Pelvic floor dysfunction is common for many women and includes symptoms that can affect all aspects of everyday life and activities. Pelvic floor muscle (PFM) training is vital for treating different types of pelvic floor dysfunction. Two common problems are uterine prolapse and urinary incontinence both of which stem from muscle weakness. Without the ability to control PFM, pelvic floor training cannot be done successfully. Being able to control PFM is vital for a well functioning pelvic floor. Through vaginal palpation exams and the use of biofeedback the tightening, lifting, and squeezing actions of these muscles can be determined. In addition, abdominal muscle training has been shown to improve pelvic floor muscle function.[11] By increasing abdominal muscle strength and control, a person may have an easier time activating the pelvic floor muscles in sync with the abdominal muscles. Many physiotherapists are specially trained to address the muscles weaknesses associated with pelvic floor dysfunction and through intervention can effectively treat this.[12]
The “prescription plan” for tight and weak muscles is different than loose and weak. I recommend going to a Pelvic Floor Physical Therapist (do a google search) or Doctor specializing in Pelvic Floor issues (Most OB/GYNs are NOT knowledgeable of this issue) to get a proper diagnosis. Otherwise, you might do the wrong thing for your condition and make it worse.
Pelvic floor dysfunction is very different than pelvic organ prolapse. Pelvic organ prolapse happens when the muscles holding a woman’s pelvic organs (uterus, rectum and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.
By definition, postpartum pelvic floor dysfunction only affects women who have given birth, though pregnancy rather than birth or birth method is thought to be the cause. A study of 184 first-time mothers who delivered by Caesarean section and 100 who delivered vaginally found that there was no significant difference in the prevalence of symptoms 10 months following delivery, suggesting that pregnancy is the cause of incontinence for many women irrespective of their mode of delivery. The study also suggested that the changes which occur to the properties of collagen and other connective tissues during pregnancy may affect pelvic floor function.[7]
I have been on this earth almost eighty years, no meds, and have not had these symptoms–yet. I had 5 pregnancies, and one episiotomy birthing one large baby, no hysterectomy. I am not overweight nor do I have a flat butt. Here are some things I’ve done over the years and now am wondering if it may have helped. I don’t know if this was developing core muscles, but when I was a kid, and through most of my life, when I went to bed I would hold my stomach in until I went to sleep. Odd, I know, but I have never had back problems. A strong stomach keeps your back strong. I garden, and have always done squats, still can, although lately I squat without thinking about it and notice it’s less easy to get back up. By doing most things my self I get plenty of exercise and I walk daily. Exercise and diet helps constipation problems. I think as we get older we don’t empty our bladder fully. If you have to lean forward, to the sides, or back or bounce a little, do it. And, true confession, I have a tiny extra bathroom where I can place my feet on the wall–works great for a Squatty Potty. Lastly, keep having orgasms.
The term “vaginal massage” may not be legit—practitioners don’t like to use it—but the treatment is. In fact, it’s part of a well-rounded therapy regimen for pelvic floor physical therapy. Certified specialists in this field can help women who are dealing with pain during sex—something 75% of women experience at some point in life, according to research.
Pain can emerge because of lifestyle factors and underlying medical problems. Sitting all day can affect the nerves in your saddle, which may translate into a burning pain in your vulva, explains Rhonda K. Kotarinos, DPT, a specialist in pelvic floor dysfunction in the Chicago area. The discomfort of chronic vaginal infections or holding urine all day long can also lead someone to “walk around with their pelvic floor clinched to their ears. It can make your pelvic floor very angry,” she says.
As physical therapists, are our hands are amazing gifts and phenomenal diagnostic tools that we can use to assess restrictions, tender points, swelling, muscle guarding, atrophy, nerve irritation and skeletal malalignment. We also use our hands to treat out these problems, provide feedback to the muscles, and facilitate the activation of certain muscle groups. There have been a great number of manual techniques that have evolved over the course of physical therapy’s history. Let’s go over a few.
