Everything you need to understand about the pelvic floor and pelvic floor dysfunction.

The Pelvic Floor is a collection of muscles, nerves, blood vessels and fascia that forms the base of the pelvis.  The Pelvic Floor Muscles stretch from the pubic bone to the coccyx (tailbone) and from side to side to form a hammock-like support.  They work together with the Transversus Abdominis (TA), Multifidus and the Diaphragm to support and stabilise the spine and to control abdominal pressure when we lift or exert effort.

The Pelvic Floor Muscles help to support the bladder, bowel and uterus as well as help to maintain bladder and bowel control.  They support the growing baby during pregnancy and assist during the birthing process.  They also play an important role in sexual sensation and function.

There are several risk factors associated with the development of a Pelvic Floor Dysfunction.  Some of the risks listed below can create a downward pressure on the Pelvic Floor, weakening and stretching it over time.  This decreases its ability to support the bladder and bowel, and sometimes the uterus.  Progressive pressure may lead to a prolapse of one of the pelvic organs or to other symptoms such as incontinence.

Risk Factors:

• Pregnant women – due to hormonal influence on soft tissues and pressure due to growing bub
• Women who have recently, or ever, had a baby (1 in 3 women will have some degree of urinary incontinence)
• Maternal factors – age, tissue quality, size of baby > 4kg
• Obstetric interventions – use of forceps, long 2nd stage of labour, posterior presentation
• Mechanism of injury – ligament/muscle avulsion, nerve compression/avulsion
• Elite athletes such as runners, gymnasts, trampolinists
• Not keeping the Pelvic Floor Muscles active
• Being overweight, obese or BMI over 25
• Regular heavy lifting (work/gym)
• History of back pain, previous injury to pelvic region
• Ongoing constipation/straining to empty bowels
• Chronic cough/sneeze, including asthma, smoking, hay fever
• Going through or have gone through menopause
• Women who have undergone gynaecological surgery

What are some signs and symptoms of a Pelvic Floor Dysfunction?

You may experience symptoms such as urinary incontinence, faecal incontinence, an overactive bladder, a bulging pressure within the vagina (prolapse), chronic pelvic pain, and painful sex.  If you are experiencing any of these symptoms, it is highly recommended that you speak to a Women’s Health Physiotherapist whom will be able to perform an assessment and provide an appropriate treatment plan to improve the condition.  It is important to know that help is available and that these symptoms are not an inevitable part of pregnancy and childbirth.

What can I do to help prevent a Pelvic Floor Dysfunction?

Ideally, in the pre-conception phase, a woman can be assessed by a Women’s Health Physiotherapist to assess the current functioning status of her pelvic floor and core abdominal muscles.  If any issues present, a treatment and exercise program can be developed then to improve these muscles and prepare the woman prior to pregnancy.  Pelvic Floor Muscle training should continue through pregnancy and then into the post-natal period for an optimum outcome.

If you have any questions or concerns, please do not hesitate to contact ATUNE Health Centres and ask to speak to a Women’s Health Physiotherapist.

Article by Erin Gander, Physiotherapist at ATUNE Health Centres