Pelvic Floor Muscle Dysfunction and Pelvic Pain
The Pelvic Floor Muscles (PFM) lie in the bottom of the pelvis forming a sling or ‘hammock’ of muscle reaching from the pubic bone at the front to the tail bone at the back.
They support the pelvic organs, the bladder and bowel in both sexes and the uterus (or womb) in women.
They are responsible for keeping us continent of urine, faeces and wind,
They work alongside our ‘core’ muscles to support the spine.
They have a role in sexual function
They support the pelvic organs, the bladder and bowel in both sexes and the uterus (or womb) in women.
They are responsible for keeping us continent of urine, faeces and wind,
They work alongside our ‘core’ muscles to support the spine.
They have a role in sexual function
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Symptoms
Sometimes the muscles do not work as they should due to factors such asPregnancy or childbirth
Pelvic surgery such as prostatectomy or hysterectomy
Being strained by a persistent cough, or constipation
Being peri or post-menopausal
Certain sports or over training
Stress/trauma
Treatments
What does Pelvic Floor Rehabilitation involve?Your physiotherapist will take a detailed history of your problem and then you will be examined appropriately, this could involve the physiotherapist looking at your abdominals, lumbar spine, ribcage, hips, pelvis and of course the pelvic floor muscles. If necessary and with your consent it may be appropriate to examine you internally.
Treatment would typically involve correction, strengthening or mobilisation of any musculoskeletal problems flagged up in the examination and of course pelvic floor exercises. Sussing out the problems wholistically helps us decide the best treatment for you
The PFM may be found to be weak and a strengthening regime is usually required. The strengthening regime may take the form of quite simple retraining, but it will also be dynamic, functional and tailored to your needs.
The PFM can be stiff or tight (known as hypertonic) and this can be as troublesome as weakness, often being the source of chronic pelvic pain conditions such as vulvodynia, penile/ testicular pains and low abdominal pain. Treatment for a hypertonic pelvic floor could involve breathing exercises, relaxation of the pelvic floor, soft tissue mobilisation and/or muscle stretches.
References
https//thepogp.co.uk/patients/glossarywww.bladderandbowel.org
www.ageuk.org.uk
www.nhs.uk/conditions
www.yourpelvicfloor.org
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Anderson CA, Omar M, Campbell SE, Hunter KF, Cody JD, Glazener CMA. Conservative management for postprostatectomy urinary incontinence. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No.: CD001843. DOI: 10.1002/14651858.CD001843.pub5
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