Pelvic Floor Function: The A-Frame Analogy

Hi guys, it’s Erienne from Peak Endurance Physical Therapy.  I want to talk today again about this A-frame house analogy when talking about the pelvic floor. So I posted a picture of this on our Instagram page last week or the week before that, and now I just want to go a little bit more in depth.

Because I find that when individuals understand what their pelvic floor is supposed to be doing and when it is supposed to be doing that, at baseline, they have far more success. They have fewer symptoms. They feel more confident. So understanding and being able to visualize what your pelvic floor should be doing is a huge first step to get going on some pelvic floor rehab.

So here is our A-frame house. We have our first floor. This is like our main level, where we spend most of our time in our house, right? The attic is at the tip. So at the attic, it comes up and together. That’s going to be important when we talk about pelvic floor actions. And then the basement is that bottom level where the house kind of goes down and out.

So we start to talk about pelvic floor actions in relation to this A-frame house. When we are at our first floor, which is again, where we spend most of our time, we are at rest of the pelvic floor. We’re not necessarily activating, we’re not necessarily trying to really relax it. We’re just at rest.

When we talk about being in the attic, that’s when we are contracting our pelvic floor. So again, as an A frame comes to the attic, it comes up and together. And that’s how pelvic floor activation should be. It is not just a squeeze of your pelvic floor, but it is an up-and-together. Almost like a draw up with the pelvic floor. So that’s why we kind of talk A-frame.

The basement is our bear down action of our pelvic floor. So when we bear down, we are actually pushing, and our pelvic floor is moving down and out. Again, it fits pretty well with that A-frame house. As we go down into the basement, we are widening and lowering.

So when we talk about when we would be in the attic, when we are in the first floor, that main level, and when we are in the basement, here are some examples.

First Floor

When we are on the first floor or main level, we are at rest in with our pelvic floor. That’s going to be most of our activities throughout the day. So when we’re moving around, doing our ADLs, when we’re at work, when we’re walking, even when we’re running, we’re not necessarily picking up that pelvic floor. Or we’re not pushing down with that pelvic floor. It’s just that rest.

Attic

When we are up in the attic, we are purposely activating that pelvic floor. When you’re pulling it up, and in. some examples of that are during a sneeze or a cough, when we’re trying not to leak. We pull that pelvic floor up to try to stop any urine that’s going to come out as we sneeze. We can use that pelvic floor contraction when we lift something heavy, whether it’s in the gym or at home, it’s part of our core brace. So we tighten our stomach muscles and we pick that pelvic floor up as well at the same time. Those are instances where we’re going to be up and together in the attic.

Basement

And then that last function is the basement. That down and out, that bearing down. That’s going to be most common when we are voiding.  So think bowel movements, even urine. Especially ladies, when we are in child labor, we are bearing down. We are pushing that pelvic floor down and out.

So understanding this and understanding when we should be in certain parts of this A-frame house is a big component of pelvic floor rehab. Because if we don’t understand where we are, and we don’t know if our pelvic floor is doing what we want it to be doing, that’s when dysfunction can come about. I hope this helps at least visualize what’s supposed to be going on in the pelvic floor.