ALL ABOUT THE PELVIC FLOOR

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The pelvic floor is a web of muscles that spans like a hammock from your pubic bone to your tailbone and serves as the base of your pelvis. It’s made up of three layers of tissue and muscle and it plays a role in everything from overall stability, bladder and bowel control, sexual function, and even childbirth.

What Do The Pelvic Floor Muscles Do?

Your pelvic floor muscles are responsible for:

  • Supporting The Abdominal Organs.
  • Supporting Bladder And Bowel Function. The pelvic floor muscles assist in the support of the urethra and bladder, the rectum, the vagina in women, and the prostate in men. These muscles are vital in controlling bladder and anal sphincter function to allow for normal urine and stool elimination.
  • Supporting Sexual Function. The pelvic floor muscles also play an important role in sexual function in both men and women. In women, pelvic floor muscle contractions are important for arousal and orgasm. For men, the pelvic floor muscles support erectile function and ejaculation.
  • Stability. The pelvic floor muscles are part of a system that helps to stabilize your torso and pelvis while you move, walk, exercise, and perform your daily activities. The muscles that work together to provide this skeletal support are known as your core muscles. These include the pelvic floor, along with your transverse abdominis (your deep stomach muscles), your multifidus (the deepest layers of your back muscles), as well as the diaphragm (the muscle that helps you breathe). They also work to regulate the changes in pressure inside the abdomen during activities like coughing, sneezing, lifting, and pushing. With any activity you do, these muscles are working together to provide the support your body needs to stay in motion and stable.

What Can Go Wrong?

The pelvic floor often works quietly in the background. Most of the time we don’t even realize that it’s there doing such important jobs for us every day. However, strain or trauma to the pelvic floor (which can sometimes happen during pregnancy and childbirth) along with the natural aging process can sometimes create problems. Your pelvic floor muscles may become underactive or too active – both of which can weaken the pelvic floor. Like any other muscle in the body, the goal is for the pelvic floor muscles to be just right: Strong and flexible.

WHAT HAPPENS WHEN YOUR PELVIC FLOOR LACKS SUPPORT?

Events such as pregnancy and childbirth can place a great deal of weight and trauma on the pelvic floor, causing the muscles to be stretched and become less supportive and underactive. This becomes a problem since it makes it much harder for your muscles to contract when they need to.

In addition, when your pelvic floor muscles lack normal support, other muscles often work to compensate. However, this may create more of an imbalance among these muscles, with some of them working harder than others.

WHAT HAPPENS IF YOUR PELVIC FLOOR IS TOO TENSE OR OVERACTIVE?

A pelvic floor that is continuously active or engaged is called a hypertonic or an overactive pelvic floor. There are many activities that can lead to a hypertonic pelvic floor, such as overworking your or tightening your core, holding on to your bladder or bowel movements for too long, or even unconsciously tightening your muscles when you are stressed or anxious.

When your pelvic floor muscles hold too much tension it can become difficult to completely relax the muscles, even when you are at rest. Over time, it may become difficult to contract and relax them normally, since they’re always “switched on.” This can cause weakness and make it difficult to coordinate the muscles for passing stool, passing urine, or engaging in sexual activity.

HOW DO I KNOW IF I HAVE A PELVIC FLOOR PROBLEM?

YOU MAY HAVE A PELVIC FLOOR THAT IS TOO Weak IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • Urinary incontinence – The inability to hold urine, resulting in bladder leakage.
  • Urinary urgency/frequency – Also known as overactive bladder. This is the feeling that you have to empty your bladder RIGHT NOW, or very often (even if you just went).
  • Stool and gas incontinence – The inability to hold a bowel movement, resulting in stool leakage or flatulence.
  • Pelvic organ prolapse – The dropping of one or more of your organs (bladder, bowel, or uterus) to, or through your vagina. You may feel a heaviness or discomfort in your genitals or lower abdomen. This often feels like a bulge in your vagina or like you are sitting on a small ball.
  • Painful intercourse or sexual dysfunction – An unwanted change in sensation during intercourse or sexual dysfunction like difficulty having an orgasm
  • Pelvic girdle pain (PGP) – Pain that is felt around the joints of the pelvis, in the lower back, hips, and legs. Pelvic girdle pain can be mild or severe. PGP is common during pregnancy but can persist afterward if you have a weakened pelvic floor.

YOU MAY HAVE A PELVIC FLOOR THAT IS OVERACTIVE IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • Constipation – Having infrequent, hard bowel movements. This may also include straining to empty your bowel.
  • Painful intercourse
  • Anal, genital or pelvic pain
  • Urinary frequency or urgency – Also known as overactive bladder.
  • Inability to empty your bladder or bowel completely
  • Painful urination

If you do experience any symptoms of a pelvic floor that is too loose or too tight, it’s important to see a physical therapist trained in pelvic floor health to determine the cause and set you on a path toward recovery. (Note: Kegel exercises are NOT recommended if you have an overactive pelvic floor.)

What Is A Pelvic Floor Physical therapist And How Can One Help Me?

A Pelvic Floor Therapist is a licensed healthcare provider who specializes in treating pelvic floor disorders and related health issues such as pelvic pain, incontinence, menopause symptoms or pelvic organ prolapse. Just like other muscles of the body, your pelvic floor muscles can be trained, and a pelvic floor therapist can help guide you through that process.

Pelvic floor rehabilitation is recommended as a first-line treatment option for a number of pelvic conditions and can greatly improve your symptoms. He or she will work with you to determine the best course of treatment depending on your symptoms and help guide you in different strengthening and stretching exercises so that you’re able to fully contract and relax your pelvic floor appropriately.

WHAT CAN I EXPECT AT AN APPOINTMENT WITH A PELVIC FLOOR THERAPIST?

A discussion around your health history, current issues, and your personal goals will help to set the direction for your examination. Your therapist may assess your spinal and hip range of motion, measure your general strength and perform a pelvic floor muscle exam to evaluate your muscle strength, tone, and coordination.

Therapy sessions may include education about your anatomy and your condition as well as instruction on tips and techniques such as diaphragmatic breathing to help manage or improve your symptoms. Your therapist may also review tips for better bladder and bowel health, along with the importance of good posture. You may be prescribed specific stretches and strengthening exercises to do at home.

Your therapist may also include the use of biofeedback to assess your pelvic floor muscle function and measure your progress over time. Biofeedback can also be useful to help you learn how to relax, isolate and coordinate your pelvic floor muscles.

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