What is the pelvic floor?
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The Pelvic floor is the collection of muscles within your pelvis which mirror the diaphragm in position. The pelvic floor has 5 general functions:
The 5 Functions of the Pelvic Floor
Support: The pelvic floor acts as a hammock to support organs such as your bladder, uterus, rectum, and abdominal organs
• Stability: Pelvic floor muscles help to support your hips, pelvic and low back
• Sphincter Function: The pelvic floor allows the control of the urethra and anus opening and closing (contraction and relaxation)
• Sump Pump: The Pelvic floor muscles help with circulation and moving lymph and blood through your pelvis back up to your trunk
• Sexual Function: Pelvic floor muscles assist in sexual arousal
What is Pelvic Floor Dysfunction?
Pelvic floor dysfunction can refer to any deviation from a pain free presentation of pelvic structures with appropriate continence, organ stability, sexual arousal and function. There can be an array of symptoms consistent with pelvic floor dysfunction including:
• Incontinence (leaking urine, gas or stool)
• Urgency with urination and defecation
• Pressure/heaviness/bulging sensation
• Organ prolapse
• Pain with intercourse or penetration
• Constipation
• Difficulty or lack of orgasm
********If you experience the above mentioned dysfunctions of the pelvic floor********* you are NOT alone!
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Urinary Incontinence affects 40% of women under the age of 65 and 60-70% of women over the age of 65 years old - Katarzyna et al 2016.
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Most women have some degree of Pelvic Organ Prolapse in their lifetime - Katarzyna et al 2016.
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1 in 4 women report moderate-severe symptoms of Urinary Incontinence, pelvic organ Prolapse, or fecal incontinence - Nygaard et al 2016
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65% of female athletes have stress urinary incontinence and/or urgency Schettino et al 2014
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52% of women have pelvic pain - Schelttino et al 2014
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18% of community dwelling men will experience urinary incontinence - Assad 2000
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11% of Male visits to their primary care provider is for pelvic pain
My certification in pelvic floor comes from Herman and Wallace Pelvic Rehabilitation Institute; many quotes were those brought to the attention of students during training; translation and application to physical therapy are in relation to my understanding and how I use this information in clinical practice. Original research is sited below.
References:
Carriere, B. (2006). The Pelvic Floor (pp. 81-97). C. M. Feldt (Ed.). Thiem
Magee, D.J. (2008). Orthopedic Physical Assessment. 5th Ed., Saunders, St. Louis. Massery, M., Hagins, M., Stafford, R., Moerchen, V. A., & Hodges, P. W. (2013). The effect of airway control by glottal structures on postural stability. American Journal of Physiology-Heart and Circulatory Physiology. Massery, M. (2016) Breathing & Posture; A Multi-system Event. Presented to the Physical Therapy Association of Washington, Tacoma, Washington, September 29, 2016.
Smith, M. D., Russell, A., & Hodges, P. W. (2006). Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy, 52(1), 11-16. Sperstad, J. B., Tennfjord, M. K., Hilde, G., Ellström-Engh, M., & Bø, K. (2016). Diastasis recti abdominis during pregnancy and 12 months after childbirth: prevalence, risk factors and report of lumbopelvic pain. British Journal of Sports Medicine, bjsports-2016.
Vleeming, A., Albert, H. B., Östgaard, H. C., Sturesson, B., & Stuge, B. (2008). European guidelines for the diagnosis and treatment of pelvic girdle pain. European Spine Journal, 17(6), 794-819.