Pelvic Floor Dysfunction
Pelvic floor dysfunction describes the weakening or tightening of pelvic floor muscles. The pelvic floor is made up of ligaments, muscles, and tissues that surround the pelvic bone. These structures attached to the front, back, and sides of the bone, as well as the lowest part of the spine, called the sacrum. The pelvic floor serves to support the organs in the pelvis including the vagina, prostate, uterus, rectum, bladder, and urethra. With pelvic floor dysfunction, when the muscles tighten or spasm, many people have difficulty with urination and bowel movements. Additionally, weakening of the muscles can cause the organs of the pelvis to drop and press down on the rectum and bladder.
There are many types of pelvic floor dysfunction and they can affect people differently. Below is a list of several common types of pelvic floor dysfunction:
Coccygodynia: pain in the tailbone that worsens during and after bowel movements.
Cystocele: involves the bladder dropping and pushing into the vagina.
Enterocele: involves the small intestine descending and pushing into the vagina, forming a bulge.
Levator syndrome: involves the pelvic floor muscles spasming after bowel movements. This type of pelvic floor dysfunction can cause lasting dull pain or achy pressure high in the rectum.
Obstructed defecation: occurs when stool enters the rectum, but the body cannot fully evacuate the bowels.
Paradoxical puborectalis contraction: involves a pelvic floor muscle called the puborectalis contracting. When this occurs, passing stool may feel like pushing against a closed door.
Pelvic organ prolapse: refers to the pelvic floor stretching and the pelvic organs dropping as a result of age, childbirth, or a collage disorder.
Proctalgia fugax: involves painful spasms of the rectum and muscles in the pelvic floor.
Pudental neuralgia: irritation or damage to the pudendal nerves, which help the pelvis function.
Rectocele: involves tissue from the rectum protruding into the vagina. Stool may get caught in this pocket, forming a bulge in the vagina.
Urethrocele: refers to the urethra pressing into the vagina.
Uterine prolapse: refers to the uterus descending and pushing into the vagina.
At Aptiva Health, we provide immediate appointments with our Physical Therapy department and General Medicine team to evaluate, diagnose, and treat pelvic floor dysfunction.
Causes & Symptoms
Pregnancy. A well known cause of pelvic floor dysfunction in women is pregnancy. Often women experience pelvic floor dysfunction after giving birth due to the pelvic floor muscles and tissues becoming strained during pregnancy, particularly if labor was long or difficult.
Heredity. Pelvic floor dysfunction can run in your family, which makes it a potential hereditary condition. Research is currently underway to determine potential genetic causes of pelvic floor dysfunction.
Trauma. Pelvic floor dysfunction can occur due to traumatic injuries to the pelvis as can occur in motor vehicle collisions, horse riding accidents, and slip and falls.
Overuse. As with other muscles and tissues in the body, overuse can be a cause of pelvic floor dysfunction. Frequent trips to the bathroom or pushing with too much force during bowel movements can lead to poor muscle coordination and cause pelvic floor dysfunction.
Overweight. A growing cause of pelvic floor dysfunction is being overweight, particularly obesity.
Age. As we age, muscles and tissues begin to weaken, which can result in pelvic floor dysfunction.
Chronic stress. A known contributing factor to pelvic floor dysfunction in women is chronic stress.
Sexual trauma. Sexual abuse and trauma have been linked to pelvic floor dysfunction in women.
Hormonal Changes. Female hormonal changes from menopause, hysterectomy, or radiation from any cancer treatment have been known causes of pelvic floor dysfunction.
Below are some common symptoms associated with pelvic floor dysfunction in women:
Frequent bathroom visits. Some people may also feel like they need to force a bowel movement or stop and start frequently while making a bowel movement.
Constipation, or a straining pain during your bowel movements.
Straining or pushing really hard to pass a bowel movement, or having to change positions on the toilet or use your hand to help eliminate stool.
Leaking stool or urine (incontinence).
Painful urination.
Ongoing pain in the pelvic region, genitals or rectum — with or without a bowel movement.
Below are some common symptoms associated with pelvic floor dysfunction in men:
Erectile dysfunction can be caused by pelvic muscle tension or pain related to pelvic floor dysfunction.
Urinary dyfunction can be caused by pelvic floor dysfunction. This describes a condition associated with leaking urine after peeing or incontinence and other bladder and bowel issues.
Prostatis. Sometimes, pelvic floor dysfunction can mimic the symptoms of prostatis (an infection or inflammation of the prostate).
Treatment at Aptiva Health
At Aptiva Health, we treat pelvic floor dysfunction in our physical therapy department. The goal in treating pelvic floor dysfunction in physical therapy is to improve the strength and function of the pelvic floor muscles and alleviate pain, weakness, and dysfunction in the muscles.
During treatment, our physical therapists access the muscles through the vagina and make manipulations on this areas to improve strength and functioning. The physical therapist may also stretch the muscles if they are short and contracted or apply resistance to improve strength if they are weakened of dysfunctional. Pelvic floor physical therapy is recommended as first-line remedy for many disorders of the pelvic region. Both men and women with weakness in pelvic floor muscles can perform exercises to strengthen the floor and enhance bladder and bowel control.
Common physical therapy techniques used to treat pelvic floor dysfunction include:
Education
Patients are taught more about their pelvic anatomy and how different elements work alone and together. They also learn how hygiene and habits affect their symptoms.
Pelvic floor exercises
Patients learn to contract and relax pelvic floor muscles relative to other muscles. They also learn breathing and timing techniques that make the exercises more effective. The exercises are designed to stretch tight muscles, strengthen weak muscles and boost flexibility.
Manual therapy
A physical therapist uses hands-on massage and stretching to improve blood circulation, mobility and posture.
Electrical stimulation
Low voltage electric current is used to teach patients how to coordinate the contractions of their muscles, helping to reduce pain and muscle spasms. A therapist may perform the treatment in the office or provide electrical stimulation unit to be used at home.
Vaginal dilators
Tube-shaped plastic devices are used to help women learn to relax their pelvic muscles for easier penetration. The progressively sized tools are typically inserted into the vagina to help stretch tight tissues. Women who have undergone gynecological cancer treatment usually find vaginal dilators helpful in vaginal rehabilitation after their treatment.