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Pelvic Floor Dysfunction: The what, the why and who it affects

By   ·  2 minute read

You may not realize this, but EVERYONE has a pelvic floor!

The pelvic floor muscles consist of a group of muscles that span the base of the pelvis, supporting the bladder, uterus & vagina (in females), prostate (in males), and rectum. These muscles play a critical role in urinary and bowel control, sexual function, and maintaining core stability.

Below is a short summary to help you learn more about why this part of your body is so important and some clinical signs and symptoms you should be aware of.

What is the pelvic floor and what are its functions?

      • ANATOMY: Levator ani, Coccygeus, Obturator internus, Piriformis and others!
      • FUNCTION: Maintain continence of urine and feces, while eliminating on demand as needed
      • FUNCTION: Contribute to sexual functions of arousal and orgasm

What is pelvic floor dysfunction?

Pelvic floor dysfunction is generally when one of the above functions goes awry. Examples of dysfunction include:

  • Urinary dysfuntion- incontinence, overactive bladder (OAB), frequency, urgency
  • Vaginal /testicular dysfunction - prolapse (female), vulvar pain, testicular pain, surgery and postpartum rehab, pain with sex, difficulty with orgasm
  • Rectal dysfunction - constipation, hemorrhoids, anal incontinence
  • Neurological dysfunction - pudendal neuralgia or neurogenic bladders

Who does it happen to?

This can happen to anyone! We commonly see pelvic floor dysfunction associated with big changes in hormones, but that is not the only cause. Periods of time, like during pregnancy or puberty are very typical periods where the pelvic floor is impacted, due to major increases in estrogen levels. Other periods of change are the immediate postpartum period and menopause. For men, changes in your testosterone levels and 

What are the symptoms?

Common symptoms people can have include urinary or rectal leaking. This is commonly seen with changes in load or pressure of the pelvic floor like with coughing, sneezing, laughing, or any increased pressure in the abdomen (squatting, deadlifting, jumping, running, etc). This can be due to a mismatch in abdomen press versus what the pelvic floor muscles are ready to handle

Other symptoms from a mis-matched pressure include prolapse or hemorrhoids can also happen due to excessive straining while doing any of the above activities.

Why does it happen?

This is very individualized, but we know some of the common culprits that contribute to the dysfunction.

Imbalance of pressure - this is when intra-abdominal pressure exceeds the pressure of the pelvic floor

Hypertonicity - Aka tightness of the pelvic floor muscles. Often people have difficulty relaxing, and it can lead to pain and leaking.

Muscle fatigue or decreased muscle endurance - Weakness after a certain threshold of pressure or time of an activity can commonly lead to pain, heaviness, and/or leaking.

What can I do about it?

See a pelvic floor therapist! But really, there are some great things that pelvic floor therapy can help with:

Pelvic floor muscle training - Just like any other muscle in your body, strengthening the pelvic floor can work on muscle coordination and strength.

Pelvic floor relaxation - If you have symptoms related to hypertonicity, common interventions to promote relaxation can help to decrease tightness in the pelvic floor, hip and lower back regions.

Sub-threshold training - Leaking, heaviness, or pain with associated with different activities or movements is often due to a capacity issue. Sub-threshold training looks at the amount you are running, jumping or lifting and modifying amount of the activity to improve symptom tolerance. Example: if 100% is when you start leaking, reducing to 80-90% or doing 2 sets of 50% to introduce rest can reduce stress on the pelvic floor.

Parasympathetic nervous system activation - Many people have an excited sympathetic nervous systems which can trigger pelvic floor symptoms. Working on breath work, physical movement, progressive muscle relaxation, time in nature, journaling, therapy, and other forms of mindfulness can help to decrease stress levels and help to decrease pelvic floor symptoms.

 

The biggest takeaway is that pelvic floor dysfunction is common, but it is not normal! It happens to people of all ages, backgrounds and symptomology.  Pelvic floor physical therapy can help to manage and decrease symptoms!