It is essential that we, as pelvic floor physical therapists, also include other assessments when we are examining our patients for the very first time. We employ the tried and true physical therapy exam practices to determine if there is an underlying condition elsewhere in your body, such as a strength deficit or alignment issue that could be affecting your pelvic floor. It’s wild to think of it, but something as seemingly unrelated as a flat foot or a hip injury can be enough to set off pelvic and abdominal pain!
Neural mobilization as the name implies, involves the restoration of neural structures back to their normal mobility: to glide and slide. Neural structures that cannot move properly can cause pain that can radiate down an extremity or into the trunk and can give the sensation of burning, zinging, and stabbing. Some orthopedic therapists practice this type of mobilization; common examples include the sciatic nerve in the leg and the ulnar nerve in the arm. Pelvic floor PTs focus on these nerves when they cause issues, but they also pay attention to nerves that innervate the perineum and genital region (bicycle seat area), such as the pudendal, iliohypogastric, obturator, ilioinguinal, genitofemoral and the femoral cutaneous nerves. By allowing these nerves to move freely, symptoms such as vulvovaginal, penile, rectal, clitoral and testicular pain, itching and burning can be greatly improved.
Your pelvic floor is the group of muscles and ligaments in your pelvic region. The pelvic floor acts like a sling to support the organs in your pelvis — including the bladder, rectum, and uterus or prostate. Contracting and relaxing these muscles allows you to control your bowel movements, urination, and, for women particularly, sexual intercourse.
Pelvic floor dysfunction is very different than pelvic organ prolapse. Pelvic organ prolapse happens when the muscles holding a woman’s pelvic organs (uterus, rectum and bladder) in place loosen and become too stretched out. Pelvic organ prolapse can cause the organs to protrude (stick out) of the vagina or rectum and may require women to push them back inside.
Thank you Dr. Northrup for sharing great information about pelvic floor dysfunction. I am a physical therapist and board-certified women’s clinical specialist. I’ve been practicing pelvic physical therapy since 1999. Over the years I have realized that we as women to not have basic information to take care of our bodies and never discuss the ‘secret’ pelvic area. I have such a passion for bringing this information forward that I wrote a book Pelvic Zone Coach, Every Wonan’s Guide To Pelvic Health and Sexual Vitality (available on Amazon).
Your pelvic floor is the group of muscles and ligaments in your pelvic region. The pelvic floor acts like a sling to support the organs in your pelvis — including the bladder, rectum, and uterus or prostate. Contracting and relaxing these muscles allows you to control your bowel movements, urination, and, for women particularly, sexual intercourse.
Help….I had a preventive hysterectomy seven months ago because of a horrible maternal family history of ovarian and uterine cancer. At 53, I had just started into menopause with skipping periods, but hadn’t gone a year. Now, I have had constant pelvic pain….it’s hard to walk sometimes, hard to stand for more than 30-40 minutes and a cystocopy showed that my bladder was inflamed. All these practitioners are telling me I have IC, but I have no frequency, no urgency or burning. When I finally went to a uro/gyn, during the exam she told me several of my pelvic muscles were tight and I the only pain I had was when touched near my bladder. I think this may be a pelvic floor dysfunction along with a hormonal imbalance, but no one listens and just keeps prescribing Uribel and other bladder drugs and now they want to do instillations. Am I completely off base that this is a wrong diagnosis? Any insights would be helpful.
Great article thank you. I notice urinary leaking occurs after about mid morning (so i always exercise first thing in the morning) and then can be either worse or non existent during the month. I’m assuming hormones are at play but havent worked out if a pattern exists … yet. I think I’ve dealt with it but then it’s back!! Look forward to implementing these points.
Never had correct diagnosis of any female related issues going to male doctors. Years on meds for bladder infections, labs say I never had until switched to female doctor with immediate result, diagnosed 3rd degree prolapse, seriously. Thank you to all the female doctors who examine and listen and more importantly, believe. And, then help resolve and prevent.
The “prescription plan” for tight and weak muscles is different than loose and weak. I recommend going to a Pelvic Floor Physical Therapist (do a google search) or Doctor specializing in Pelvic Floor issues (Most OB/GYNs are NOT knowledgeable of this issue) to get a proper diagnosis. Otherwise, you might do the wrong thing for your condition and make it worse.
