The Pelvic Floor Muscles
The idea of an anatomic pelvic floor has been in the media a lot lately as more people recognize the importance of this group of muscles. People who have experienced pregnancy are likely already familiar with their pelvic floor muscles. An aging population grappling with common age-related issues, like incontinence, is becoming more acquainted with the relevance of their pelvic floor muscles. Pelvic floor therapies have become more commonly available for these populations and others. And as more people investigate the role of connecting their core to their health and wellness, the pelvic floor muscles come up again. So what and where are these muscles? In this article, we’ll explore exactly that. Read on to find out.
The Pelvic Floor Muscles
The pelvic floor is the soft tissue that collectively fills the bowl-shaped space between the bones and forms the base of the pelvis. The pelvic floor is also called the pelvic diaphragm because the combined muscles of the pelvic floor form a sheet of connective tissue that creates a partition for the viscera above it.
The group of muscles that work together to create the pelvic floor includes four muscles. They are the puborectalis, pubococcygeus, iliococcygeus, and the coccygeus. Three of those muscles are further subgrouped together based on their function. Those three, the puborectalis, pubococcygeus, and iliococcygeus, are collectively referred to as the levator ani muscle group.
There are, of course, other muscles that attach to the pelvis and affect the tone of the pelvic connective tissue as a whole. But those muscles, like the piriformis and obturator internus, are primarily considered muscles of the hip joint, so we won’t cover them further here.
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Location
Although the three levator ani muscles and coccygeus work together, they each have specific attachments.
Puborectalis
Puborectalis attaches to the back of the pubic bone on either side of the pubic symphysis, then the two sides curve back and around to create a continuous U-shaped band of tissue that loops behind the rectal hiatus.
Pubococcygeus
Pubococcygeus also attaches to the back of the pubic bone on either side of the pubic symphysis, but its attachment is lateral to the puborectalis attachment on each side. Both the right and left sides of the pubococcygeus then attach to the anococcygeal ligament and the coccyx.
Iliococcygeus
The iliococcygeus attaches to the internal obturator fascia and then attaches at the other end to the anococcygeal ligament and coccyx, along with the pubococcygeus.
Coccygeus
The coccygeus muscle runs in a more medial to lateral direction than the levator ani group of muscles, which run in a more anterior to posterior direction. There are right and left sides of this muscle as well. Each side attaches to the ischial spine and then attaches at the other end to the inferior sacrum and coccyx.
Pelvic floor muscle actions
Support
All of the muscles of the pelvic floor primarily work together in their function. The function of the pelvic floor, or pelvic diaphragm, is, like other diaphragms in our body, to keep certain things corralled in a particular space. In this case, the pelvic floor prevents our viscera, that is, our abdominal and pelvic organs and their associated structures, from dropping or protruding out of our body.
Elimination
The name of the group of three levator ani muscles (puborectalis, pubococcygeus, and iliococcygeus) gives us a clue to another function of the pelvic floor muscles. Levator is from the Latin lavare, which means lift. And ani means ring, and of course, refers to the anus. So, these muscles are important for maintaining urinary and bowel continence. These muscles relax or contract depending on where we are in the cycle of elimination.
Movement of the tailbone
Although movements at the coccyx itself are small, the coccygeus muscle also contributes to flexion of the coccyx.
Conclusion
The pelvic floor muscles have important supportive functions as well as muscular actions. Healthy tone in this muscle group provides essential support for our organs above. Contraction and relaxation of these muscles are necessary for healthy urinary and bowel continence.
References
Gilroy, A.M., B.R. MacPherson, and J.C. Wikenheiser (Eds.) 2025. Atlas of Anatomy. (5th ed.) Thieme.