Your Powerful Pelvis: All The Physical Pelvic Functions You May Never Have Heard About
- Dr. Liliana Sainato-Monardo, LMT, DPT
- Jun 3, 2023
- 16 min read
Updated: Nov 2, 2023
Your pelvis is physical, emotional, and energetic. Whenever I share this, I notice that most people get excited to hear about the emotional and energetic piece (if that’s you, you can explore more here)!
But the physical pelvis is soooo much more complex and dynamic than most of us were ever taught.
Yes, it plays a huge role in sex and birth, but it also influences a number of other things that we do every single day!!
In order to make this easier to understand, I'm going to take you through it one by one and weave in a little anatomy lesson as we navigate through this surprisingly exhaustive list!
Here is a quick access Table of Contents in case you want to jump around!
1. Center of Gravity
Your pelvis helps dictates where you are in space and how you travel through it. To start understanding this, let's look at where your pelvis lives in your body.
The bones of the pelvis create this big, irregular, lofty structure that sits almost dead center in your body. Your center of gravity (the centralized point that gravity acts around) sits right within or a little above your pelvis. It changes slightly as you change position, but remains roughly tethered to this area.
Because of this, your pelvic position significantly contributes to your sense of balance in space.
Have you ever noticed - when someone starts to fall forward, the most common response (whether conscious or not) is to bend at the waist, sticking the pelvis backward to help counteract the weight forward. Similarly when falling backward, most people will lead with their pelvis in the forward direction to try to regain their standing position.
Another way to think about this is to consider martial arts/body defense technique. Across the board, you will hear "if you can control someone's pelvis, you can control where they go." This is because the pelvis represents a stable center point with the limbs and torso extending away from it.
Proper control at the pelvis influences the balance of the whole body!
2. Shock Absorption and Load Distribution
And speaking of balance and moving through space, your pelvis also influences the way force/energy moves through your body as you walk and move through the world!
Every time you take a step, your foot interfaces with the Earth and pushes downward while the floor beneath you exerts an equal but opposite force. It requires strength and energy to maintain the upright position (i.e. fight gravity) and propel yourself forward. The amount of force/energy generation needed depends on the surface you are walking on.
But this force does not stop at the bottom of your foot. With each step you take, force travels upward and downward through your body. Your pelvis is a key player in this process.
Every time your pelvis receives force, its absorbs and redirects it in order to conserve energy and efficiently modulate the force. Typically, force traveling through the pelvis crosses over to the opposite side. This is due in part because of the shape of pelvis. It is made up of two halves that are able to rotate slightly at the SI (sacroiliac) joint. This slight movement contributes to the force distribution across the fascial path known as the Spiral Line of the body.
Being able to distribute force across the pelvis is this spiral shape, not only effectively absorbs shock, but also helps us accelerate and decelerate, and produce torque and power when needed.
If you'd like to learn more about this, look up "Spiral Lines of The Body - Anatomy Trains" and "Deep Longitudinal Kinetic Chain."
3. Organ Support
Now let’s zoom our anatomy lesson in and have a look at the pelvic muscles!
The photo on the left is a top view of the pelvis; the photo on the right is a side view. Outlined in red and highlighted in yellow is the pelvic inlet. If your pelvis was a box, the inlet would be the top opening and your pelvic bones would be the sides. Your pelvic muscles would create the "floor" of that box, keeping all the contents inside. When it is time to release something from the pelvis space (e.g. pee, poop, gas, your monthly blood, or even a baby) the pelvic muscles open, and [whatever it is] passes through the pelvic outlet.
In the photo below, I've cut away half of the boney pelvis to show that there are a lot of organs in your abdomen. Your pelvic bones and pelvic muscles provides the necessary support for these organs.
The muscles of the pelvis are referred to most often as the pelvic floor. But you may also hear it referred to as the pelvic bowl or pelvic diaphragm.
These muscles attach all around the inner rim of the boney pelvis and scoop down to create a hammock or bowl-like shape. This sling of muscles provides support for all the organs living inside your torso.
