The human body is an intricate and awe-inspiring machine, composed of various interconnected systems that work together harmoniously. One crucial, yet often overlooked, part of this complex system is the pelvic floor. Situated at the base of the pelvis, the pelvic floor plays a vital role in maintaining overall health and well-being.
In this post, we will delve into the importance of pelvic floor health and conditioning, as well as explore the conditions that can be effectively addressed with the assistance of a pelvic health physiotherapist.
Understanding the Pelvic Floor
The pelvic floor is a group of muscles, ligaments, and tissues that form a hammock-like structure supporting the pelvic organs, including the bladder, bowel, uterus, and rectum. These muscles work together to control urinary and faecal continence, stabilize the pelvis and spine, and contribute to sexual function. The pelvic floor is also one of our core muscles and must be exercised to achieve full core strength. The core is made up of pelvic floor, transversus abdominis, diaphragm, multifidus and obliques.
The female pelvic floor has the highest number of oestrogen receptors in the body. As oestrogen declines during perimenopause & menopause, our pelvic floor becomes weaker with this hormonal change. Incorporating pelvic floor exercises into daily life can reduce the risk of developing a pelvic organ prolapse and/or incontinence later in life.
Pelvic Floor Health and Conditioning
Similar to any other muscle group in the body, the pelvic floor requires regular exercise and proper care to maintain optimal strength and functionality. A healthy and well-conditioned pelvic floor offers many benefits, such as improved bladder and bowel control, enhanced sexual satisfaction, reduced risk of pelvic organ prolapse, and reduced back pain. Several factors can contribute to pelvic floor dysfunction, including pregnancy and childbirth, endometriosis / adenomyosis, hysterectomy, trauma, aging, obesity, chronic coughing, and high-impact activities. These factors can weaken or strain the pelvic floor muscles, leading to various issues like urinary incontinence, faecal incontinence, pelvic organ prolapse, and sexual dysfunction.
The Role of a Pelvic Health Physiotherapist
The role of a pelvic health physiotherapist is to assess, diagnose, and provide treatment for those experiencing pelvic floor dysfunction or related conditions. Pelvic health physios have expertise in the anatomy, physiology, and biomechanics of the pelvic floor, allowing them to address a wide range of pelvic health concerns.
Treatment will begin with a thorough assessment to understand any symptoms, medical history, and lifestyle factors that may be contributing to a condition. This assessment may include a combination of subjective questioning, physical examination, and specialised tests to evaluate pelvic floor muscle strength, endurance, coordination, and function.
Based on the assessment findings, the physiotherapist will develop an individualised treatment plan tailored to the specific needs of the patient. The goal of treatment is to restore optimal pelvic floor function, alleviate symptoms, and improve overall quality of life.
Treatment modalities may include:
- Pelvic Floor Exercises: These exercises, also known as Kegel exercises, involve contracting and relaxing the pelvic floor muscles to strengthen and improve their coordination. The physiotherapist will guide patients in performing these exercises correctly and provide progressions as needed.
- Breath work: we need to ensure we are breathing correctly for full engagement of the pelvic floor muscles. The diaphragm and pelvic floor work together and help regulate pressure in the abdomen.
- Manual Therapy: Hands-on techniques such as soft tissue massage, myofascial release, and joint mobilisations can be employed to address muscle tension, trigger points, and restrictions in the pelvic region.
- Biofeedback: Biofeedback devices are used to provide real-time visual or auditory feedback on pelvic floor muscle activity. This helps patients develop awareness and control over their pelvic floor muscles.
- Education and Lifestyle Modifications: Pelvic health physiotherapists educate patients about healthy bladder and bowel habits, posture, body mechanics, and strategies to minimise symptoms.
- Electrical Stimulation: In some cases, electrical stimulation may be used to enhance muscle activation and improve pelvic floor muscle strength and coordination.
What conditions can Pelvic health physiotherapists can assist with?
- Urinary Incontinence: Stress incontinence, urge incontinence, or mixed incontinence, which involves involuntary leakage of urine.
- Pelvic Organ Prolapse: The descent of pelvic organs such as the bladder or uterus into the vaginal canal due to weakened pelvic floor support.
- Pelvic Pain: Chronic pelvic pain syndromes, including vulvodynia, interstitial cystitis, pelvic floor muscle tension, and complications/pain resulting from pelvic mesh repairs.
- Pregnancy and Postpartum Care: Preparing the pelvic floor for childbirth, managing pregnancy-related discomfort, and assisting in postpartum recovery.
- Sexual Dysfunction: Addressing conditions such as vaginismus and pain during intercourse.
- Abdominal doming: May indicate incorrect breathing patterns and pelvic floor dysfunction.
- Erectile dysfunction: Pelvic floor exercises can help increase blood flow to the area.
- Prostate issues / prostectomy: Pelvic floor exercises are necessary to restore strength post op.
- Pelvic pain following surgical procedures.
By working closely with a pelvic health physiotherapist, individuals can regain control over their pelvic floor muscles, alleviate symptoms, and improve their overall pelvic floor health and well-being. Therapists provide personalised care, empowering patients to actively participate in their recovery and achieve a better quality of life.
Find out more about our pelvic health physiotherapists, Hannah Shanks and Carmen Lech here