Now that you know have some background on me, let’s talk about my favorite subject--the pelvic floor!
The pelvic floor is a group of muscles that live at the bottom of your pelvis. The pelvic floor exists in both men & women. If these muscles are working well, they are barely a blip on your radar. If these muscles are not working well, they can consume 90% of your life.
They have several jobs through your day:
Support the pelvis
Support your organs from below
Keep urine and stool in their respective holding structures until you get to the bathroom
When you get to the bathroom, they should relax to allow you to empty your bowel and bladder effectively
Assist in sexual function
Additionally, these muscles don’t live on an island by themselves. They are the bottom part of your core, which is essentially a big pressure system. When most people talk about their core, they are talking about their rectus abdominis or oblique muscles--the muscles we can see. When I talk about the core muscles, I mean the muscles viewed below. In the image, it is as if you are looking at the a person from the side and seeing the deepest layer of their core muscles. These muscles all should work together as a team do allow you to do all your normal activities, stand or sit upright, and go through your day without pain or leakage. Unfortunately, since the pelvic floor is the bottom of this group, problems in the core usually show up in the form of pelvic floor dysfunction.
Permission to use copyright image from Pelvic Guru, LLC
What kinds of symptoms can you experience if you have a problem in the pelvic floor muscles?
Urine loss with cough, laugh, exercise, or a strong urge
Loss of stool with a strong urge, a cough or sneeze, or without awareness
Pain in the abdomen, genitals, rectum, tailbone, and inner thighs
Difficulty emptying the bowels and/or bladder
Heaviness and/or pressure in your pelvis
Symptoms of pelvic organ prolapse
Pain with intercourse or pelvic exams
Pain with urination or bowel movements
Urinary urgency and frequency (also known as overactive bladder)
Long standing low back pain that has not responded to previous treatment
These symptoms are really common, but none of them are normal. Statistics will vary depending on your source, but research shows 35-50% of women have experienced urinary incontinence over the last year. Risk for incontinence in women increases around menopause, pregnancy/postpartum, and with increased athleticism. The male pelvic floor is typically more stable so incontinence is less common, but it does happen. All men after a prostatectomy will have some degree of urinary incontinence. According to the research this can take up to a year to improve on its own, but I have treated men who have been 5 or more years out from their surgeries who are still having problems.
Pelvic pain can be caused by a variety of structures and sometimes there are multiple structures that are contributing to pain. Pain can range from an annoyance to the inability to work, exercise, or complete household activities. If you search for the prevalence of pelvic pain, then you will see a large range of statistics depending on what key words you use in your search. These statistics can range from 3-15% in males and 4-26% in women. Physical therapy will not 100% resolve 100% of pelvic pain, but it can make a significant difference in day to day activities and management strategies.
There are so many other specific pelvic floor dysfunctions that I will cover in the future, but just know that you are not alone if you are dealing with any of these issues! With The Pace Yourself Programs, my goal is to create an opportunity for you to better understand your anatomy and help you understand the root of your pelvic floor problems. Physical therapy is not always right for everyone right now and you might think it is embarrassing or you might think that you don’t have time to go see someone right now. And that’s okay! I am designing these programs with you in mind! Each program will teach you why you are having these problems, what strategies are useful to eliminate or help you manage these symptoms, and when you might want to seek additional help. There are big things coming so join my email list and follow me on social media so that you can keep up in real time!!