Hello Students,
Before we learn about the functions of the pelvic diaphragm muscles, let's identify them by locating them in the figure below.
Identify the following muscles:
1. pelvic diaphragm
2. pubococcygesu
3. puborectalis
4. iliococcygeus
5. coccygeus
6. piriformis
7. ilacs
8. psoas major
Upon learning location and function we begin to understand our pain and why relaxation exercises, stretching, lengthening and strengthening is a must if we want to begin resolving our pain. As different and unique as we all are we are very much alike.
IC patients often focus solely on diet when the FACT is strengthening muscles is just as if not more important than diet. Diet should should consist of foods that are easy to digest and that are fast existing which, we will talk more about in future lessons. If you think that food does not affect your pelvic area think again.
Male Pelvis
Female Pelvis
The pelvic diaphragm is the largest muscle group in the pelvic floor and is responsible for most of the function or dysfunction of this area.
This layer is divided into the coccygeus muscle and the levator ani muscles.
The coccygeus muscle originates at the spine of the ischium, inserts on the anterior portion of the coccyx and S4, and is innervated by the ventral rami of sacral nerves 4 and 5. The coccygeus flexes the coccyx and may help stabilize the sacrum through its scarococygeal attachments.
The levaotor ani muscle is further divided into the ilococygeus and the puboccoccygeus muscles. The iliococcygeus originates from the pubic ramus and arcus tendentious ligament (an extension of the obturatior internus fascia) and inserts on the coccyx.
The puboccoccygeus muscles is divided into the pubovaginalis and puborectalis muscles. The pubovaginalis originates at the posterior aspect of the os pubis and inserts on the perineal body and vaginal walls, forming a sling around the vagina.
The puborectalis originates from the pubic bone and obturatio internus fascias and inserts onto the coccyx and lateral walls of the rectum, similarly forming a sling around the rectum.
The innervation of the levator ani muscles is from the inferior rectal branch of the pudendal nerve of S2 through S4 and ventral rami of S2 through s4. The function of the levator ani muscles is to support the pelvic viscera.
The pelvic diaphragm muscles are approximately 70% slow-twitch muscles fiber (type1) and 30% fast-twitch muscles fibers (type 2). Both types of muscles fibers have specific functions in the pelvic floor, and a complete exercise program should train both types of muscles fibers. The physiology of these muscles is similar to that of other skeletal muscles. Sensation in the region is limited and may be decreased with surgery or childbirth. The PFM responds to quick stretch and has extensive fascia throughout the muscle layer.
The PFM contract as a unit to achieve various functions. Impairments can occur in a single layer or throughout the entire skeletal muscle layers.
Related Muscles
The piriformis and the obturator internus (the intrapelvic hip rotators) are located within the pelvis and can affect the function of the PFMs. The piriformis originates on the anterior surface of S1 to S4. (See The Anterior Sacroiliac ligament in the figure below)
It's inferior border is close to the superior border of the coccygeus muscle and it inserts at the great trochanter of the femur. (See Greater Trochanter in the figure below)
The obturator internus originates at the inner rim of the obturator foramen and inserts onto the great trochanter. The levator ani muscles attach to an extension of the obturator internus fascia (i.e. the arcus tendinous, also called the white line). (see white line in the figure below)
This muscles is best envisioned three dimensionally. Impairments in length, strength, endurance, and patterns of recruitment of the piriformis and obturator internus muscles often contribute to PFM impairments and vice versa. Hip function may need to be considered with pelvic floor dysfunction and pelvic floor dysfunction with hip dysfunction.
The adductor muscles group also may participate in PFM pain syndromes. The muscle originate at the pubic ramus and ischial tuberosity, inserts on the posterior femur and medial femoral condyle, and is innervated by the obturator and sciatic nerves. Adductor fascia at the pubic rami is in close proximity to the superficial perineal muscle fascia.
The psoas minor and major muscles originate form vertebral bodies and disks of T12 through L5. The iliacus muscle originate at the medial iliac fossa. Both muscles fuse and travel in an anteroinferior direction under the inguinal ligament to insert onto the lesser trocanter of the femur.
The iliopsoas muscle is innervated by the L2 , L3 and L4 spinal nerves. It is a key muscle to treat in lumpbopelvic dysfunctions. Travell and Simons Call it the hidden prankster and stress its importance in pelvic function.
Trigger points in the psoas muscles are a common cause of pain in both the lower back and the groin. They can also contribute to gynecological symptoms . Despite their seeming inaccessibility, psoas muscles are actually very easy to massage. Psoas trigger points refer pain to low back. When the trigger points are really bad, back pain can extend from the lower shoulder blade area to the upper gluteal region. Pain is worse when you're standing. Sit-ups are impossible and you may have difficulty getting up out of a chair. Severely troubled psosas muscles may prevent you from standing or walking so it is very important to exercise these muscles.
How to exercise Psoas trigger points can be found HERE
Deep Tissue massage for Psoas Muscle can be found Here
Psoas Muscle Exercise can be found Here
Your assignment is is the read this material and re-read it again. Locate the different muscles that are shown on the pics/figures and to do watch the three videos and try out these exercise. Don't be afraid to have your partner watch the video's with you or teach him/her how to do these exercise so they can help you. This also helps to bring the two you closer together.
Next we will return to this same page and begin learning the definition, functions etc.......
PS: Sorry I am late posting the class, we had a few family crisis this week.
Gloria Prater, Wellness Educator
Feel free to ask questions or make comments.
No comments:
Post a Comment