Pelvic Floor Dysfunction
Raise your hand if you've ever
- Experienced lower back pain, pelvic pain and/or sacroiliac joint pain
- Headed to the toilet 'just in case.'
- Felt a sneeze coming on and crossed your legs
- Found yourself straining to poo
- Woke up more than once overnight for a wee
Did you know these can all be signs of pelvic floor dysfunction? Pelvic floor dysfunction can look and present differently for every person and sometimes discussing symptoms ‘down there' can be difficult. As you can see from the above, many people have or will experience one or more of these over their lifetime, which is why we believe the conversation around pelvic health should be an open, sensitive, and transparent topic for people of all ages.
So, what is the pelvic floor?
The pelvic floor comprises layers of muscles, ligaments, and fascia that extend like a hammock from the tailbone at the base of the spine to the pubic bone. It has many essential functions within the body, including
- Assisting in stabilising your spine, hips and pelvis
- Providing support for your organs against gravity and intra-abdominal pressure
- Assisting in respiration
- Sexual function
- Helping venous and lymphatic flow to prevent congestion
- Maintaining urinary and faecal continence
With so many roles within the body, it's understandable that the pelvic floor, like all our muscles and tissues, sometimes doesn't work optimally! Whether that's due to pregnancy, chronic constipation, hormonal changes, a sedentary lifestyle or dysfunctional breathing patterns, our pelvic floor needs treatment and exercise just like the rest of our body.
Urinary leakage and incontinence may be the most apparent symptom of pelvic floor dysfunction; however, it can also involve and is not limited to, the following symptoms.
· Regardless of the amount, urine leakage during activities such as coughing, sneezing, laughing, running or weight training.
· Urgency to urinate, with or without leakage.
· Needing to go to the toilet multiple times in the night
· Inability to control the release of wind
· Tampons dislodging or falling out.
· A distinct bulge at the vaginal opening
· A sensation of heaviness or dragging in the vagina.
· Pain experienced during intercourse.
· Lower back pain, pelvic pain and sacroiliac joint pain can also be associated with pelvic floor muscle dysfunction.
I have these symptoms, so I should just do Kegels, right?
Not always! Sometimes, a pelvic floor can be tight – which, conversely, doesn't also mean strong. If the pelvic floor is constantly engaged, it can't increase its strength in times when we need it, like coughing, sneezing, lifting heavy things, etc. Think of jumping on a trampoline versus jumping on concrete – the natural give in the trampoline allows for more fun; in the same way, a healthy pelvic floor will enable us to jump for joy – with no leakage! As you can see, it's essential to conduct a thorough assessment before engaging in any exercises to avoid exacerbating any dysfunction that may be present.
How can osteopaths help my pelvic floor?
As osteopaths, we think of the body like a team, where structure and function work together. When we help with women's health and pelvic floor issues, we don't just focus on the pelvic floor alone. We check the whole team – your entire musculoskeletal system – to ensure everything works well together for your pelvic floor to do its job.
Dr. Sandra Nixon has completed additional training in assessing, treating and rehabilitating the pelvic floor using various internal and external techniques to address pelvic floor concerns. Her goal is to provide the best possible service for patients, utilising a
compassionate and considerate approach to address your pelvic health concerns. For personalised and comprehensive care, schedule your consultation with Dr Sandy. Your pelvic health matters, and she's here to help you return to jumping for joy!
References
Culleton-Quinn, E., Bø, K., Fleming, N., Mockler, D., Cusack, C., & Daly, D. (2022). Elite female athletes’ experiences of symptoms of pelvic floor dysfunction: A systematic review. International Urogynecology Journal, 33(10), 2681–2711. https://doi.org/10.1007/s00192-022-05302-6
Dufour, S., Vandyken, B., Forget, M.-J., & Vandyken, C. (2018). Association between lumbopelvic pain and pelvic floor dysfunction in women: A cross sectional study. Musculoskeletal Science & Practice, 34, 47–53. https://doi.org/10.1016/j.msksp.2017.12.001
Eliasson, K., Elfving, B., Nordgren, B., & Mattsson, E. (2008). Urinary incontinence in women with low back pain. Manual Therapy, 13(3), 206–212. https://doi.org/10.1016/j.math.2006.12.006
Hage‐Fransen, M. A. H., Wiezer, M., Otto, A., Wieffer‐Platvoet, M. S., Slotman, M. H., Nijhuis‐van der Sanden, M. W. G., & Pool‐Goudzwaard, A. L. (2021). Pregnancy‐ and obstetric‐related risk factors for urinary incontinence, fecal incontinence, or pelvic organ prolapse later in life: A systematic review and meta‐analysis. Acta Obstetricia et Gynecologica Scandinavica, 100(3), 373–382. https://doi.org/10.1111/aogs.14027
Ugur Tosun, B., & Yilmaz Gokmen, G. (2023). Cause of non-specific low back pain in women: pelvic floor muscle weakness. International Urogynecology Journal, 34(9), 2317–2323. https://doi.org/10.1007/s00192-023-05606-1