Without these muscles, the only thing that would be separating your abdominal organs from the outside world would be your skin! Your pelvic muscles create a much stronger and more functional barrier.
I created this short video on my anatomy app (Complete Anatomy - highly recommend!!) to show you how many muscles live here and to really illustrate their bowl-like nature!
If the pelvic muscles can no longer provide support for the abdominal organs, it is possible for the organs to start protruding out beyond the muscular barrier. This is known as Pelvic Organ Prolapse and it can be treated! If you think you may be experiencing this, fear not! A Pelvic Floor Physical Therapist can evaluate your symptoms, and if caught early enough can be fully reversed without surgery!
4. Contraction
Next let’s look at the pelvic muscles in action! As I shared in the last section, there are a variety of muscles that contribute to overall pelvic muscle support and integrity. They run in all different directions and work together and effectively close off the pelvic outlet.
These muscles are just like any other muscle in your body - you have voluntary control over them, you can strengthen them, and you can stretch them!
In fact, it is important for your overall health to have an awareness of and coordinated control of these muscles!
Since these muscles are relatively small and overlapping, it is not possible to contract one at a time. Instead they contract as a group! When they contract, the "bowl" becomes shallower (like a salad bowl) and when they relax or stretch the "bowl" deepens (like a soup bowl).
Although these multitudes of muscles create one big bowl and are meant to contract together, there is some nuance to it! First, your pelvic muscles have a deep and a superficial layer! It is possible to have strength in one but not the other! Secondly, it is possible to bias your contraction a little more in the front or a little more in the back. This isn’t to say that you can isolate your contraction fully, but it does mean that the contraction can be unbalanced. And lastly, because your boney pelvis is made up of two halves, your pelvic bowl is similarly observed in the context of right side vs left side. And it is actually quite common for people to present with one side being much stronger or much tighter than the other side!
All of these components can be evaluated by a Pelvic Floor Physical Therapist. I highly recommend going to see one even if you have no symptoms just to get a baseline understanding of your strength and coordination!
These muscles need to be able to contract to keep things like pee, poop, and gas inside at will. When your pelvic muscles are strong, they can contract around your urinary and rectal opening to cut off the flow. If your muscles are weak and unable to squeeze the opening shut, you may experience leakage.
And like I mentioned, these muscles are just like any other muscle in the body. So if you notice leakage, your muscles can be trained and strengthened to prevent it happening any further!
Voluntary contraction of the pelvic muscles is often called a Kegel. Kegels are important to practice, however, they are not the only thing needed for pelvic health and they are not for everyone! Be sure to consult with a Pelvic Floor Physical Therapist to find out if Kegels would be supportive for you.
5. Relaxation
On the flip side, when you’re ready to release any pee, poop, or gas, your muscles need to be able to relax enough to let everything out easily. It is possible to have incomplete emptying if your muscles aren’t capable of full relaxation.
Difficulty relaxing is relatively common to find in people experiencing pelvic symptoms. An overactive pelvic floor may contribute to experiences such as painful sex or painful periods (among others). It can also contribute to peripheral pain such as hip pain or low back pain. And, believe it or not, it can also worsen constipation!
Lastly, pelvic muscle relaxation can influence the course of labor and delivery. An appropriate amount of pelvic muscle relaxation can help delivery move smoothly. Excessive tension may make it difficult to deliver without an episiotomy or some degree of natural tearing.
Ideally, your pelvic muscles can contract fully and relax fully at will. If you struggle to tune into this part of your body or suspect that your symptoms are a result of inadequate pelvic relaxation, consult a Pelvic Floor Physical Therapist. And if you are pregnant, consider hiring a Pelvic Floor Physical Therapist to help strengthen your body during pregnancy and stretch your muscles to help prevent tearing during delivery!
6. Penetration & Orgasm
Sexual function is one of the more obvious function of the pelvis! But even so, it is quite nuanced!
