Pelvic Floor Dysfunction
What Is the Pelvic Floor?
Caitlin McCurdy-Robinson, PT, DPT, owner of Inner Strength Physical Therapy, explained, “simply put, the pelvic floor is a group of muscles from the pelvic bone to the tailbone that supports the pelvic and lower abdominal organs, helps with continence and contributes to healthy sexual function.” In the most basic terms, the pelvic floor helps control bodily functions such as peeing, pooping, passing gas and giving birth, while also impacting a person’s sexual experience.
There are many signs that may indicate your pelvic floor could use some help. If you are experiencing pelvic pain, pelvic pressure, urinary leakage with daily movement or exercise, pain with sexual intercourse or chronic constipation, you may have pelvic floor dysfunction.
McCurdy-Robinson said that “while pelvic floor issues are common, this does not mean they are normal or should be ignored.” In fact, she noted that pelvic floor problems might prevent people from participating in sports they used to enjoy. Or the pain could be impacting their careers, making prolonged sitting painful and impacting their ability to focus while at work. And because there is often embarrassment associated with such a personal type of pain, people are less likely to speak up or seek professional help.
Pelvic Floor Exercises and Therapy
Lily Elmore, PT, DPT, a physical therapist at the Medical University of South Carolina who specializes in working with women experiencing pelvic floor dysfunction, said that most pelvic floor issues can be simplified into two categories: The muscles are too tight, or they are too weak. Pelvic floor physical therapy can be tailored to address either of these issues and their accompanying symptoms. Both Elmore and McCurdy-Robinson agreed that there is no one-size-fits-all approach to pelvic floor health. For overall health and well-being, focusing on core strength is a great place to start, but, if you are experiencing specific symptoms, consulting with a specialist is best.
When the pelvic muscles are too tight, people tend to experience symptoms such as urinary urgency (needing to go suddenly), frequency (needing to go often), feeling like they aren’t able to completely empty their bladder, pelvic pain or pain with sexual activity. To help address these issues, exercises may be focused on relaxing the pelvic floor, breathing and safely stretching the muscles around the hips and core. In many cases, these may be familiar yoga or Pilates core exercises that can be continued at home.
When the muscles are too weak, many women focus solely on kegel exercises. “But kegel exercises –when an individual practices tightening and relaxing the muscles in the pelvic floor – can be done incorrectly,” said Elmore. And if pelvic tension is contributing to symptoms, kegel exercises could even make some pain worse. “Even simple adjustments to sitting posture and how people sit on the toilet to empty their bowels and bladder can make a big difference” Elmore explained.
Pelvic Floor Therapy for Men
For men, the pelvic floor also helps control urination, bowel movements and sexual function. Men could experience pelvic floor dysfunction due to normal aging or after surgery or radiation for prostate cancer. Men may also need pelvic floor therapy if they are experiencing pain with sexual activity, erectile dysfunction or urinary leakage.
Getting Started with Pelvic Floor Physical Therapy
If you think you may need help, start a conversation with your trusted health care provider or reach out directly to a pelvic floor physical therapist. Regardless of where you go, Elmore knows women can feel apprehensive about such personal care. She reminds every patient that “pelvic floor physical therapists are specially trained to be sensitive and work at your pace in a private and comfortable setting.” McCurdy-Robinson echoed this sentiment, stating “an internal exam is not a requirement at the first visit, or sometimes ever, and we will always allow our patients to ask questions and feel comfortable with their treatment plan.”
By Blair Webb Grass, RN, MSN, CNM (ret.)
