Women’s Wellness Patient Education
Many women are unaware of the changes that the pelvic floor goes through during pregnancy and delivery; following surgery or through the natural aging process.
The muscles of the pelvic floor can become dysfunctional from being stretched or shortened, tight, hyper-responsive and prone to spasms and weakened. This can cause pain and/or dysfunction of the bladder, bowel and genitals.
The pelvic floor consists of several layers of muscles that create a sling between the pubic bone and tailbone. These muscles have three critical functions:
- To aid in sexual appreciation (orgasm)
- To assist in stopping and starting the flow of urine or the passage of gas or stool for urinary and fecal continence
- To support the pelvic organs, including the intestines, bladder, and uterus
Also, adversely affecting the pelvic floor tone are the following:
- Abdominal/Pelvic Pain
- Irritable Bowel Syndrome
- Urinary retention; urinary urgency and frequency
- Anal/Rectal Pain due to fissures, fistulas or hemorrhoids
- Bacterial infection (bladder or vaginal), acute or chronic
- Chronic yeast infections
- Pelvic Organ Prolapse
- High levels of stress
- Musculoskeletal Abnormalities
Sacroiliac joint or spine dysfunction; tightness of posterior capsule of hip or iliotibial band; degenerative changes of the hip joint or lumbar spine; scoliosis; leg length discrepancy; muscle imbalances of the pelvic girdle, abdominals and thighs.
- Activity-related injuries
Prolonged bicycle riding, horseback riding, prolonged sitting, squatting exercises with heavy weights, excessive abdominal exercises (mat and equipment), and sitting inner and outer thigh strengthening exercises (equipment).
- Physical trauma
Contusion or fracture of tailbone; vaginal deliveries with use of forceps or vacuum, episiotomy or tearing; chronic constipation with straining; surgical trauma to the spine, pelvis, hip or thigh; surgical scars; repetitive work-related activity or trauma; car accident; physical/sexual abuse.
It is important to restore an optimal resting length of the pelvic floor muscles for them to be able to correctly contract and release, as well as, to be less tender and painful. The surrounding musculature needs to be addressed as well.
Physical therapy includes the following:
- Elimination or reduction of tender/trigger points.
- Elimination or reduction of scar adhesions and connective/soft tissue restrictions, both internally and externally.
- Enhanced pelvic floor muscle awareness using a biofeedback or electrical stimulation device.
- Correction of pelvic floor muscle imbalances by down-training (relaxation) and up-training (strengthening) exercises.
- Correction of any joint(s) mal-alignment to promote pain-free joint mobility; instruction in exercises for posture, and inhibition/strengthening of the appropriate abdominal, pelvic, buttock and thigh musculature.