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The pubic bone, also known as the pubis, is one of the three main bones that make up the pelvis, located between the abdomen and thighs. The pubic symphysis joint connects the left and right pelvic bones, allowing the pelvis to absorb weight and enabling childbirth. Tendons from muscles in the torso and thighs connect with ligaments in the pubic symphysis, and the pelvic floor muscles stretch from the pubic bone to the tailbone. These muscles support the pelvic organs and assist with essential bodily functions such as urination, defecation, and sexual intercourse. Pelvic floor muscles can weaken over time, leading to issues such as incontinence, and can be strengthened through targeted exercises.
| Characteristics | Values |
|---|---|
| Pubic bone location | Between the abdomen and thighs |
| Pubic bone function | Protects the urinary organs and the internal sex organs |
| Pubic symphysis joint location | Bottom of the pelvis |
| Pubic symphysis joint function | Allows the pelvis to absorb weight and shock; helps pelvic bones widen during childbirth |
| Pubic symphysis joint composition | Two kinds of cartilage and four ligaments |
| Pubic bone attachment points | Tissue that connects bone to bone (ligaments); tissue that connects muscle to bone (tendons) |
| Pelvic floor muscles | Levator ani, coccygeus, obturator internus, piriformis, gluteus maximus |
| Pelvic floor muscle function | Stabilise the core, secure organs, assist with bodily functions like peeing, pooping and sex |
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What You'll Learn
Pelvic floor muscles
The pelvic floor muscles are a group of muscles that form the base of the core muscles. They stretch from the pubic bone in the front of the body to the tailbone (coccyx) at the back, and from one sitting bone (ischial tuberosity) to the other on either side of the pelvis. The pelvic floor muscles are made up of layers of muscles and connective tissues (ligaments) that intertwine to form a single sheet of layered muscle with three openings: the anus, urethra, and vagina.
The pelvic floor muscles support the pelvic organs, including the bladder, bowel, and uterus (womb) in women. They help to control the release of urine, faeces, and flatus, and prevent incontinence and prolapse. When contracted, the pelvic floor muscles lift the internal organs of the pelvis and tighten the openings of the vagina, anus, and urethra. Relaxing the pelvic floor muscles has the opposite effect, allowing for the passage of urine and faeces. The pelvic floor muscles also play a crucial role in sexual function for both men and women. In men, they are important for erectile function and ejaculation, while in women, they provide support for the baby during pregnancy and need to be relaxed during childbirth.
Pelvic floor exercises, also known as Kegel exercises, can help improve muscle tone and brain connection to the pelvic floor muscles. These exercises involve contracting and relaxing the pelvic floor muscles, which can be done by squeezing and relaxing the muscles around the three openings: the vaginal opening, urethra, and anus. By performing these exercises, individuals can improve their pelvic health and prevent potential issues associated with weak pelvic floor muscles.
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Pubic symphysis joint
The pubic symphysis joint is a secondary cartilaginous joint located in the midline between the bodies of the pubic bones. It is a sturdy, fibrous disc made of fibrocartilage, which is a thick mesh of fibres composed of mostly type I collagen. Type I collagen creates a solid structure for bones, skin, tendons, and connective tissues, like joints. The joint is wider in the front than in the back by about 3 to 5 millimetres. It sits in front of the bladder and above the clitoris or penis.
The pubic symphysis joint is important as it connects the left and right pelvic bones, allowing them to work together to distribute weight from the upper body to the legs and feet. It also helps to absorb shock when walking or running, reducing the impact on the body. This joint is especially important during pregnancy, as it becomes more flexible, allowing the pelvic bones to widen for childbirth.
Tendons from the torso and thigh muscles connect with ligaments in the pubic symphysis. Tendons from the thigh (gracilis), oblique (obliquus externus), and abdominal muscles (rectus abdominis) all attach to the fibrocartilage disc. This disc is held in place by four ligaments: the superior, inferior, anterior, and posterior pubic ligaments. These ligaments keep the disc from slipping or moving excessively.
The pubic symphysis is susceptible to injury, particularly in sports that involve stretching the legs far apart. A blockage in this joint can occur, leading to severe pain and, in some cases, requiring medical intervention to realign the bones. During pregnancy, the joint can also be affected by symphysiolysis, a separation or slipping of the symphysis, which is influenced by hormones that increase flexibility for childbirth.
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Pubic bone
The pubic bone, also known as the pubis, is one of the three main bones that make up the pelvis, located between the abdomen and thighs. It is the most forward-facing of the pelvic bones, which also include the ilium and ischium. The pubis, ilium, and ischium unite to form the innominate bone (hip bone) of the pelvis in adults.
