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Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

by | Chiropractic, Mobility & Flexibility

For individuals experiencing pelvis pain symptoms and associated problems, can integrating pelvic floor physical therapy exercises help with treatment and prevention?

Your Pelvic Health: A Guide To Pelvic Floor Physical Therapy

Pelvic Floor Physical Therapy

When the muscles fail to function correctly, individuals can experience symptoms like:

  1. Painful intercourse
  2. Prolapse – when an organ or tissue drops or shifts out of place.
  3. Urinary incontinence
  4. Constipation problems
  5. These conditions are common in pregnant individuals or older women.

These symptoms can be treated with pelvic floor physical therapy to alleviate discomfort. Pelvic floor physical therapy can help women and individuals with vaginas:

  • Alleviate issues like painful sex, urinary leakage, and prolapse.
  • In physical therapy, individuals work on breathing, relaxation, and lengthening and strengthening techniques to train their muscles to function optimally.

Causes of Pelvic Floor Issues

Pelvic floor dysfunction tends to happen with age, during pregnancy, or in combination with events like the postpartum period and menopause, which can lower hormone levels.

  • Individuals who are pregnant are especially prone to pelvic floor issues but might not know they have a problem.
  • The pregnancy weight of a uterus can pressure and strain the muscles.
  • Vaginal childbirth can also stretch or weaken the muscles. (Ilaria Soave, et al., 2019)

Symptoms

Symptoms can include: (Columbia Surgery. 2022)

  • Pain in the pelvis region
  • Back pain
  • Painful urination
  • Constipation
  • Urinary leakage or incontinence
  • Stool leakage or incontinence
  • Painful intercourse
  • If left untreated, these symptoms can worsen over time.

Pelvic Floor Physical Therapy

An individual will meet with a specialist to discuss symptoms and undergo a physical examination that includes:

  1. Pelvic floor exam.
  2. Evaluation of posture, mobility, and core strength.
  3. Once the initial exams and evaluation are complete, the practitioner will go over pelvic floor exercises and provide a treatment plan.
  4. Recommended exercises vary based on symptoms but focus on relaxing, stretching, and/or strengthening muscles.

Muscle Relaxation

  • To relax the muscles, a therapist may recommend breathing exercises.
  • For pregnant individuals, this means timing breaths with contractions.
  • For individuals experiencing constipation, breathing exercises can help the body relax and reduce strain.

Stretching Muscles

  • Stretching can help relieve muscle tightness and stiffness.
  • A therapist may help stretch the pelvic floor through various therapy modalities.
  • This type of physical therapy can help loosen tight muscles or help gently reset dislocated organs back into place.

Strengthening Muscles

  • After the pelvic floor is loose and relaxed, the focus typically switches to strengthening the muscles.
  • Strength work may target abdominal muscles or the pelvic floor muscles themselves.

With time, commitment, and targeted treatment, individuals can use pelvic floor physical therapy to loosen tissues, strengthen muscles, and restore function.

Spinal Decompression In Depth

References

U.S. Food and Drug Administration. (2019). Pelvic organ prolapse (pop).

Sartori, D. V. B., Kawano, P. R., Yamamoto, H. A., Guerra, R., Pajolli, P. R., & Amaro, J. L. (2021). Pelvic floor muscle strength is correlated with sexual function. Investigative and clinical urology, 62(1), 79–84. doi.org/10.4111/icu.20190248

Raizada, V., & Mittal, R. K. (2008). Pelvic floor anatomy and applied physiology. Gastroenterology clinics of North America, 37(3), 493–vii. doi.org/10.1016/j.gtc.2008.06.003

Soave, I., Scarani, S., Mallozzi, M., Nobili, F., Marci, R., & Caserta, D. (2019). Pelvic floor muscle training for prevention and treatment of urinary incontinence during pregnancy and after childbirth and its effect on urinary system and supportive structures assessed by objective measurement techniques. Archives of gynecology and obstetrics, 299(3), 609–623. doi.org/10.1007/s00404-018-5036-6

Columbia Surgery. (2022). Pelvic floor disorders: frequently asked questions.

