By: Lisa O'Brien PT, DPT, Cert. DN
Pelvic floor dysfunction is a very common problem for people of all ages. Although it is more common in women, men can have pelvic floor disorders as well. So what is it? Everyone has heard about the dreaded spritzing after sneezing, coughing or even jumping up and down in excitement. With severe cases, people may just move the wrong way and oops! Many women, especially after having children, think it is normal to have occasional leakage but this is not the case at all. Pelvic floor dysfunction typically occurs because of weakness in the muscles of the pelvic floor likely caused by passive insufficiency. Passive insufficiency is defined as the inability of a muscle to contract normally due to excessive stretching of the muscle. This stretching can be secondary to childbirth, excessive straining to use the bathroom or injury/surgery (mesh placement or sutures from surgery).
Symptoms associated with pelvic floor dysfunction include lower urinary tract symptoms, bowel symptoms, prolapse, and pain. So how do you know if you are suffering from this type of disorder? Typically symptoms develop slowly and may not be noticeable at first. As time goes on, these symptoms can worsen which decreases overall quality of life due to fear of leaving the house secondary to excessive leakage without warning. The most common symptoms of the urinary system are leaking, urgency, hesitancy, bladder and urethral pain. Common symptoms of bowel dysfunction include constipation, incontinence, staining and rectal pain.
The pelvic floor is a dome-shaped muscle complex consisting of many bones, muscles and connective tissues. These structures work together to support organs within the pelvis and lower abdomen, maintain continence and allow for bladder and bowel emptying. A normal functioning pelvic floor requires relaxation and coordination of muscles including those of the urinary and anal sphincters. Therefore, impaired ability to relax or contract the appropriate muscles leads to incontinence (lack of voluntary control over urination or defecation). It is important to realize that the pelvic floor is not the only problem in most cases. One study found that tight, weak, spasmed and uncoordinated muscles of the pelvic floor, lower abdominals, lumbar spine and hips were the main cause of a wide range of pelvic floor symptoms. The lower extremities, hips, abdomen, pelvis, and spine are all connected to work together as one kinetic chain. Dysfunction in one or more of these areas may cause overcompensation and dysfunction of associated muscles including those located in the pelvic floor.
Pelvic floor disorders are more common than you think, with over 76% of the population suffering from urinary tract disorders and 16 per 100,000 with defecatory issues. So what is the big deal? These disorders can worsen over time and that mild spritz can turn into moderate to severe leakage if not treated by a licensed physical therapist. Furthermore, a person who has one type of pelvic floor dysfunction, is more common to develop another form if they ignore initial signs and symptoms. For example, a study showed that 82% of people with defecatory disorders also suffer from 2 other urinary problems and 57% with 4 or more symptoms of urinary dysfunction. The moral of the story is, if you are dealing with this on a daily basis a physical therapist can help! There are many exercises that a physical therapist can give you to strengthen muscles needed to stop the dreaded occasional spritzing and decrease the chance of symptoms worsening over time.
So why is it important to see a physical therapist for pelvic floor dysfunction? How can they help? Yes, kegals help with the ability to contract the pelvic floor but they are only part of the answer. Most people think they are capable of performing a kegal, but many women need specific instruction to perform a pelvic floor contraction. In fact, most women do this exercise incorrectly and strain instead of contracting the pelvic floor muscles. If these exercises are performed incorrectly it can result in descent of the perineum, which will eventually worsen symptoms if continued. A physical therapist can use cueing and other strategies to optimize lumbopelvic and spinal function and to improve bowel, bladder function. You can also expect to incorporate other exercises to strengthen and stabilize the core to allow for return to normal functioning with all daily activities.
At Professional Rehabilitation Services we pride ourselves in distinction and providing a higher level of care. So if you or someone you know has been diagnosed with pelvic floor dysfunction or another musculoskeletal problem and would like to know more about physical therapy options including dry needling, seek the consultation of a physical therapist at one of our six locations or see your physician for a referral to one of our facilities. Physical therapy is a regularly covered service by most health insurance plans. Free 15-minute consultations are a great way to identify if you are a candidate for treatment! At Professional Rehabilitation Services, we treat a wide variety of musculoskeletal and neurological conditions using the latest in evidence based therapies provided by highly credentialed physical therapists. Professional Rehabilitation Services has six convenient locations in Pawleys Island, Murrells Inlet, Surfside Beach, Myrtle Beach, Conway, and Little River. For further information on this or other related topics you can contact Richard DeFalco, DPT, OCS, CSCS, CWcHP at Professional Rehabilitation Services (Myrtle Beach) (843) 839-1300, Brian P. Kinmartin PT, DPT, MTC, STC, OCS, CWcHP (Pawleys Island) (843) 235-0200, Richard A. Owens, MPT, OCS, Cert. SMT, CWcHP (Surfside) (843) 831-0163, Jill P. Phelan, PT, DPT (Conway) (843) 773-3031, Lisa O'Brien, PT, DPT (Murrells Inlet) (843) 314-3224, Karl Ehlers, PT, DPT (Little River) (843) 281- 4222 or visit our website at www.prsrehabservices.com where you can learn more about the company and even download a referral form for your physician to fill out. You can also call and schedule a free 15-minute consultation!