The perineal body is found at the midline of the perineum. If you sit on a chair, you can then find the pubic bone, tail bone and ischial tuberosities (the two prominences you can feel if you rock from side to side). Drawing a line from pubic bone to IT and then to tail bone and onto IT and back to pubic bone, you make a diamond shape. The perineal body sits in the middle of this diamond, between the anal and urogenital triangles in both males and females. Resembling a sort of pyramid, it is a meeting place of multiple muscles.
If we visualise the pyramidal structure of the perineal body as a tensing pole with the following soft tissues attached:-
Bulbospongiosus – anterolateral
Deep transverse perineal muscles (males) – lateral
Compressor Urethra (females) – anterior
External anal sphincter – posterolateral
Internal anal sphincter – posterior
Levator Ani (Puborectalis) – lateral
Longitudinal muscles anus – anterolateral
Perineal membrane – anterior
Rectovaginal fascia (females) – superior
Rectoprostatic fascia (males) – superior
The perineal body is said to provide strength (Siccardi, Bordoni 2021) and maintain the integrity of the pelvic floor, especially in females.
We know the abdominal muscles and the Thoracolumbar fascia of the back also connect into this area ( for a tour of these fascial connections, you can join a Balancing the Diaphragms workshop if you are a movement or manual practitioner or Balancing the Diaphragms class with myself done once a month)
How would the balance of the tensioning pole be if you had a C-section scar an episiotomy, low back pain or a problem with the prostate? When you think about any of those things, what do you find yourself doing? Maybe grip a little between the thighs, a sharp intake of breath. These things may create stiffness, restrictions and a general lack of glide. The tensioning pole, critical for its role in maintaining the integrity of the pelvic floor is less able to balance the tension!
