What Is Pelvic Floor Dysfunction?
It is estimated that 1 in 4 women experience women’s health problems during their lifetime. However, many tolerate these problems, often for years, either too embarrassed to seek help or unaware that there are treatments available. There are a number of reasons that the pelvic floor can become dysfunctional.
Childbirth— It is common that the pelvic floor is weaker after childbirth and women can develop symptoms of incontinence or prolapse. As a result women may start to subconsciously hold the pelvic floor, fearing the symptoms.
Trauma– Trauma to the pelvic floor can be as a result of a direct blow to the coccyx, this can affect the alignment of the coccyx, the sacrum and the pelvis, and the inflammation can set up a holding pattern in the pelvic floor over time. Frequently, the lumbar spine and thoracic spine are involved, too.
Pelvic Girdle Pain— In pregnancy it is the potentially debilitating pain that some women experience when the pelvis loses stability and alignment. The pelvic floor can often become overactive as a result of the “hanging on” that sets up to compensate for the lack of stability of the pelvis.
Poor Posture– Poor posture can set up a negative holding pattern in the pelvic floor.
Typically the shoulders become flexed forwards, the middle back or thoracic spine stiffens in flexed forward position, the upper abdomen tenses, the lower stomach protrudes, the gluteal muscles become inactive and the pelvic floor works harder by tensing up negatively and symptoms may develop. Symptoms that can develop include stress incontinence, bladder overactivity, pelvic pain or even pelvic organ descent over time.
Chronic Constipation—The pelvic floor can be overactive and the muscles may not lengthen or release sufficiently for the motion to pass. If pain becomes a feature and a cycle ensues, this may lead to development of trigger points, further dysfunction and possibly, in some cases even leading to organ descent.
Chronic Pelvic Pain— Chronic pelvic pain is a very debilitating condition. It includes:
- Urologic chronic pelvic pain
- Pudendal neuralgia or pudendal neuropathy or the less common pudendal nerve entrapment
- Vulvar vestibulitis, generalised, provoked or unprovoked
- Vaginal pain, labial pain, clitoral pain
- Interstitial cystitis
- Vaginismus
- Proctodynia
- Anismus
Treatment for Pelvic Floor Dysfunction
Generally patients respond well to manual therapy and breathing release techniques as well as learning how to voluntarily release the pelvic floor and changing the holding patterns in the body in general.
The Physiotherapist will design a treatment program specifically for the patient, based on their aims and goals and functional ability levels. Progress is regularly reviewed and treatment programs are modified to help the patient achieve the best outcome possible.
If you see this condition with any of your patients, please think of referring to us so that we can assist you in getting the best results possible for your patients. Contact BMJ Therapy – Physiotherapy Singapore today.