Are you experiencing period pain, low back pain, hip pain, incontinence, or constipation? You may have an issue with your pelvic floor.
Your pelvic floor is a group of muscles that sit in the bottom of your pelvis. They help to provide structural support to the pelvis, hips and pelvic organs (bladder, uterus, bowel), as well as helping to control the starting and stopping of bladder and bowel movements (wees and poos).
Like any muscles in your body, they can be tight and need releasing or lengthening, or be weak and need strengthening. It is common for us to see the presentations listed earlier in our patients, and they don’t know that their pelvic floor is a contributing factor. Keep reading to find out if you may have a pelvic floor dysfunction.
Weak/lengthened pelvic floor:
The most common cause of a weak pelvic floor is pregnancy and childbirth. The pelvic floor lengthens throughout pregnancy to make space for the growing foetus. The increasing pressure down on the pelvic floor for the duration of pregnancy, as well as a natural vaginal delivery, will cause the pelvic floor to lengthen. It is a natural and necessary part of pregnancy and birth. Problems can arise when the core, pelvic floor and abdominal muscles aren’t rehabilitated post pregnancy, so the weakness lasts longer and can lead to other problems.
Other causes of a weak pelvic floor are recent pelvic or abdominal surgery, menopause, chronic cough, and straining on the toilet.
If your pelvic floor is weak, it can’t provide support to the pelvic organs, such as the bladder, uterus (in those who have one) and bowel. This means you can be at risk of pelvic organ prolapse, or bladder or bowel incontinence.
The signs of a weak pelvic floor can include a dragging, bulging or heaviness in the pelvic region (lower tummy, vagina or rectum), an inability to control your bladder or bowel (unable to stop a wee flow, or unable to stop a bowel movement or passing wind), or low back pain.
Tight/overactive pelvic floor:
There are many causes of a tight pelvic floor. These include stress and anxiety, pelvic pain including period pain and endometriosis), birth trauma and scarring, hypermobility, elite athlete training, or holding their bowel or bladder regularly (e.g. not wanting to use public toilets).
When the pelvic floor is tight and can’t lengthen, like any tight muscle, it restricts the movement of the surrounding joints including pubic bone, sacro-iliac joints (SIJs) and hips. It also doesn’t allow for adjustment with pressure increases in the abdominal cavity.
The signs of a tight pelvic floor include low back pain, pelvic pain, hip pain, coccyx pain, painful sex, straining on the toilet, incontinence, and urinary frequency and urgency (symptoms similar to a urinary tract infection).
As you can see, there is some overlap in the symptoms of both a tight and weak pelvic floor. This means that it is important that if you suspect you have an issue with your pelvic floor, you should get an assessment done with a qualified health professional to see what kind of dysfunction you have.
Training your pelvic floor needs to be specific to what you need, to avoid increasing symptoms. If you have a tight pelvic floor but think it is weak, and you focus on strengthening it and end up making it tighter, you can cause an increase in your symptoms. Training your pelvic floor with a program designed specifically for you can assist with improvement of your symptoms.
At Premier Sports and Spinal Medicine, we have Osteopaths trained in internal and external assessment of the pelvic floor. They are able to assess if there is any dysfunction, as well as assess the spine, pelvis and hips, to find out exactly what is causing your problems. They can create a treatment plan for you based on what your body needs.
Continence Foundation of Australia, https://www.continence.org.au/about-continence/continence-health/pelvic-floor