Many people with interstitial cystitis (IC) have problems with the group of muscles in the lower pelvic area and develop a condition called pelvic floor dysfunction (PFD). If you have IC and a poor urine stream, feel the need to push or bear down to urinate, and have painful intercourse, you may have PFD. Treating PFD may be very helpful in reducing symptoms and pain for some IC patients—most patients see improvement after several weeks of therapy.
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!
Pelvic floor dysfunction may include any of a group of clinical conditions that includes urinary incontinence, fecal incontinence, pelvic organ prolapse, sensory and emptying abnormalities of the lower urinary tract, defecatory dysfunction, sexual dysfunction and several chronic pain syndromes, including vulvodynia in women and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) in men. The three most common and definable conditions encountered clinically are urinary incontinence, anal incontinence and pelvic organ prolapse.
Pelvic floor dysfunction is a common condition where you’re unable to correctly relax and coordinate the muscles in your pelvic floor to urinate or to have a bowel movement. If you’re a woman, you may also feel pain during sex, and if you’re a man you may have problems having or keeping an erection (erectile dysfunction or ED). Your pelvic floor is a group of muscles found in the floor (the base) of your pelvis (the bottom of your torso).
OMG I have it so bad can you help me, having rectocele repaired for 2nd time along with bladder lift oct 24 dr. Acher-Welch Ehlers Danlos Syndrom is also one of the diagnosis I have causing lots of elasticity to my skin. Saw you on IIN Talk love your style and information, our whole class is talking about how they love you. Just wanted to let you know, I’m still finishing the video but loving every bit of it as did my classmates. You are spot on in everything I know or am learning. Go Dr. N
My pelvic floor dysfunction has the opposite effect in terms of peeing. My bladder will not fully empty when I pee although I’ll wait and wait until a little more will come out, then I’ll go lie down because I have some burning sensation and discomfort. At that time, lying down, I will experience of flood of urine. my urologist wants to test me by filling my bladder up but that is counterintuitive to me so I’m not sure if I should have that test?
Use vaginal weights. Weightlifting strengthens your muscles. You gain the same effect when you use vaginal weights. Inserting cone-shaped weights into your vagina helps to train your pelvic floor muscles. You simply contract your pelvic floor muscles to keep the weight in place. You can find vaginal weights, such as Yoni Eggs, or Lelo balls, online. I find this approach far superior to the standard Kegel exercises which, in far too many women, just make the one small pubococcygeus muscle tight and don’t do much of anything with the rest of the pelvic floor.
Discussed extensively in Travel and Simon’s two volume series, trigger points are taut (firm) points in the muscle that have a consistent referral pattern (they transmit pain to the another part of the body). Trigger points are not only important because they cause pain, they also can affect how the muscle works. This is one of the main reasons our therapists at Beyond Basics are fastidious about ensuring all trigger points are released in the abdomen, back, legs and pelvic floor before transitioning to any core stabiltiy or strengthening exercises that can re activate a trigger point.
Exercise. There are a number of exercises you can do at home or at the gym to help strengthen your pelvic floor. Some of the best exercises include bridge pose, wall squats, jumping jacks, and dead bug crunch. For instructions on how to do these exercises, ask a knowledgeable trainer. You can also search online for video instructions. I also recommend that you Google Katy Bowman, who has many good resources for pelvic floor exercises.
Once we determine the cause of our patient’s pelvic floor dysfunction, we design a plan tailored to the patient’s needs. At Beyond Basics, we have a diverse crew of physical therapists who bring their own training and background into each treatment. What is really beautiful about that, is that all teach and help each other grow as practitioners. It will be difficult to go over every single type of treatment in one blog post, but we will review some of the main staples of pelvic floor rehab.
I’m not sure this diagnosis is correct; how is it confirmed? I’ve been recommended by my new GYN to go to this therapy with this new diagnosis. I have pain during sex. I HATE the muscle feelings of doing Keegles- absolutely hate those feelings. Doc says I won’t be doing Keegles. Have been athletic entire life, and continue to play tennis, do Zumba, garden, snorkle, kayack, still, as I’m a very healthy 57 year old, with left side internal pain during sex, sometimes what feels like a broken pelvic BONE pain. How is this diagnosis confirmed?
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.
Pelvic Floor Dysfunction usually does not occur due to one-time events such as childbirth. However, childbirth, repeated heavy lifting, and hip or back injuries can cause your pelvic floor to weaken, increasing the likelihood of PFD. In short, whenever the muscles, tendons, ligaments, or nerves of the pelvic floor are affected, you are at risk for PFD.
The pelvic floor muscles support various pelvic organs, including the bladder, prostate, rectum, and female reproductive organs. The muscles themselves are also involved in the functioning of the urinary and anal sphincters. When they are functioning normally, you are able to control your bowel and bladder movements by contracting and relaxing these muscles.
Every since my hysterectomy 4 years ago I have chronic pain. I’m now 46 years old and have tried everything. They say my muscle tone is good, as I do Kegals daily and my estrogen and testosterone are low but could be worse. The doctor says I have scar tissue on the vault that pushing on nerve endings. I can’t take gabapintin nor lyrica as they are too strong and I hate how it feels. I’ve had pelvic PT and use those skills. They now want to give me steroid shots a the top of the vault. Actually this wk but I’m about to chicken out. It seems everything tried makes it more agitated. Im at my wits end.
As you can now see, there is so much out there that can be done for people suffering with pelvic floor dysfunction. This blog is by no means extensive, and there are even more options you and your physical therapist can explore to help manage your pain or other pelvic issues. Pelvic floor dysfunction requires a multidisciplinary approach for most of our patients. Hopefully, this blog helped to paint a picture of what you will experience with a pelvic floor physical therapist. We advise that you seek out an expert and experienced pelvic floor physical therapist in order to help better your life and improve your function.
I’m not sure this diagnosis is correct; how is it confirmed? I’ve been recommended by my new GYN to go to this therapy with this new diagnosis. I have pain during sex. I HATE the muscle feelings of doing Keegles- absolutely hate those feelings. Doc says I won’t be doing Keegles. Have been athletic entire life, and continue to play tennis, do Zumba, garden, snorkle, kayack, still, as I’m a very healthy 57 year old, with left side internal pain during sex, sometimes what feels like a broken pelvic BONE pain. How is this diagnosis confirmed?
Ultrasound uses high-frequency sound waves applied through a wand or probe on your skin to produce an internal image or to help treat pain. Real-time ultrasound can let you see your pelvic floor muscles functioning and help you learn to relax them. Therapeutic ultrasound uses sound waves to produce deep warmth that may help reduce spasm and increase blood flow or, on a nonthermal setting, may promote healing and reduce inflammation.
