Pelvic Floor Dysfunction

The term “pelvic floor” refers to the muscles that lie at the base of the trunk, in the pelvis. These muscles have several important functions: support of the internal organs and stability of the lumbar spine is a major one. They also play a vital role in urinary control and continence, as well as pregnancy and childbirth.

Like any other muscle group in the body, there is a myriad of things that can go wrong in this region. Pelvic pain can seriously affect quality of life, and may be associated with low back pain. Incontinence – difficulty maintaining control of urine, feces, or gas – is thought to be one of the major underreported health problems in the United States. Up to 17% of women pre-menopause suffer from incontinence, and the prevalence is higher post-menopause. Men can also have incontinence, particularly after medical interventions for prostate issues.

Pregnancy and post-pregnancy are a time of many changes in the body, and the pelvic floor is no exception. In fact, the pelvic floor has to be strong to support the growing weight of the baby, stretch to allow birth, and then recover its muscular integrity to function optimally again afterwards.

Symptoms of pelvic floor dysfunction include:

  • Involuntary leakage of urine, gas, and/or feces – even a little bit is not normal, and can usually be improved. It may be associated with movements such as jumping, actions like laughing, and/or may be accompanied by a strong urge that is difficult or impossible to suppress
  • Pelvic pain – may feel sharp, aching, or burning pain in the vagina or rectum
  • Pain or dysfunction associated with pregnancy or post-pregnancy, including either of the above, as well as scar tissue, sacro-iliac joint problems, loss of core strength, etc.

Treatment of Pelvic Floor Conditions

Unfortunately, many people who suffer from pelvic pain or incontinence do not talk to their health care providers about it. This may be due to embarrassment, but is often due to the fact that many people don’t know there are things that can be done to improve the problem.
There are sometimes surgical techniques that can be performed, but you can ask your health care provider to send you to physical therapy first.

Physical Therapy

Physical Therapy can often achieve good results for your issue, give you new tools to deal with the problem, and offer you an understanding of what is happening in your body.
A physical therapist who specializes in pelvic floor rehabilitation can do the following:
Assess the pelvic floor muscles and determine if the problem is due to tight muscles, weak muscles, or a neurological issue.

  • They may teach you pelvic floor exercises called Kegels – but this exercise is not for everyone. Your PT will be able to tell you if you should be doing Kegels, how to do them correctly, and how many you should be doing.
  • Assess the rest of your musculoskeletal system to determine if you also need increased core strength, or other support for your pelvic floor.

Perform muscle or joint mobilization to reduce tension and holding patterns in the tissues.

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