Did you know that the concept of joint movement being controlled by muscles and ligaments applies to our bladder and bowel movements as well? These activities are controlled by a group of muscles conveniently called the pelvic floor muscles. They sit between the coccyx and the anterior pelvis creating a “bowl-like” structure and have a role in our normal micturition, excretion, and sexual functions. Yes, both men and women have these muscles and both are susceptible to under or overactivity just like any other muscle and can alter the normal flow of our bowel and bladder movements causing incontinence, constipation, leakage, and perineal pain. Dysfunction of these muscles are often seen after childbirth, surgical/traumatic/emotional events, pelvic organ prolapse, and diabetes. More so, pelvic floor dysfunction can be caused by repetitive tasks involving heavy lifting, straining, and advanced age.
Treatment for pelvic floor dysfunction does not have to involve surgery or medications; physical therapists are able to specialize in the treatment of pelvic floor dysfunction and assist those with varying diagnoses stemming from the pelvic floor muscles. Research has confirmed that conservative, physical therapy interventions demonstrate the best possible outcomes for those suffering from pelvic floor symptoms more so than surgical or pharmaceutical interventions.
How can pelvic therapy help treat pelvic floor dysfunction? It really all depends on what your unique body requires. Depending on what the therapist finds during your evaluation you may be treated with one of the following: soft tissue manipulation, biofeedback, neurological re-education, strengthening, bladder retraining, postural training, toileting training, and above all patient education on best lifestyle modifications to improve your quality of life! The important thing to remember is that simple “kegels” are not the answer to everything. It really is in your best interest to get assessed by a pelvic floor therapist to determine your needs.
Many shy away from speaking up about their incontinence and pelvic floor dysfunctions, but with a pelvic therapist you can be as open and comfortable as you want. There is no such thing as “too much information” during sessions. All questions and concerns will be answered with the most sincere and helpful information available. No shame, no awkwardness, they’ve heard it all and are more than happy to talk about “taboo” topics without hesitation.
Male or female, there is no reason someone should continue suffering from leakage, incontinence, or pain within their perineum and a doctor of physical therapy is the best professional to help you overcome these dysfunctions and improve your quality of life.
Santamaria is a pelvic floor specialist at Performance Plus Physical Therapy.