Pelvic floor physiotherapy helps in treating pelvic floor dysfunction to alleviate pain.
Pelvic floor muscles sit like a hammock to hold and support the pelvic organ. For an optimal function the pelvic floor these muscles should contract to maintain continence and prolapse. They have to relax to allow for urination, bowel movements, and in women, sexual intercourse.
Conditions treated due to hyper and hypotonic pelvic floor muscles are:
- Urinary incontinence (stress, urge, mixed) due to age, after child birth, or post abdominal surgery.
- Pelvic organ prolapse which includes: uterine, bladder, rectal prolapse.
- Pelvic pain.
Common causes for pelvic pain are as below:
- Dyspareunia: pain during intercourse.
- Vestibulodynia: pain around the opening of the vagina and the inner lip of vulva.
- Vaginismus: (painful and difficulty to have a penetration during sexual intercourse, using a tampon, or for a pelvic floor exam).
- Vulvodynia: pain around the opening of the vagina (Vulva).
- Pudendal Neuralgia: Pain and numbness due to irritation to the Pudendal nerve giving symptoms in the pelvic area, buttocks.
- Interstitial cystitis: painful bladder syndrome causing chronic bladder pressure and pain.
- Dysmenorrhea: Painful menstrual period with strong abdominal cramps.
- Coccydynia: tail bone pain.
- Chronic pelvic pain.
Pelvic floor Physiotherapy techniques used at Physio Now are, but not limited to:
Hands on technique such as
- Connective tissue mobilization.
- Vaginal, vulvar, scrotal mobilization.
- Myofascial release.
- Pelvic muscle stimulator for muscle reeducation.
- Dilators, Thera wand for pelvic floor relaxation.
- Neurodynamic for nerve involvement.
Strengthening exercise for pelvic floor, back, and core and education on pelvic care.
Studies show that Physiotherapists with specialized training in pelvic floor rehabilitation (using internal examination to teach the exercises) should be the first line of defense. Instead of surgical consultation, for stress, urge, and mixed incontinence in women.
The pelvic floor muscles are a group of muscles that seats just like a hammock from the front of your pelvis/pubic bone to the back attaching to the sacrum. They are also attached to the sides of your pelvis bone. These muscles support the bladder, uterus, prostate, and rectum. They also wrap around your urethra, rectum, and vagina (in women).
For the optimum use of these muscles, the need to function and contract well to maintain continence. They relax to allow for urination, bowel movements, and in women, sexual intercourse.
When these muscles have too much tension (hypertonic) they will often cause pelvic pain or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they will contribute to stress incontinence and organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.
Hypertonic muscles in Pelvic floor can cause the following symptoms:
- Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
- Constipation, straining, pain with bowel movements
- Unexplained pain in your low back, pelvic region, hips, genital area, or rectum
- Pain during or after intercourse, orgasm, or sexual stimulation
- Uncoordinated muscle contractions causing the pelvic floor muscles to spasm
- Pelvic floor dysfunction is diagnosed by specially trained doctors and physiotherapists by using internal and external “hands-on” or manual techniques to evaluate the function of the pelvic floor muscles. They will also assess your ability to contract and relax these muscles. The bones and muscles of your lower back, hips, and sacro-iliac joints will be assessed as well since these joints can stress your pelvic floor muscles.
When your pelvic floor muscles are tight and weak, you physio will treat the tension before the weakness. Once your muscles have reached a normal resting tone, and are able to relax fully, their strength will be reassessed, and strengthening exercises are prescribed, if appropriate by your Physio.
Self-care is an important part of treatment. Avoid pushing or straining when urinating and ask your health care provider about how to treat constipation. Relaxing the muscles in the pelvic floor area is important, and doing reverse Kegels may be one way to help lengthen and relax these muscles. Using methods such as warm baths twice daily can also be helpful.
If you use medication like compounded vaginal or rectal diazepam, it can be quite helpful. Your doctor can prescribe you these. You can use these as local muscle relaxants in the vagina or rectum. Good posture to keep pressure off your bladder and pelvic organs, and other stretching techniques such as yoga, can be helpful to avoid tightening and spasms in the pelvic floor muscles as well.
Persistent pain education is an important part of treating pelvic floor dysfunction since the pelvic area is an area that we often hold our stress. Anxiety, stress and our thoughts, attitudes and beliefs can perpetuate the pain in our pelvis; understanding how our pain system works has shown to be an effective way of reducing the threat of ongoing pelvic floor dysfunction.
Kegels are NOT for everyone, sometimes doing Kegels can do more harm than help.
IF YOU THINK YOU ARE SUFFERING FROM ANY OF THE ABOVE OR HAVE QUESTIONS REGARDING ANY PELVIC PROBLEM.
PLEASE GIVE US A CALL OR BOOK YOUR APPOINTMENT AT PHYSIO NOW.
For Further information on the topic please refer Endometriosis Foundation of America