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No one likes to talk about the pain "down there," but pelvic floor dysfunction can make your life miserable. From frequent urination that interferes with sleep, to the feeling that you are sitting on a golf ball, pelvic floor dysfunction is a real pain in the you-know-what. And though it may not be the first topic you bring up at your dinner party, chances are good that at least 20% of your guests have experienced pelvic floor dy
sfunction. Yep, it's that common.
Why don't we hear much about it?
Well, again, would you bring it
up at a dinner party? And besides, symptoms vary so much that determining that it is pelvic floor dysfunction (PFD) takes detective work. PFD even eludes many health care providers.
Some folks describe a feeling that they have a headache in the
ir pelvis, or stress incontinence, urinary urgency, or leakage.
Those issues seem easy to pin on a pelvic floor issue.
But if someone has lower back or SI joint pain that does not get better with treatment, chronic hip tightness, or a lingering hamstring pull, pelvic floor dysfunction could be the cause. And with chronic prostatitis or sexual dysfunction, the pelvic floor is often at least part of the issue.
You may remember Kegels, those exercises to tighten and strengthen the pelvic floor muscles. When Kegel exercises we
re first
introduc
ed in 1948, they were the cat's meow. Just doing Kegels would take care of any pelvic floor problems... until they didn't. With research, practitioners and
researchers found that many pelvic floor problems were happening because of tightness, and doing Kegels made the problem worse. Having strength in the pelvic floor muscles is important, but so is
having flexibility. B
eing able to relax
those m
uscles is often the
first step
to
feeling
better again.
Another problem with Kegels is knowing if you are doing the right thing. Pelvic floor muscles aren't easy to access and you may think you're doing it right thing when you're using every muscle but the correct one.
What causes pelvic floor dysfunction?
LOTS of things:
- Long hours on a bike without a proper bike fit.
- Sitting all day, every day, especially on a hard surface.
- A pelvic fracture.
- A fall onto your tail bone.
- Untreated lower back pain.
- Traction on nerves during childbirth or vaginal surgery.
- Diastasis recti - where your abdominal muscles separate in a vertical line around the belly button.
- Stress that makes you want to tuck your tail like a nervous dog.
Think of your trunk as a big box. The bottom
of the box is the pelvic floor.
Each side of the box needs to have integrity to create a stable
co
nt
ainer from which your limbs move. If there is a split in th
e muscle a
rou
nd the outer abdominal muscle, that "side" of the box is weak causing other areas (like the pelvic floor) to tighten up. Or if you have a lot of
l
y
mphatic congestion around your midriff, your "container" is not as firm and
again, the pelvic floo
r may respond by spasming. Conversely, your lower back muscles are super tight and the distortion of the box makes it impossible to activate the pelvic floor muscles. Abdominal scars
or adhesions can do the same thing; you may
be so tight that you can't even fire the pelvic floor muscles.
The variations are endless.
The really good news:
Pelvic floor dysfunction can be treated using a variety of techniques that create balance in the muscles of the hips, abdomen and pelvis. Working on abdominal lymph nodes, learning how to support the large abdominal muscle that has a tear in it, or retraining pelvic floor muscles all can be helpful in treating the variety of problems we see. Correcting imbalances of the lower back and pelvis and strengthening afterwards all can help.
We have many tools at our disposal to evaluate and treat pelvic floor dysfunction. The key is determining what is causing what and then tackling the imbalances and dysfunctions one at a time. It may be a long road to complete resolution but it can't feel nearly as unending as suffering from pelvic floor dysfunction.
We've learned a lot about treatment of pelvic floor dysfunction and we are seeing some remarkable changes. Stay tuned for more on this topic, or contact your therapist if you just can't wait another minute.
A solution is waiting for you.
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