urethra, vagina, and anus all squeeze shut.  Squeezing will stop your urine flow.  You can also feel them squeeze with a finger in the vagina or anus.  There are different products to help with pelvic floor strengthening, like vaginal weights or peri trainers.  These products can help you measure the strength of your pelvic floor.

For more information on the pelvic floor muscles, read  What are pelvic floor muscles?

(link to https://pelvicguru.com/beginners-guide-to-pelvic-floor-muscle-exercises/)

Female Pelvic Med Reconstr Surg 2021;27711-8.