The pubic bone has a different form and function in people assigned female at birth compared to those assigned male at birth. In people assigned female at birth, the bladder is directly behind the pubic bone, with the uterus, fallopian tubes, ovaries, and upper vagina located behind the bladder, and the rectum at the back of the pelvis. The female pelvis is typically wider and more accommodating to childbirth, while the male pelvis is more heart-shaped and narrow.
The pubic bone consists of two halves, each with three sections: the pubic body, the superior pubic ramus, and the inferior pubic ramus. The pubic body is the largest portion, forming the wide, strong, middle, and flat part of the pubic bone. The superior pubic ramus is the upper section that connects to the wing-shaped ilium and the upper portion of the L-shaped ischium. The inferior pubic ramus is the lower section that connects to the lower portion of the ischium.
The right and left halves of the pubic bone are connected by cartilage called the pubic symphysis, which allows for flexibility and movement. The pubic symphysis joint is made of two types of cartilage and four ligaments, allowing the pelvic bones to move independently while remaining strong and stable. This joint enables the pelvis to absorb shock and weight, especially during activities like walking or running. During pregnancy, the pubic symphysis becomes more flexible, allowing the pelvic bones to widen and separate for childbirth.
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Pelvic fractures
The pelvis is a ring-like structure of bones located at the base of the spine. The pubic symphysis joint sits at the bottom of the pelvis, connecting the left and right pelvic bones. This joint is made of two kinds of cartilage and four ligaments, allowing flexibility and enabling the pelvis to absorb weight and shock. Tendons from the torso and thigh muscles connect with the ligaments in the pubic symphysis.
Pelvic ring fractures are typically associated with high-impact trauma and are often accompanied by other injuries. These fractures can be classified as either stable or unstable. In a stable fracture, there is usually only one break in the pelvic ring, and the broken ends of the bones align. Stable fractures commonly occur due to low-energy events and can often be managed non-surgically.
Unstable fractures, on the other hand, involve two or more breaks in the pelvic ring, with the broken ends of the bones misaligned. These fractures typically result from high-energy events and may require surgical intervention. Pelvic fractures can also be classified based on the specific fracture pattern, such as anterior-posterior compression or lateral compression.
The treatment for pelvic fractures depends on the severity of the injury. While low-energy fractures can often be managed conservatively, high-energy pelvic fractures usually require surgery to reconstruct the pelvis and restore stability. Early stable fixation of pelvic fractures improves outcomes, reducing the need for blood transfusions, systemic complications, and hospital stay durations.
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Pelvic floor disorders
PFDs can cause dysfunction in the pelvic organs, leading to issues such as urinary incontinence, vaginal prolapse, and bowel incontinence. These disorders arise from the laxity of pelvic ligaments and weakness in the pelvic floor muscles, resulting in the excessive descent of the pelvic organs and their dysfunction. It is important to note that pelvic floor disorders do not include cancers of the pelvic organs.
The symptoms of PFDs vary depending on the specific disorder but may include a frequent urge to urinate, leaking urine, and a feeling of heaviness in the vagina. Another common symptom is itching around the openings of the urethra, vagina, or anus. Many factors can contribute to the development of PFDs, including childbirth, older age, and certain types of surgery.
There are various treatments available for PFDs, including medication, rehabilitative physiotherapy focused on the pelvic floor, and surgery. A combination of these options is often used for effective control of the disorder. For example, patients with bowel incontinence are taught pelvic floor and anal muscle-strengthening exercises, while those with obstructed defaecation learn coordination methods to relax the pelvic floor muscles when passing motion.
To prevent PFDs, individuals can perform exercises that strengthen the muscle groups at the bottom of the pelvis (pelvic floor), such as Kegel exercises. It is also important to wear comfortable shoes that reduce pressure on the joints during activities like walking or running. Consulting with a musculoskeletal specialist, such as a physical therapist or chiropractor, can help individuals find the right treatments and exercises to stabilise and strengthen their pelvic area.
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Frequently asked questions
The pubic area muscles are the pelvic floor muscles. They stretch from the pubic bone at the front of the body to the tailbone (coccyx) at the back.
The pelvic floor muscles help stabilise the core and secure organs in the pelvis, such as the bladder, bowel (large intestine) and internal reproductive organs. They also provide the flexibility to assist with bodily functions like urination, defecation and sex.
Weak pelvic floor muscles can lead to conditions like incontinence or pelvic organ prolapse. They can weaken over time due to injury, childbirth, surgery, or the ageing process.
You can strengthen your pelvic floor muscles through exercises such as Kegels, which target the vaginal wall, and abductor muscle exercises that target the inner thighs.
