Silent signs you have a Pelvic Floor Disorder

The pelvic floor consists of various structures, including muscles, ligaments, and tissues around the pelvic bones. The muscles support the pelvic floor from all sides. The patient may be asymptomatic initially, and especially, women may find reluctant to visit a healthcare professional. Nearly 41-50% of >40 yrs of age women demonstrate pelvic floor prolapse, however, very few of them (~17%) seek professional help. Both men and women get affected, women are more likely to get affected by pelvic floor dysfunction.

What is pelvic floor dysfunction?

The pelvic bones are supported by various structures, including muscles, ligaments, and other tissues. The bones are joined with the sacrum posteriorly. Various organs supported by pelvic bones are the bladder, rectum, urethra, uterus, and vagina/ prostrate.

The pelvic floor dysfunction includes a variety of symptoms e.g., Tightening or weakening of the pelvic floor muscles.  During the tightening of the muscles, there might be trouble in bladder/ bowel emptying. On the contrary, when there is a weakness in pelvic muscles, organs might drop/ press onto the other structures such as the rectum and bladder. These symptoms can interfere with the activities of daily living (ADLs) as well.

What are the causes? Symptoms?

The various symptoms of pelvic floor dysfunction include the inability to control the bladder and bowel functions, abnormal vaginal sensation with a strange budging sensation, intercourse is painful, and difficulty in emptying the bladder and bowels. Pelvic pain and stress urinary incontinence (urine leaking during activities such as coughing and laughing etc.)

The pelvic floor disorders can happen due to increasing age (mostly in females), systemic illnesses, chronic respiratory conditions, collagen diseases, pregnancy-related issues such as trauma during delivery, multiple deliveries, and large babies, etc.

Coccygodynia (also known as coccydynia, coxalgia, coccygeal neuralgia, or tailbone pain) is the medical term used to describe pain in the coccyx (tailbone region). The coccyx is attached to various muscles (levator ani, coccygeal, gluteus maximus, and iliococcygeus muscles) and ligaments (sacrococcygeal, sacrospinous, and sacrotuberous ligaments). Voluntary bowel movements are controlled by these muscles and ligaments, hence these structures provide support to the pelvic floor.

Recognize the symptoms early and get better before the symptoms deteriorate. It’s not normal to experience bladder and bowel problems, but it could be a sign of underlying pelvic floor disorder.

Treatment

Pelvic floor muscles strengthening during pregnancy might prevent post-delivery urinary incontinence. Women should start doing the exercises even before getting pregnant. Even males can benefit from these exercises as conditions such as pelvic floor prolapse and urinary incontinence can be avoided within them. The exercise includes holding/ squeezing (~10 sec) the pelvic muscles without breath-holding. A physical therapist can treat pelvic floor prolapses using strengthening (Kegels) exercises, biofeedback (electrical stimulation, ultrasound, or massage of the pelvic floor muscles), and relaxation techniques. If everything fails, surgery can be performed.

Here at Aktivhealth, we use a pelvic trainer to assess and treat pelvic floor dysfunctions. Pelvic trainer helps in improving the strength and coordination of pelvic floor muscles and for the treatment of pelvic floor dysfunctions/ functional disturbances. Along with pelvic dysfunction examination, such individuals are also assessed for movement patterns, including breathing pattern and gait/walking pattern. After holistic therapy, which could include diet and lifestyle changes as well, a person can return to normal.

Written by: Parminder Kaur, Physical Therapist (AktivHealth)