Pelvic floor dysfunction is a condition that affects many individuals of all ages and genders. You may have heard of the pelvic floor before, but it is an area of the body that does not get talked about often. Just like any other area in the body, the pelvic floor can get injured, weak, or sore – and can cause many other symptoms! Read below to learn more about the pelvic floor, pelvic floor dysfunction, and how a physiotherapist may help you with your pelvic floor symptoms.
What is the Pelvic Floor?
The pelvic floor is made up of the muscles, ligaments, and fascia that run from your tailbone to your pubic bone. There are 3 layers that make up your pelvic floor. The first layer is made up of your urogenital triangle and anal triangle which include muscles that help control your sexual organs and anus. The second layer is the fascial layer which includes your urinary sphincter muscles that help control the flow of urine. And the third layer is your pelvic diaphragm, which is the deepest layer of your pelvic floor and includes the set of muscles that is often referred to when talking about the pelvic floor. The pelvic diaphragm helps provide support for all of your sexual organs, bladder, and rectum.
Why is the pelvic floor important?
The pelvic floor provides support for your sexual organs, bladder, and rectum. The ability to contract and relax the pelvic floor muscles plays a large role in our ability to urinate and have bowel movements. The pelvic floor is also part of your ‘core,’ which is made up of your abdominal muscles, pelvic floor muscles, diaphragm, and lower back muscles. Your pelvic floor muscles need to coordinate with the rest of the muscles in your core to help maintain the appropriate amount of pressure inside your abdomen during daily activities. When one of these sets of muscles is not functioning properly, you may notice pelvic floor symptoms such as leakage, pain, or weakness.
Pelvic Floor Dysfunction
Just like any other group of muscles in the body, our pelvic floor should be able to contract and relax, can be strained or injured, or can be short and tight. The muscles inability to function optimally and work together is referred to pelvic floor dysfunction (PFD).
There are many conditions and causes of PFD. Pelvic floor dysfunction can be caused by things such as hormonal changes, childbirth trauma (vaginally or via c-section), hysterectomy, obesity, prostatectomy, chronic straining, or chronic illness.
When the pelvic floor musculature is not functioning normally, you can experience a variety of symptoms including incontinence, pelvic organ prolapse, pain during intercourse, pelvic pain, menstrual pain, pregnancy-related pelvic pain, difficulty going to the bathroom, tailbone pain, and lower back pain.
One of the most common pelvic floor concerns is incontinence. There are five types of urinary incontinence, each impacted by the pelvic floor. Read below to learn more:
1. Stress incontinence
Stress incontinence is the loss of urine due to an increase in intrabdominal pressure. Your body’s intrabdominal pressure will increase due to things like sneezing, coughing, laughing, running, lifting heavy, or jumping. Only a small amount of urine leakage is expected with stress incontinence.
2. Urge incontinence
Urge incontinence is the strong, uncontrollable urge to pee or the inability to delaying using the washroom. With urge incontinence you may find that you have to get up to go to the bathroom in the middle of the night. Many individuals will have environmental triggers that set off the urge to void, such as unlocking front door of the house when arriving at home or seeing running water.
3. Overflow incontinence
With overflow incontinence, you may feel that you are unable to fully empty your bladder when going to the bathroom, and you may experience constant leakage of a small amount of urine throughout the day.
4. Functional Incontinence
Functional incontinence is usually caused by a physical or cognitive impairment that affects an individual’s ability to void normally – whether that be making it to the bathroom in time or being able to control their bladder.
5. Mixed Incontinence
Mixed incontinence is the combination of two or more of the above types of incontinence. The most common combination is stress and urge incontinence.
Incontinence most commonly affects those who are pregnant, given birth, or have had prostatectomies, but can affect anyone regardless of age or gender. Incontinence can occur or worsen due to things such as bladder or urinary infections, drinking too much alcohol or caffeine, eating spicy food, menopause, or pregnancy. Over time, incontinence symptoms can worsen if not treated, which is why it is important to seek help from a physical therapist as soon as you can.
Another common condition related to pelvic floor dysfunction is pelvic organ prolapse. Pelvic organ prolapse occurs when the muscles and fascia in the pelvic floor are not adequately supporting the pelvic organs. Symptoms of pelvic organ prolapse include the sensation of pressure in the pelvic floor, pelvic pain, and the protrusion of tissue at the vaginal opening. Oftentimes an individual’s symptoms will be aggravated by standing and relieved by laying down.
What is Pelvic Floor Physiotherapy?
Pelvic floor physiotherapy addresses any concerns an individual may have with their pelvic floor. By assessing the pelvic floor and supporting joints and muscles, your physiotherapist can help you identify what may be causing your pelvic health concerns. Some clinics offer certified internal pelvic floor physiotherapists, who may use internal palpation as an addition to their assessment to help identify areas of concern and provide treatment. Currently at Nova Physiotherapy, Sheridan offers non-internal assessment and treatment of the pelvic floor and is able to refer you on to an internal pelvic floor physiotherapist as needed.
Who is Pelvic Floor Physiotherapy for?
Pelvic floor physiotherapy is for everyone! No matter your age, gender, or concern, consulting a pelvic health physiotherapist is for anyone having pelvic health concerns.
What to expect in an assessment and treatment.
Your initial assessment is 1 hour long and will include a subjective and objective assessment. The subjective assessment includes a discussion about your current concerns, symptoms, and past medical history. Your physical therapist may ask you questions regarding things such as incontinence, leakage, pelvic pain, pregnancy and childbirth history, or surgical history to help understand the cause of your symptoms and how to best help you.
In the objective assessment, your physiotherapist will perform a movement scan and will assess things like your range of motion (of your back, hips, and pelvis), test your strength, palpate muscles involved in your condition or injury, and assess how the joints in your back, hip and pelvis are moving.
After the assessment is complete, your physiotherapist will explain their findings, and will discuss a treatment plan with you. Your treatment plan may include manual therapy (such as soft tissue release, joint mobilizations, and stretching), exercise instruction during the session, a home exercise program, advice on activity modifications and symptom management, and education regarding your condition.
Pelvic floor dysfunction is commonly overlooked and the symptoms an individual experiences may be labeled as ‘normal.’ While having pelvic floor dysfunction symptoms may be common, it is not normal. It is a condition that may leave you feeling embarrassed or discouraged, but pelvic floor dysfunction is a treatable condition, and many individuals have found benefit from pursuing pelvic floor physiotherapy.
Sheridan has a special interest in working with individuals with pelvic floor concerns. If this is you, let’s get you booked in for an assessment with Sheridan. Click here to secure your spot!
