The pelvic floor is a group of muscles and connective tissue that stretch like a hammock from the tail bone to the pubic bone. The muscles work together to support the pelvic organs. In women the pelvic floor supports the bladder, uterus and bowel, similarly in men it supports the bladder and bowel. A problem with the pelvic floor is referred to as pelvic floor dysfunction. This dysfunction can either be a muscle weakness or due to overactive bladder syndrome.
What do the pelvic floor muscles do?
The pelvic floor muscles support the muscles that lie on top of it. The sphincters of the pelvis give us the ability to control the flow of urine, faeces and wind and delay emptying until it is convenient. When the muscles of the floor contract the organs of the pelvis lift and the sphincters tighten. Relaxing the floor allows the sphincters to relax and urine and faeces to pass through.
The pelvic floor is also important in supporting the womb during pregnancy and assists in the birthing process. It also works with the abdominal and spinal muscles to support the spine. And is also important in sexual function for both men and women.
What is a sign of dysfunction?
Dysfunction of the pelvic floor can present as:
- A frequent need to urinate. When you do go, you may stop and start many times.
- Painful urination.
- The feeling that you need to have several bowel movements during a short period of time.
- The feeling that you cannot complete a bowel movement.
- Constipation or straining pain with bowel movements.
- Pain in your lower back that cannot be explained by other causes.
- Ongoing pain in your pelvic region, genitals, or rectum.
- Pain for women during intercourse.
What can cause dysfunction?
- Pregnancy and childbirth for women
- Pelvic surgery
- Male prostate surgery
- Straining on the toilet
- Chronic coughing
- Heavy lifting
- High impact exercise
Why choose physiotherapy?
A physiotherapist is able to confirm a diagnosis for stress incontinence or overactive bladder syndrome. An assessment includes an extensive history of the urinary system, lifestyle, gynaecological and urology history and medical history. You may also be asked to complete a bladder diary between appointments. A vaginal or rectal examination may be required so as to assess how the pelvic muscles and connective tissue are working. However this examination is not a mandatory component of the assessment.
Follow up consultations involve education on the condition and specific treatment based on assessment findings. Treatment may include pelvic floor muscle training, lifestyle advice, bladder retraining, dietary changes, clinical pilates and exercise advice.
Pelvic floor rehabilitation is important for both men and women. Therefore it is important to speak to your GP or physiotherapist if you have any concerns regarding your pelvic floor.