Generally, pelvic floor muscles (like any other muscle group in the body) can have hypotonic or hypertonic tendencies. Our nervous system plays a major role in managing muscle tone. If a client is living in a constant state of anxiety and stress or they find sex stressful, it’s likely their pelvic floor muscles will have a difficult time coordinating with the system. Regulating the pelvic floor will be especially difficult during sex.

Our pelvic floor muscles form the base of our spine and deep core. They wear many hats: bladder and bowel elimination, sexual activity, support and stability, pressure management, and shock absorption. I often refer to this group of muscles as Grand Central Station: there are a million convoluted routes to take! There is a TON going on down there. Not only are there about 16-20 muscles, but numerous ligaments, tendons, nerves, and fascial connections that help us complete ADLs/IADLs without the very embarrassing occurrence of urinary or bowel leakage and passing gas uncontrollably.

Let’s talk about what roles these pelvic floor muscles & organs play in our favorite occupation - sex!

Welcome to the second part of our three-part series on addressing sexuality and intimacy after spinal cord injury (SCI). Today, we’ll delve deeper into the crucial role that Occupational Therapists (OTs) play in supporting individuals with SCI in this aspect of their lives. With their expertise and unique perspective, OTs can provide invaluable guidance and interventions to empower SCI patients and promote a positive and fulfilling sexual experience. The OT can be the shining light of comfort and advocacy! OTs are perfectly situated to lead these efforts in a clinical setting both for their patients and for the interdisciplinary team. Let's continue our exploration of the strategies and approaches that OTs employ in this domain.

The Bump’n Joystick adapter is the first sex toy designed for and by people within the disabled community. Research shows that impaired hand function is the biggest barrier to using sex toys currently on the market – over 50% of physically disabled people surveyed said they struggle to achieve an orgasm solo. The Bump’n joystick removes this barrier and makes self-love possible regardless of hand function, by utilizing a person’s gross motor movements.

So what is it?

When I first started addressing sexuality with clients and making recommendations for sex toys I went through the steps of printing out a screen shot of a vibrator on a work computer, folding it in half, and slyly giving it to my client in front of their families.

But now, thanks to the folks at Direct-Rec App, OT clinicians can share sexual wellness products directly and privately with their clients. Dang… where was this 10 years ago!?

I have often thought about the lack of discussion around pleasure and conversely the prioritization of discussing sexual risk and pathology in sexual dialogues – to include academic dialogues, professional dialogues, and even familial or personal dialogues.