Pelvic Floor Pain and Back Pain

Pelvic Floor Pain and Back Pain

by | Lower Back Pain

The pelvic floor is essentially the spine, and when pain presents, it can be mistaken for back pain. However, these two conditions are frequently linked. The National Institutes of Health- NIH reported that a quarter of women are impacted by pelvic floor disorders and up to 16% of men. The pelvic floor is made up of muscles. If the muscles begin to spasm, they can spread pain upwards and even downwards. This is where the misdiagnosis of lower back pain comes in.

Pelvic Floor Pain and Back Pain

The Pelvic Floor

The pelvic floor is comprised of muscles and connective tissue, known as fascia. The muscles and fascia intertwine, creating a support system for the pelvic organs. The pelvic floor muscles act as a spring system that supports the organs. When downward pressure is applied, and the spring system is working correctly, they push back up to support the muscles. These muscles create the base known as the core. The core muscles support the abdomen, diaphragm, and back muscles, supporting the spine. This is why back, pelvic pain is prevalent as these muscles are interconnected.

Pelvic Floor Dysfunction and Back Pain

If there is pelvic floor dysfunction, there is an inability to control the muscles. There can be too much or insufficient tension, resulting in urinary incontinence or inability to complete bowel movements. It can also be mistaken for back pain or contributes to pelvic and low back pain. The core muscles support the torso and promote stabilization during movement. If they are not working correctly, the torso and pelvis become unstable. The SI – sacroiliac joints linked with the pelvis and the lower spine can begin to present with posterior pelvic and back pain.

Symptoms

Dysfunction can present in several ways, including:

Causes of Dysfunction

Causes of dysfunction include:

  • Weakness of the muscles or tight muscles.
  • Vaginal dryness by a lack of estrogen during menopause.
  • Tight inner thigh muscles.
  • Back pain itself can cause dysfunction.

Women make up the majority of cases that result from:

  • Pregnancy
  • Childbirth
  • Endometriosis – a condition in which uterine tissue grows outside the uterus.

Men can also develop problems. As a man’s body ages, prostate problems can cause urinary leakage and frequency problems. It can develop from activities like bicycling. The seat can compress the pudendal nerve, causing pain and dysfunction.

Retraining the Muscles

The dysfunction can be helped by reactivating and strengthening the pelvic and core muscles. Training the pelvic floor and the core muscles will help boost support for the spine and alleviate discomfort and pain. First, it is recommended to get a physical evaluation by a chiropractor or physical therapist to determine if the pelvic floor muscles are too tight or weak. The objective is to improve the strength of the pelvic floor muscles or relax them if they are too tight. A chiropractor and physical therapist can work on the muscles, educate on stretches, exercises, nutrition, and offer additional help and support.

Body Composition

Muscle Adaptation

The point of resistance training is to get the muscles to function more effectively. It begins with the contractile proteins that control muscle shortening and lengthening. Resistance exercise can cause some of the proteins to get pulled apart. The stress the muscles experience is the stimulus for the muscles to rebuild bigger, stronger, or more powerful. After resistance exercise, the muscle synthesizes proteins helped by nutritional stimuli and protein consumption. Satellite cells also activate to help build up the broken-down muscle. Resistance exercise causes activation.

References

Cleveland Clinic. (2020). “Pelvic Floor Dysfunction.” my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction

National Institutes of Health. (September 2008) “Roughly One-Quarter of U.S. Women Affected by Pelvic Floor Disorders” www.nih.gov/news-events/news-releases/roughly-one-quarter-us-women-affected-pelvic-floor-disorders

Smith, Christopher P. “Male chronic pelvic pain: An update.” Indian journal of urology: IJU: journal of the Urological Society of India vol. 32,1 (2016): 34-9. doi:10.4103/0970-1591.173105

World Health Organization. (2013) “Low back pain” www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf