Maureen Mason, DPT
This is the same question I had several years back even coming out of my program when first introduced to Pelvic Floor Physical Therapy. Surprisingly enough, most Physical Therapy Programs offer little education on the Pelvic Floor throughout their curriculum. If seeking a specialist in this field they will have (should DEFINITELY have) several years of additional continuing education in this specialty in order to treat your pelvic floor diagnosis/symptoms appropriately.
Unfortunately, the Pelvic Floor is often a forgotten land. Rarely will someone go to the gym to work on their Pelvic Floor, or seek nutritional advice to improve this part of their body. However, if you have a specific “problem” with anything associated with your Pelvic Floor then it is THE MOST IMPORTANT part of your body and you will do ANYTHING to get rid of your symptoms, whatever they might be.
I think it’s important to note that both women and men have a Pelvic Floor, and can have pain/symptoms associated with this area. They are essentially made up of the same structures with differences in external parts. Statistically (according to the Journal of American PT Association – Sept 2012, and what we normally see in our clinic today) the ratio of female to male patients seeking help with Pelvic Floor symptoms is approx. 92% female to 8% male.
Anatomically speaking, your Pelvic Floor, sometimes referred to as the Pelvic Diaphragm, consist of three layers of several very important muscles (seen in images below) attaching to your sacrum and iliac bones (your hip/pelvic bones).
Superficial perineal layer: Bulbocavernosus, Ischiocavernosus, Superficial transverse perineal, external anal sphincter (EAS).
Deep urogenital diaphragm layer: Compressor urethra, Ureterovaginal sphincter, Deep transverse perineal
Pelvic diaphragm: Levator ani: pubococcygeus (pubovaginalis, puborectalis), iliococcygeus, Coccygeus/ischiococcygeus, Piriformis, Obturator internus
Surprising to see how much is “down there” right? And that isn’t including organs, blood supply, or external genitalia.
The Pelvic Floor has many functions which make all these muscles very important. To name a few it helps supports pelvic floor organs, assists in urinary and fecal continence, aides in birthing children for women, aides in sexual performance, stabilizes connecting joints, and supplies and acts as a venous and lymphatic pump for the pelvis overall.
And this is all assuming everything is working properly of course!
Now that we can identify WHAT and WHERE the Pelvic Floor is, we can discuss some of the MANY diagnosis and symptoms that can occur effecting this area and that can alter, most of the time SEVERELY alter, our lives in many ways.
Urinary Incontinence – Involuntary loss of urine
Stress urinary Incontinence – Involuntary loss of urine with stress (i.e. cough, laugh, sneezing, exercise)
Encopresis – Involuntary loss of stool
Pelvic Organ Prolapse – Cystocele, Rectocele, Enterocele, Uterine Prolapse, Rectal Prolapse.
Dyspareunia – Pain with Intercourse
Vulvodynia/Vestibulitis – Pain/Inflammation at the Vulva
Interstitial Cystitis – pain, pressure, or discomfort associated with the bladder
Rectus Diastasis – Separation of Rectus Abdominus resulting in pain or dysfunction
Constipation/Irritable bowel Syndrome/Other
Endometriosis
Pubic Bone Pain/Tail bone pain
PGAD – Persistent genital arousal disorder
Post Prostatecomy symptoms
Penile Pain
Other post-partum complications/symptoms
General Pelvic instabilities
Of course I could go into specific details about each and every diagnosis listed here (which I plan to do in future blogs, especially if feedback requests for info on a certain topic) yet the important KEY POINT to take from this in general is your Pelvic Floor is NO LONGER a “forgotten land” and many times the answer that’s normal at your age, It’s all in your head, you just need to relax, and/or You just had a baby not too long ago, give yourself more time is NOT the end all. There is help!
I feel like I should say that again, THERE IS HELP! Specialists that CARE and can aide in decreasing any symptoms you may have.
So at this point you might ask…What is the first step? Who can I talk to? Who can I contact for more information in my area?
Great question! First speak with your physician about seeing a Pelvic Floor Physical Therapist. If you are in our area please don’t hesitate to contact us for any information needed or to set up an appointment for an evaluation.
There are also thousands of pelvic floor therapist around the world.
Here are a couple websites that can help you find one is your area.
Please contact FunctionSmart Physical Therapy for any questions you may have!
Visit our website for more information: http://www.functionsmart.com/