Image by Katarzyna Grabowska

PELVIC FLOOR PHYSIOTHERAPY

Your Questions Answered

WHAT IS THE PELVIC FLOOR?

The pelvic floor is a sling of muscles that sits like a hammock across the bottom of the bony pelvis, supporting the bladder, uterus and bowels. Just like any other muscle in the body, we want the pelvic floor muscles to be strong, flexible and coordinated in order to function at their best. These muscles can become weak and uncoordinated, due to pregnancy/childbirth and aging, and can also become tight, just like any other muscle in our body. When you cough, sneeze, jump or carry something heavy, there is a downward pressure on your organs. The pelvic floor muscles have to have the strength, flexibility and coordination to withstand this pressure to prevent any leakage, heaviness or pelvic pain. Functions of the pelvic floor include primary core stability of the back and pelvis, support of the internal pelvic organs, proper bowel and bladder control, and sexual health.

WHAT HAPPENS WHEN IT ISN'T WORKING PROPERLY?

You probably haven’t put much thought into your pelvic floor muscles unless they aren’t working properly. Pelvic floor dysfunction can lead to a variety of problems, including:

  • Urinary incontinence (leakage) 

  • Urinary urgency, frequency or hesitancy

  • Bowel issues such as constipation or faecal incontinence

  • Prolapsed bladder, uterus or rectum

  • Pelvic pain

  • Diastasis recti or other core and abdominal wall dysfunction

  • Pelvic inflammatory disease

  • Endometriosis

  • Pain with sex (dyspareunia)

  • Pubic symphysis dysfunction

  • Pelvic girdle pain, sciatica, or SI joint pain during or after pregnancy

  • Pre/Postnatal exercise 

  • Childbirth preparation and pre-natal education

  • Painful intercourse

  • Painful bladder syndrome (interstitial cystitis)

  • Persistent low back, hip, groin, or abdominal pain

  • Scar tissue restricting the abdomen, pelvic floor or vulvar region

  • Post surgery for hysterectomies or any other pelvic surgery

COMMON, BUT NOT NORMAL!

  • It is not normal to leak when you laugh, cough, or sneeze.

  • It is not normal to feel pressure or heaviness in your pelvic region.

  • It is not normal to have pain with intercourse. 

  • It is not normal to feel pain in the pelvic region.

WHAT DOES THE RESEARCH SAY?

In 2010, the Cochrane Collaboration published a review, Pelvic Floor Muscle Training vs. No Treatment, or Inactive Control Treatments, for Urinary Incontinence in Women, which analyzed the effectiveness of pelvic floor strengthening in stress and urge incontinence. The Cochrane Collaboration concluded that there is Level I/ Grade A evidence (the strongest level of evidence available) for pelvic floor strengthening for urge and stress incontinence. The Cochrane Collaboration recommended that pelvic floor strengthening should be taught by a physiotherapist using internal assessment and treatment techniques, and this treatment should be the first line of defense for urge and stress incontinence. This means that the research says pelvic floor physiotherapy should happen with all patients who leak before surgery is considered.

Find the study HERE

WHAT ABOUT MALES?

​Pelvic floor physiotherapy can be extremely helpful to address some of the challenges that men may have when their pelvic floors are not working properly including:

  • Post-Prostatectomy incontinence

  • Erectile dysfunction

  • Pelvic Pain including Chronic Prostatitis, Testicular, Pudendal Neuralgia and Penile Pain syndromes 

  • Nocturia (frequent urination at night)

  • Symptoms of retention which can often be associated with Benign Prostate Hyperplasia and/or a tight pelvic floor

  • Tight pelvic floor muscles

  • Chronic Constipation

HOW CAN PHYSIOTHERAPY HELP?

A pelvic floor physiotherapist has specialized training in the assessment and treatment of pelvic floor dysfunction. After a thorough history and external assessment of the lumbo-pelvic region, an internal vaginal exam may be performed if appropriate. This is the best way to access these muscles to assess tone, strength, coordination and pain. Following your assessment, we will discuss your condition and set goals to develop a treatment plan, which may include pelvic floor exercises, hip and core stability, muscle release techniques, lifestyle/dietary changes, and more. 

Give us a call or book a consultation with our pelvic floor physiotherapist, Claire McDonald in Squamish, BC.