Muscular problems in the pelvic floor can cause symptoms ranging from involuntary loss of urine (urinary incontinence) to chronic pelvic pain. Millions suffer from pelvic floor disorders, yet, for many, the symptoms go unidentified and untreated. Although discussing symptoms associated with pelvic floor dysfunction is difficult for some, it is important to realize that pelvic floor pain and dysfunction are not normal and can successfully be treated.
What is the pelvic floor?
The pelvic floor is made of muscles and tissues that form a “sling” from the pubic bone to the tailbone. They support abdominal and pelvic organs and help to control bladder, bowel, and sexual function.
What are the symptoms of pelvic floor dysfunction?
Symptoms of pelvic pain, urinary frequency or urgency, painful intercourse, sensation of pelvic pressure or heaviness, painful defecation, tailbone pain, and low back pain can occur when the muscles of the pelvic floor are too tight. Weakness in these muscles can contribute to urinary or bowel incontinence, bladder or rectal prolapse, and low back pain.
What causes pelvic floor dysfunction?
Sometimes the cause of pelvic floor dysfunction is unknown; however, some common causes include:
- Chronic poor posture with weak core muscles
- Pregnancy or complicated vaginal delivery
- Abdominal or pelvic surgery such as a hysterectomy or prostatectomy
- Trauma (fall on a tailbone, auto accident)
- Inflammation or infection
- Pelvic organ disease (endometriosis, irritable bowel, interstitial cystitis, prostatitis)
- Athletic injuries
- Chronic constipation.
How are pelvic floor problems treated?
Treatment of pelvic floor problems begins with a visit to the doctor for a thorough physical history, examination, and diagnosis. If the underlying cause is related to muscular dysfunction in or around your pelvic floor, referral to a physical therapist who specializes in evaluation and treatment of the pelvic floor can be the next step.
What does physical therapy treatment entail?
Your physical therapist will take a thorough history of your current condition and evaluate the structure and function of the pelvic floor region. An internal exam may be necessary to fully evaluate the muscles of the pelvic floor. The therapist may also use a biofeedback device to assess muscle activity. Following the evaluation, your therapist will discuss treatment options with you.
Treatment may include a number of therapeutic approaches to strengthen weak muscles and to release muscle tension. Physical therapists often use a technique called manual therapy to help improve muscle mobility, realign pelvic bones and the spine, and relieve tension in the muscles that attach to the pelvis. Neuromuscular re-education, which often uses biofeedback, helps muscles of the pelvic floor learn to fire with proper force and timing. Ultrasound and electric stimulation can help with pain relief. Strengthening exercises for the muscles of the pelvic floor, trunk and legs improve strength, endurance and may alleviate symptoms. Your therapist will also teach you self-treatment techniques, ways to manage symptoms and give you a home exercise program.
Where can I find someone who specializes in this?
The American Physical Therapy Association has recognized women’s health and pelvic floor treatment as areas of specialty within the practice of physical therapy. Practitioners can be found throughout the region. If you feel you have pelvic floor dysfunction, talk to your doctor to see if physical therapy is right for you.