Problems in the Pelvis: Pelvic Floor Dysfunction

The pelvis is an incredibly important area of the body. It houses vital organs and the nerves that service the legs. However, the pelvis can seem like a “black box” when trying to figure out pain or dysfunction in this area. In this article we will discuss pelvic floor dysfunction and pelvic pain, as well as ways that physiotherapy can help!

What is the pelvic floor?

The pelvis protects many organs including the bladder, bowel, and reproductive organs. In order to keep these organs secure and working properly, a group of muscles called the pelvic floor muscles span across the bottom of the pelvis like a hammock. These muscles help to prevent the pelvic organs from falling out through the pelvis, and assist with bowel, bladder, and sexual function through contracting and relaxing.

When the pelvic floor muscles are not working properly, you can experience pelvic pain or dysfunction. Pelvic pain can occur during any of the pelvic functions (bowel, bladder, or sexual) or with certain positions or movements. On the other hand, dysfunction means that these pelvic functions are not working properly, as in constipation or incontinence.

Pelvic floor dysfunction can be caused in different ways. The pelvic floor muscles may be hypertonic (too much contraction), which can cause difficulty or pain going to the washroom or during sexual activity. The muscles may be hypotonic (too much relaxation), which can lead to pain, incontinence, or organ prolapse, which is when one of the pelvic organs pushes out through the pelvic floor. Lastly, the muscles may have poor synergy (muscles not working well together) which can cause a mix of these symptoms.

Who does this affect?

Pelvic floor dysfunction can happen to anyone! This condition affects women more than men and becomes more common as we get older. For women, pregnancy, medical procedures in the pelvic area like hysterectomy, and genetics (family members with similar dysfunction) can increase your risk. For men, medical procedures in the pelvic area like prostate surgery can increase your likelihood of pelvic floor dysfunction.

Here are some factors that increase the risk for pelvic floor dysfunction that anyone can have:

  • Injury to the pelvis or pelvic floor muscles
  • Chronic coughing or sneezing that increases your abdominal pressure
  • Constipation
  • Heavy lifting
  • Prolonged high-intensity exercise
  • Being overweight or having obesity
  • History of back pain

What else could this be?

Pelvic floor dysfunction is a common problem, but its symptoms can appear similar to other, sometimes very serious, conditions. Here are some conditions to watch out for that have similar symptoms:

  • Pelvic pain: This could be prostate inflammation, urinary tract infection, endometriosis, irritable/inflammatory bowel disease (IBS/IBD), pelvic neuropathy, or tumour, among many other conditions!
  • Bowel or bladder issues: Could be IBS/IBD, cauda equina syndrome, changes associated with pregnancy and childbirth, enlarged prostate, or the effects of ageing.

It’s important to check in with your primary healthcare provider if you have any persistent or sudden symptoms in order to avoid leaving a potentially serious condition untreated!

Physiotherapy treatment for pelvic floor dysfunction

Pelvic floor dysfunction can often get better with physiotherapy treatment! If you’ve been cleared of some of the more serious conditions we’ve listed above, check in with your physiotherapist to learn how to improve your condition. To summarize, here are the main components of a physiotherapy program for pelvic floor dysfunction:

  • Education: Pelvic floor dysfunction symptoms can be confusing! We can help to understand your condition and what kind of treatments can help improve your symptoms.
  • Exercise: Just like most other muscles in the body, the pelvic floor muscles respond very well to exercise! Your physiotherapist can guide you through exercises to improve their function, which will have a positive impact on your symptoms.

If you’ve been experiencing pelvic dysfunction or pain, book an appointment with us today to see how we can help!

About The Author

Jonathan Rankin obtained his MSc in Physiotherapy at McMaster University, and also completed both a BSc and an MSc in Human Kinetics from the University of Ottawa. He has a strong background in exercise, from working as a personal trainer at the University of Ottawa to conducting research on exercise during pregnancy in his master’s degree.

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