Pelvic Floor Dysfunction

What is Pelvic Floor Dysfuntion?

Your pelvic floor is made up of a layer of muscles and other tissues that stretch from your pubic bone at the front, to your tailbone at the back and sit at the base of your pelvis.

The main roles of your pelvic floor are to provide continence, by assisting in the closure of our bladder, vagina or rectum (back passage) and to support our pelvic organs; the bladder, uterus (womb) and bowel that sit inside the pelvis. They also have a role in sexual function. The pelvic floor muscles normally work together with our deep abdominal and deep back muscles to provide us with our core stability so it is important for these muscles to remain strong.

Both men and women have a pelvic floor which can become weak for a number of reasons. Pelvic floor dysfunction occurs when these muscles and layers of tissue become weak and are unable to support the pelvic organs, resulting in pelvic pain or problems with maintaining continence.

Causes of Pelvic Floor Dysfuntion

Pelvic floor dysfunction can happen for a variety of reasons and there are many causes. Some common reasons are; pregnancy and childbirth, constipation, being overweight, not keeping the pelvic  oor muscles active, heavy lifting, having a cough that goes for a long time, e.g. smoker’s cough/ bronchitis) and growing older.

The pressure in our abdomen constantly changes with our day to day tasks. When we cough, sneeze, lift, and bend, our deep abdominal and back muscles, and our pelvic  oor, work to withstand these changes in pressure. Over time, these muscles can get weak and the pelvic  oor can stretch, especially if the pressure changes occur frequently (e.g. chronic coughing).

The most common reason for pelvic floor dysfunction is pregnancy and childbirth, which place these tissues under heavy strain and stretch, both throughout the pregnancy and delivery. Women who have caesarean deliveries are also at risk of pelvic  oor dysfunction.

Signs & Symptoms of Pelvic Floor Dysfunction

Signs of pelvic floor dysfunction can be varied.

The most common sign of pelvic floor dysfunction is leaking some urine when you cough, sneeze, run or jump. Other symptoms include not being able to “hold on” when you need to go to the toilet, feeling like you need to go to the toilet very frequently, feeling a heaviness or a dragging feeling in the vagina, straining when moving your bowels, or suffering from haemorrhoids.

In addition, those who have long standing low back, pelvic or groin pain can have a pelvic floor dysfunction. In this instance, the pelvic floor muscles don’t work together with the deep abdominal and deep back muscles so core stability is compromised which can cause pain. 

Treatment & Management of Pelvic Floor Dysfuntion

Your physiotherapist will assess whether your pelvic floor muscles are working properly either by palpating on your lower tummy or by using the Real Time Ultrasound (RTUS). From these findings, your physiotherapist will teach you how to activate and work these muscles correctly.

You will get an exercise program which assists in retraining your pelvic floor to work normally and will assist in your recovery. Ongoing management can include Clinical Exercise – both one-on-one, and in a class.

You may be referred to a continence and pelvic floor physiotherapy specialist, who will further assess and treat the pelvic floor dysfunction. It is important to follow the guidelines regarding specific pelvic floor exercises, as well as exercise in general in order to prevent further dysfunction and the potential need for surgery.

Self Management of Pelvic Floor Dysfunction

• Completing your home exercise program that includes pelvic floor and core stability exercises as recommended by your physiotherapist
• Listening to ‘return to exercise’ advice from your physiotherapist
• Use of a core stability belt if back pain is severe and when needed

For more information, you can read our detailed guides to the pelvic floor Part 1 and Part 2 or learn more about our discrete continence services. Or contact your nearst Back In Motion practice for an initial assessment. Click here to download the PDF.