While it may be common, pelvic floor dysfunction is not normal. The good news is that with better awareness, as well as specialized physiotherapy, we can take charge of our pelvic floor function.
Jenna Wilkes, MScPT, a pelvic health physiotherapist, explains that hormonal changes throughout their lives and the functions that the uterus and vagina fulfill mean pelvic dysfunction is more common among women.
What is the pelvic floor?
Comprising several layers of muscles and connective tissue attached to the front, back, and sides of the pelvic bone, the pelvic floor supports the bladder, bowel, and reproductive organs. These muscles work alongside core muscles to absorb pressure created during lifting, coughing, and sneezing to protect your organs and spine.
“A strong pelvic floor is a functional pelvic floor,” says Wilkes. When working properly, these important muscles should allow control over urine flow from the urethra and gas and fecal matter from the rectum, as well as relaxation to allow for penetration during intercourse.
Causes and impacts of dysfunction
Pelvic floor dysfunction arises when the muscles become overly relaxed or weakened, though too much tightness in these muscles can cause dysfunction as well. Such dysfunction is commonly linked to injury or trauma—including childbirth and surgery, stress during pregnancy, overuse (as from repeated heavy lifting, chronic coughing, or constipation), hormonal changes, and aging.
Pelvic floor dysfunction can lead to
- bladder or bowel leakage
- difficulty emptying the bowels or bladder
- pelvic organ prolapse
- pain during intercourse
- overactive bladder
- pain during pregnancy
- pain in the pelvis, back, tailbone, hips, and legs
Physiotherapy for the pelvic floor
This specialized branch of physiotherapy uses internal and external assessment to establish appropriate treatment for an individual’s pelvic floor muscles, as well as their core stability, to help resolve and prevent common pelvic dysfunctions.
During the initial assessment, your pelvic physiotherapist will
- ask you detailed questions about your lifestyle and background, such as bathroom habits and any pain you regularly experience
- conduct an external exam to assess your postural alignment, strength, and how much movement you have in your low back, hips, and pelvis
- analyze your breathing patterns to ensure the diaphragm, core, and pelvic floor are working together
- conduct an internal exam, if needed (and you’re comfortable with it), to determine how the pelvic floor is functioning
Pelvic floor physiotherapy is especially helpful during and after pregnancy. If you’re thinking about conceiving, consider seeing a pelvic physiotherapist.
To Kegel or not to Kegel?
“That is the question! Kegels are not for everyone and are often not done properly because people lack the awareness of where these muscles are,” warns Wilkes, explaining that Kegels can often be helpful for a weak pelvic floor, but may worsen symptoms associated with an overactive pelvic floor. A pelvic physiotherapist can help you determine if Kegels are right for you and if you are doing them correctly.
By Laura Newton