The pelvic floor is a region of the body comprised of muscles, bones, tendons, ligaments, joints, fascia, nerves, blood vessels, visceral organs, and skin. Both men and women have pelvic floors. The pelvic floor is located at the bottom of the torso and it acts as a sling or hammock to support the organs and physiological function of the organs held within this region, including bowel, bladder, and genital function.
The pelvic floor is made up of over 20 different muscles that move and function as a unit. To have a properly balanced and functioning pelvic floor, there must be adequate strength, movement, and pressure management. The pelvic floor is designed to provide support, as it acts as the postural alignment for the pelvic organs, and stability, as it is the bottom of the trunk/core muscles. It provides sphincter control for bladder and bowel function, acts as a drainage system for fluid and the lymphatic system, and is responsible for sexual function.
What are Pelvic Floor Disorders?
A pelvic floor disorder occurs when the functioning of this region of the body is not optimal. When there is a dysfunction with the support or stability of the pelvic floor, there may be organ prolapse (ie fallen bladder or uterus), core instability, diastasis recti/mommy tummy, as well as, low back and pelvic pain. Pelvic floor disorders also include sphincteric problems, such as urinary or fecal incontinence, overactive bladder, retention, and constipation, sexual problems, such as pain during intercourse and infertility, and drainage problems, causing such concerns as pelvic congestion and lymphedema.
This is an area that many women and men feel a disconnect with and do not know where to go to seek help. Often when individuals are experiencing difficulty and have concerns like pelvic pain, dysfunction, and incontinence, they believe that the only ways to help are to “live with it,” take medication (that has multiple side effects), or have surgery (which may or may not ultimately help). Many times, when an individual has pain in the pelvic floor, multiple tests are ordered and the pain is misdiagnosed without really understanding the problem. On some occasions, a patient is told to do 100 kegels a day and that should solve the problem. But, what if the problem isn’t weakness, but tightness, malalignment, or compression? What if you are not utilizing the correct posture and musculature to help yourself? Everyone should not get the same “dose” of an exercise nor should everyone be doing strengthening using this method.
How can Physical Therapy and CranioSacral Therapy help?
Since the pelvic floor is comprised of muscles, tissue, bone, and fascia, and is an area that moves, this is an area in which Physical Therapy and CranioSacral Therapy can help. The pelvic floor can become malaligned impacting function. Muscles internally and externally can become tight or weak through posture, position, childbirth, trauma, overuse/too much pressure, just like the other muscles of the body. The muscles attach to bones and can pull the bones out of alignment, the muscles and the bones can compress nerves and blood flow, causing pain and dysfunction, the ability to contract the pelvic floor can be compromised decreasing stability and control.
When treating the pelvic floor, it is important to look at structure and function. What is the posture of the muscles, bones, tissue, and fascia in the pelvic floor and the entire body? What does the strength look like? What are the patient’s concerns (pelvic pain, pain with intercourse, incontinence, weakness, prolapse)? What is the patient’s history (childbirth, trauma, heavy lifting, endometriosis, surgeries)?
It is hard to function in an optimal state of wellness when you are experiencing pelvic floor dysfunction or pain and it is also hard to get well, when you don’t know that there is help for your symptoms. By assessing the entire body and the pelvic floor, a Physical Therapist and CranioSacral Therapist is able to create an individualized plan of care to address a patient’s weakness, tightness, malalignment, posture, scar tissue adherence, organ dysfunction, fascial restrictions, lymph/blood flow, nerve compression, and overall well-being.
When helping individuals with pelvic floor disorders, it is important to look not just at the physical symptoms, but also at the emotional symptoms CranioSacral Therapy can help the body to release somatoemotional experiences (from life experiences or trauma, where emotional symptoms that the body holds on to can create physical symptoms) that may be limiting progress and/or causing an individual to be stuck in a pain cycle. Working on connecting within, releasing these emotional experiences, and on balancing the mind, body, and spirit can also assist with improving pelvic floor disorders.
If you are experiencing pelvic floor pain, weakness, incontinence, and dysfunction, please know that hands on, manual therapy with Physical Therapy and CranioSacral Therapy can help to decrease your symptoms and improve your quality of life. Find the balance within your body and work to restore the health of your pelvic floor and your physical and emotional well-being.
(Featured in Natural Awakenings, November 2017)