Pelvic floor dysfunction

The pelvic floor consists of several muscles that support many of your organs including the bladder, rectum, uterus or prostate. The coordinated contraction and relaxation of the pelvic floor muscles controls bowel and bladder function - the pelvic floor must relax to allow urination, bowel movements, and in women, sexual intercourse. Pelvic floor dysfunction occurs when the pelvic floor muscles are too high-toned or low-toned, contributing to urinary incontinence, constipation, pain during intercourse, or pain in the lower back, pelvic area, genitals, or rectum.

There are several conditions and circumstances that can weaken or damage the pelvic floor. These include:

  • Pregnancy and childbirth: During pregnancy, the baby's growing weight can put pressure on the pelvic floor muscles, causing them to weaken. During childbirth, the muscles stretch and sometimes tear.
  • Trauma to the pelvis: This includes surgery, radiation to the pelvis, and a history of sexual abuse.
  • Age: Your muscles naturally weaken with age.
  • Chronic constipation or coughing: Long-term constipation or coughing can strain the pelvic floor muscles.
  • Obesity: Being overweight can put extra pressure on your pelvic floor muscles.
  • Neurological disorders: Multiple sclerosis, Parkinson's disease or spinal nerve damage can affect the nerves that control the pelvic floor muscles.
  • Health conditions: underlying conditions such as irritable bowel syndrome (IBS), endometriosis and interstitial cystitis can contribute to pelvic floor pain

Symptoms of pelvic floor dysfunction vary for each person and may include:

  • Urination problems: this may include urinary incontinence (inability to control urine or leakage) or overactive bladder (increase in urge and frequency).
  • Bowel movement problems: this may include straining of the bowel, constipation, incomplete or painful bowel movements and incontinence of stools .
  • Rectal pain: The rectum is the last part of the large intestine. This sudden pain can wake you up at night. It may last for a few minutes before disappearing.
  • Pelvic pain: Pain or pressure in the pelvis is a common symptom that can come and go. Some people develop chronic (more than three to six months) pelvic pain.
  • Sexual dysfunction: This may include difficulty getting an erection or having an orgasm. Painful sex can also be a symptom of pelvic floor dysfunction (for women).

The goal of any pelvic floor dysfunction treatment is to relax the pelvic floor muscles and avoid overworking them. Treatment usually combines different methods to solve your problem.

The procedures that would be applied could be:

  • Manual therapy of the pelvic floor muscles
  • Treatment of painful trigger points on the pelvic floor
  • Pelvic floor muscle exercises 
  • Specific stretching exercises
  • Breathing and relaxation techniques
  • Home exercise program
  • Modalities such as electrical stimulation, ultrasound, magnetic stimulation, etc.