When it comes to arousal, your pelvic muscles need to be able to relax fully in order to allow the maximal amount of blood to flow into the tissue. Without adequate relaxation, circulation (and therefore erection - both penile and clitoral) will be limited.
Furthermore, your pelvic muscles need to be able to relax in order to accommodate penetration. Both vaginal and anal penetration will be limited or challenging if your pelvic muscles are tight and unable to relax. Again, just like any other muscle, your pelvic muscles can be trained to stretch and relax. So if you are having difficulty with penetration of any kind, you can see a Pelvic Floor Physical Therapist for support!
Lastly, your pelvic muscles contribute to your ability to orgasm. An orgasm, though it is an involuntary response, is created via a sustained, rhythmic pelvic muscle contraction. If your pelvic muscles lack strength and stamina, your orgasms may be suffering. Intentional relaxation and contraction training can help you to achieve that overwhelming pleasurable sensation!
7. Sensation
Beyond muscle health, we have nerve health! There are MANY nerves that lead to and influence the pelvis. Nerves are the electrical messengers of the body. In order to send and receive information accurately, nerves need space.
When a nerve doesn’t have the freedom to slide and glide along it’s designated path, it get can get stuck or pinched.
A nerve that’s stuck will not be able to communicate properly, and thus causes changes in sensation or muscle activity. This might feel like an itch that just won’t go away, unexplained tingling, burning, persistent tension, unexplained weakness, hypersensitivity, or numbness.
Here is a picture to show just how many nerves there are in this region of the body!
Any of these nerves can get stuck when there is muscle or fascial tightness.
Muscle tightness or tension happens as a result of a contraction without full relaxation. This can happen when there is inflammation, poor circulation, poor muscle health, overuse, compensatory activation, or even emotional holding.
Fascia, however, does not contract. It is a connective tissue that wraps all the structures in the body. It has a web like matrix filled with a gel like fluid. It has many layers and can be found between every individual organ/muscle/bone/etc in the body.
Fascia gets tight when your tissues are dehydrated and there isn’t enough circulation to clear cellular waste. This causes the tissue to stick together and become rigid.
Tension of any kind can press down on the nerve and make it difficult to send clear sensory information. This is important to think about, because pelvic symptoms such as chronic pelvic pain, painful periods, and uncomfortable pregnancies (among others) may not just be a muscular dysfunction. Nerve health is an important piece of the puzzle that is often overlooked!
Muscle and fascia tightness can be prevented with adequate nutrition, hydration, cardio training, and mobility training. When your pelvic tissues are hydrated and supple, your nerves can communicate freely and sensation is clear and vibrant!
8. Circulation Support (aka "Sump Pump")
If you look up “functions of the pelvic floor”, you will likely get a list of 5 functions, all starting with the letter S (stability, sphincteric, sexual, support, and sump pump).
My list covers all of those areas, but in a bit of different format. This is how my brain likes to think of it, so maybe yours will too!
But the last on that list, sump pump, has always bothered me. A sump pump is a plumbing appliance that pumps water against gravity up to its necessary destination.
The pelvic muscles, much like a sump pump, help direct blood back up to the heart every time they contract. This happens because of their bowl-like shape, their location in the body, and the combined power of all the muscles contracting together.
An important pelvic function, no doubt!
But I just can’t get over calling it a sump pump. I don’t have much experience working with a sump pump so the comparison doesn’t really land for me… and something about putting the pelvis metaphorically next to a ~plumbing appliance~ feels a little.. off for me?
I get it - its a short list of 5 and they all start with S… but I really think that when you have a deep, grounded understanding, the acronyms and funny names are a little unnecessary. My personal philosophy is that when learning about something feels fun and exciting, the information feels captivating and it sticks - even if it takes a couple read throughs.
I genuinely hope reading this blog has felt exciting for you! If you’d like any further explanation, please leave comment or, as always, feel free to reach out!!
