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.

As promised, I'm continuing my three part series of important topics to cover when addressing sexuality and intimacy, which brings us to Sexplay. As a part of Sexplay, I'm going to talk about dirty talk, pleasure, and sensate focus. All of these can be helpful for our clients (and let's be real - US!) to understand as potential activity demands. Below are some strategies and exercises you can share with your clients!