What Is the Pelvic Floor?
The pelvic floor is made up of layers of muscle, nerves controlling the muscles, and fascia that connect everything together. These layers stretch like a hammock from the tailbone at the back, to the pubic bone in front and support the pelvic organs, the urinary tract, digestive tract, reproductive organs, bladder, and prostate in men, The muscles of the pelvic floor assists with continence through control of the urinary and anal sphincters. It facilitates birth by resisting the descent of the presenting part, causing the fetus to rotate forwards to navigate through the pelvic girdle. pelvic floor muscles help sexual function and maintain optimal intra-abdominal pressure.
What are pelvic floor disorders?
Pelvic floor disorders happen when the supporting tissue within the pelvic floor is weakened or damaged and they no longer perform their functions. The different types of pelvic floor disorders are named according to the organ affected. The most common types of pelvic floor disorders include:
- Urinary incontinence, or lack of bladder control
- Fecal incontinence, or lack of bowel control
- Pelvic organ prolapse, a condition in which the uterus, bladder and bowel may descent into the vagina
- Sexual dysfunction
- Pain in the lower back, pelvis, genitals or rectum
What are the symptoms of pelvic floor disorders?
People with pelvic floor disorders may experience the following symptoms:
- Urinary problems, such as leakage of urine, an urgent need to urinate, pain and burning with urination or incomplete emptying of the bladder
- Constipation, pain during bowel movements
- Pain or pressure in the vaginal wall or rectum
- A heavy feeling in the pelvis or a bulge in the vagina or rectum
- Muscle spasms and pain in the pelvic area
- Bladder pain
- Pain during intercourse
How physical therapy can help with pelvic floor disorders?
- Therapeutic exercise
Flexibility and/or strengthening exercises, exercises to correct posture, instruction on proper lifting and carrying, relaxation, body positioning, and home exercise program.
- Manual therapy
External and internal soft tissue mobilization, myofascial and trigger point release, connective tissue manipulation, visceral mobilization.
- Biofeedback
biofeedback muscle training allows patients to view their pelvic muscle activity at rest and during various strengthening or relaxation exercises. This helps increase awareness that they are using their muscles correctly.
- Instruction regarding normal voiding mechanics.
- Instruction regarding normal defecation mechanics.
- Bladder and/or bowel retraining.
- Transcutaneous Electrical Nerve Stimulation (TENS): gentle and soothing pulses, applied via external electrodes, or a vaginal probe. The stimulation prevents pain signals from reaching the brain and increases endorphin production. TENS decreases overall pain perception and assist with mobility and function.
- Electrical stimulation: can strengthen pelvic muscles, inhibit overactive bladder conditions, and assist with correcting urinary retention
- Ultrasound: uses sound waves to generate heat within a body part, increasing circulation and decreasing inflammation. It's often used in preparation for manual therapy.
- Treatment of related lumbosacral, hip, SI joint, coccyx and pelvic girdle conditions