So anyway, instead of sump pump, I like to refer to this function as circulation support! The pelvis assists the flow of blood (as well as the flow of lymph!) back upstream so that the heart does not have to struggle to pump all 5 liters of blood back up against gravity to its small home up high in the ribcage.
Without the support of the pelvis, it would be easier to accumulate fluid in the lower half of the body, leading to excess inflammation and potentially, pelvic congestion.
9. Breathing Mechanics
Next on the list, one of the most important: breathing mechanics. Thankfully, with the rise of mindfulness and meditation, many people are capable of brining their awareness to their breath and even influencing the way they breathe.
My only problem with this is that in so many circles, pelvic breathing is left out of the conversation!
Many of us can identify when we’re chest breathing, some can easily feel their diaphragm moving, and plenty have experience belly breathing.
But what happens when we send the breath farther down? Pelvic breathing!
The skill of breathing into your pelvis is important because 1) you can actually use your breath to stretch your pelvic muscles from the inside, 2) this breathing supports a strong posture and a strong core, and 3) it is a powerful tool to help you ground and connect to your pelvis.
So how can your breath stretch you tissues form the inside, you ask? Well, let’s think about it!
Your abdomen is a closed pressure system. This means that the pressure inside always stays the same. This is why when you poke a finger in your belly, your belly squishes in and then pops back out.
This means that any pressure added to the system has to be compensated for somewhere. Every time your lungs fill with air, they expand and exert a force. If you’re a chest breather, that force will move your ribcage and your chest will rise. If you keep your ribcage absolutely still and “send your breath” down, the force will move your diaphragm down and your belly will come forward.
If instead, you kept your ribcage still, sent your breath down to move your diaphragm, and instead of letting the belly come forward, let the pressure move down even further, the result would be an expansion of your pelvic muscles (into that soup bowl shape we mentioned here).
If you were to lay on your back with knees bent and feet flat, you could place a mirror between your legs and observe this slight expansion down through the pelvis and away from your torso.
It is a noticeable movement. Maybe not as big as your whole belly expanding forward, but enough of a movement to feel and witness with careful attention.
If you have a tight or overactive pelvic floor, the movement may not feel or look as noticeable. This is normal. Over time, using the breath to stretch the muscles out can prove to be quite effective, and you may begin to notice a difference. Always be kind and patient with yourself as you try new things!
When you breathe into your pelvis, you create a powerful connection between the diaphragm and pelvic floor.
When this relationship is maintained, your breath has a clear, straight path to travel and thus your posture and core control can be much more effective. If your breath isn’t following this clear, straight path, the pressure will push against the area of least resistance. Let’s say you tend to sit with a more rounded, forward leaning posture. When you breathe in without intention, the pressure may follow the rounded area of your back and continue to stretch the tissue in that direction, thus contributing to that rounded postural pattern.
Breathing into your pelvis also allows you to maintain a really strong core. People who breathe into their belly often ask me, “how am I supposed to hold my core strong and expand my belly outward?” A great question!! The answer is: you don’t! We’ll cover this more in the next section.
Additionally, having awareness of your breath and pelvic floor movement can be helpful when trying to heal any emotional or energetic tension stored in your pelvic tissue. Intentional breathing can help in the process of trauma release and is a powerful tool for connecting to self-sourced safety. You can read more about that here.
10. Core control
And lastly! Another incredibly important one: core control! Hopefully, reading about breathing mechanics gave you a bit of insight on what is happening between the diaphragm, abdomen, and pelvic floor on a regular basis. As we breathe, the interplay is never lost. But what happens when we intentionally activate our core, say at the gym or in pilates, etc?
Your core is so much more than just your “6 pack” in the front. It is actually a whole system of muscles working together to keep you stabilized. The purpose of the core is to provide a stable, centralized area so that your limbs can extend away from it and move freely, without causing you to fall over.
Now, remember, your abdomen is a closed pressure system. This is possible because we have muscles within our torso that create a cylinder-shaped chamber and maintain the pressure within it. This chamber is created by the diaphragm (the top), your abdominal muscles (in front), your back muscles (in the back), and your pelvic muscles (on the bottom).
