PELVIC PAIN AND PELVIC FLOOR DYSFUNCTION What is pelvic pain and pelvic floor dysfunction? There are a number of conditions which cause pain and pelvic floor dysfunction. We have discussed a few of those conditions here today. Fortunately most of the conditions are treated with physiotherapy interventions. Pelvic pain and dysfunction Common conditions related with internal pelvic structures: Provoked vestibulodynia: In this your pelvic area is very sensitive to touch or pressure. You will feel pain with light touch, pressure, inserting tampons, wearing tight pants or intercourse. urinary urgency Vaginismus: You feel difficulty and/or pain with vaginal penetration. This will lead to avoidance of sexual activity or internal pelvic examination. Bladder pain syndrome: You feel pain and pressure with urge to urinate at any time. You will get an increased urge to urinate. Symptoms usually starts with bladder infection. Dysmenorrhea: You will feel painful cramps with…

Pelvic Floor: Posture PELVIC FLOOR: POSTURE is a very important area if you have issues with urinary incontinence, pelvic pain, etc.  The muscles of the pelvic floor support the abdominal and pelvic viscera.  These muscles are active in standing and sitting. Furthermore, because the abdomen is a fluid-filled cavity, intra-abdominal pressure  is distributed in all directions.  The Pelvic Floor muscles, which form the floor of the abdominal cavity, contribute to its muscle control. As a result of this contribution to control of intra-abdominal pressure, the muscles of the pelvic floor are likely to contribute to control of the spine and pelvis. The slouched posture places a lot of pressure on our internal organs and pelvic floor. This can cause a worsening of: urinary incontinence, pelvic pain,  symptoms related to prolapse, and rectus diastasis. Pelvic Floor: Posture, sitting slumped Research has shown that when we sit in a slumped posture, our pelvic…

Vaginismus and Physiotherapy Vaginismus is a painful feeling of discomfort or inability when inserting a tampon, finger, penis or during a doctor’s internal pelvic exam. It occurs when there are involuntary contractions of the muscles in the outer third of the vagina. Primary Vaginismus: when a woman has never been able to have pain free intercourse due to pelvic floor muscle spasm. Secondary Vaginismus: pain that develops sometimes later in life after a traumatic event such as childbirth, surgery, or a medical condition. With Vaginismus, there is usually significant Connective Tissue Dysfunction that needs to be addressed first before any internal work. It is suggested that you follow up the self-help treatment for connective tissue dysfunction before embarking on the stretching exercises with the dilators. Pelvic floor exercises and Desensitisation techniques A physiotherapist may be able to teach you pelvic floor exercises, such as squeezing and releasing your pelvic floor…

Prostatitis Prostatitis or Prostatodynia Physiotherapy Prostatodynia or Chronic Pelvic Pain Syndrome (CPPS) is a pelvic pain condition in men. This means ‘inflammation of the prostate’. There are two basic types of prostatitis, acute and chronic. Acute Bacterial Prostatitis Acute Bacterial Prostatitis is an infection of the prostate. This type of Prostatitis causes chills and fever. In this case, you need your Doctor’s attention promptly! Nonbacterial or Chronic Prostatitis The other is Nonbacterial or Chronic Prostatitis. This can be treated with alternative treatments such as Pelvic physiotherapy, exercises, lifestyle modifications etc. Investigations in this case show that bacteria and yeast are negative. The physical examination does not usually show anything unusual. However, the prostate may be swollen. What can make the problem even more confusing is that often young, otherwise healthy men develop this condition. Antibiotics, pain-killers, and medications prescribed are often not effective. Many men have…

Pelvic Health Physiotherapy What is pelvic health physiotherapy? Pelvic floor muscles form the ‘bowl’ or ‘hammock’ that supports our lower back and pelvic organs (bladder, uterus/prostate and rectum). Pelvic health physiotherapists have taken courses allowing them to perform an internal evaluation in order to assess the tension and strength of these muscles. Often there is too much tone of the pelvic floor leading to weakness. What are common symptoms of pelvic health dysfunction? • Leakage of urine with coughing, sneezing, laughing and exercise • Urgent need to urinate or leaking before you get to the washroom • Constipation/straining with bowel movements • Heavy feeling or bulge in the vagina • Pain in the pelvic or low back or genital area • Pain with intercourse Check out this link for more information. Some benefits of Pelvic Floor Physiotherapy • Leave your house without worrying about your bladder • Exercise without worrying…