In order to fully and properly activate your core, you need to be able to consider all of these components. If not, just like we saw with breathing mechanics, the pressure created will defer to the area of least resistance.
This is exactly why some people experience leakage while working out, specifically weight lifting. When you ask your body to lift a heavy weight, your core must activate to support the movement. Many people will feel their core activate in the front, brace for the movement, and then experience leakage at the height of the lift/movement. This is because when they braced, they did not activate or engage their pelvic floor. As a result, the pressure pushed downward onto the bladder. The pelvic floor was not prepared to keep the opening/sphincter closed, so the excess pressure caused leakage.
In order to prevent this and to engage the core properly, you need to bring awareness to two main things: 1) the pelvic floor and 2) the deep core.
Pelvic floor awareness takes time to cultivate, especially since many of us experience some level of disconnect to this area of our bodies. I recommend getting support as you navigate this so that you can be sure you are activating it correctly! But in a nutshell, pelvic floor activation is the feeling you experience when you start to pee and squeeze your muscles mid-stream to stop the flow! You can try this once or twice to get the feeling, but don’t intentionally cut your stream off often as it can influence your ability to fully empty! For more on the mechanics of activation, revisit the section on contraction!
The bread and butter of this section is the deep core.
Let’s look at some anatomy, again! Your “abs” are made up of 4 layers of muscles. Each muscle runs in a different direction so that you have access to 4 different types of movement at your torso. The first layer (your 6-pack) runs up and down. When activated, this muscle allows you to crunch or bend in half. The second and third layers are your obliques. They run in opposite diagonals and when activated allow you to twist in either direction. And lastly, the 4th and deepest layer, runs sideways! When activated this muscle creates a strong, taut band across your midsection to provide support, almost like a corset! Watch the video below to see all the layers!
When activating your core, the most important layer to be aware of is the deepest layer - your transverse abdominis. It will provide you with the most effective support!
And, fun fact: when you activate your deep core more than 40%, it automatically recruits and activates your pelvic floor! The same is true in reverse. Once your pelvic floor is activated more than 40%, your deep core kicks on as well! These two sets of muscles work together to complete the core and keep you stabilized.
Every time you go to activate your core, there should be a coordinated effort by the entire core to create stability on all sides of the body! That looks like this:
Main components
Abdominal Muscles - activation of the deep core to stabilize, superficial abdominal muscles ready to activate as needed, mild give to accommodate breathing
Pelvic Floor - activation to stabilize, mild give to accommodate breathing
Supporting components
Diaphragm - slight activation to help stabilize ribs, easy contraction and relaxation to accommodate full breaths
Back Muscles - moderate activation to maintain neutral pelvic position
All Muscles - full relaxation after each exercise
All of this should be happening before inviting your body into each rep of exercise. In this way, you start every rep from a clear, stable, organized place. This reduces your likelihood of unnecessary compensation and thus reduces your chance of injury. If you find that the exercise becomes harder because of this - don’t fret! That just means you probably weren’t ready for that movement to begin with and need to focus on stability first! Practicing like this also ensures that you “work your core out” with every single session, which is much for functional and effective in the long term.
So there you have it!!
A complete list of all the pelvic superpowers you may never have been taught… until now!
It truly blows my mind that the pelvis has so many functions! This part of the body is so integral on so many levels, and yet, I didn't learn about half of this stuff until the end of my GRADUATE education!!
If this post was intriguing to you and this type of education lights you up, please leave a comment ot let us know and share with your friends! A big part of our mission is to make this knowledge as accessible to as many people as possible.
And if any of these functions stood out to you and you want to learn more about how they present in YOUR unique body, feel free to book a Pelvic Floor Physical Therapy session! We would love to explore and dive deeper with you!
Photo sources:
Photos and videos not listed were created by Dr. Liliana Sainato Monardo for the sole use of The Pelvic Empowerment Movement.
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