Endometriosis Physiotherapy Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis Physiotherapy: fortunately there is something that you can do about this! Cause of Endometriosis The cause of endometriosis is unknown. One theory is that the endometrial tissue is deposited in unusual locations by the retrograde flow of menstrual debris through the Fallopian tubes into the pelvic and abdominal cavities. The cause of this retrograde menstruation is not clearly understood. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity (i.e. the peritoneum). It is also likely the direct transfer of endometrial tissues at the time of surgery may be responsible for the endometriosis implants occasionally found in surgical scars (for example, episiotomy…

post-prostatectomy-incontinence Post-prostatectomy-incontinence is a common problem after radical prostatectomy. Patients report that this is the symptom which most disrupts their quality of life. Up to 75 percent of men experience a short period of mild incontinence. This is particularly after removal of the catheter that was placed during surgery. Most patients regain total urinary control after radical prostatectomy. However, this can take up to a year to achieve. Apparently, a small percentage (2% to 4%) experience permanent incontinence. Following radical prostatectomy, men who experience post-prostatectomy-incontinence may express concerns about visible wetness, urine odor, and the type of clothing that can be comfortably worn. Types of Urinary Incontinence The two types of post-protatectomy incontinence following prostate surgery are: • Stress incontinence – Stress incontinence is the involuntary loss of urine that can occur during physical activity, like lifting a heavy object, or when you laugh or sneeze. These . activities put…

Female & Male pelvic pain There are various conditions which are treatable under male and female pelvic pain. Vulvodynia Pain that affects the entire vulva Symptoms • Burning • Stabbing • Stinging • Itching • Sensitive to touch and pressure • Functional limitation (Sex/ tampon/clothes) Vestibulodynia The vestibule is where the vulva (area of the skin on the outside) meets with the vagina. It is an extremely sensitive part of your body. Symptoms: Hypersensitivity on light touch, such as during intercourse and on insertion of tampons.Some women have pain but are able to tolerate penetrative sex. They may have soreness and tenderness. This may include soreness with tight clothes and even light touch to the area. Dyspareunia, Vaginismus, Dysmenorrhea, Irritable Bowel Syndrome (IBS) and Endometriosis Vaginismus: Inability to penetrate due to spasm of the muscles Dyspareunia: Painful vaginal penetration in the absence of disease Dysmenorrhea: Irritable Bowel Syndrome (IBS): Abdominal…

  Urinary tract infections Urinary tract infections typically occur when bacteria enter the urinary tract through the urethra. Bacteria then begin to multiply in the bladder. The most common UTIs occur mainly in women and affect the bladder and urethra. • Infection of the bladder (cystitis). • Infection of the urethra (urethritis) Symptoms • A strong, persistent urge to urinate • A burning sensation when urinating • Passing frequent, small amounts of urine • Urine that appears cloudy • Urine that appears red, bright pink or cola-colored — a sign of blood in the urine • Strong-smelling urine • Pelvic pain, in women — especially in the center of the pelvis and around the area of the pubic bone Check out this video for more information: http://www.webmd.com/women/guide/your-guide-urinary-tract-infections#1 Lifestyle changes: Urinary tract infections can be painful. You can take steps to ease your discomfort until antibiotics treat the infection. Follow these…

Urinary Incontinence Urinary incontinence is the involuntary leakage of urine. This condition is more common among women than men. An estimated 30 percent of females aged 30-60 are thought to suffer from it, compared to 1.5-5 percent of men. 3.3 million Canadians have Urinary Incontinence. – 1 in 4 women – 1 in 9 men Only 1 in 12 people tell a health care worker, WHY? – Embarrassed – They think it is a Private Issue – Some think it is an Inevitable part of aging….IT IS NOT! This issue has a lot of Social Consequences like decreased self esteem.It also causes impaired emotional status, depression and isolation. It impedes social and physical activity. It has a heavy economic burden on patients, families and society (Hunskaar, 1991, Temml, 2000). Risk Factors for Urinary Incontinence Gynecological or urinary surgery • Chronic Illness • Medication • Smoking • Chronic straining • Obesity…