Pelvic floor dysfunction has a wide range of symptoms varying from erectile dysfunction in men and painful intercourse in women to chronic pain in the lower back and sacroiliac joints. Of course, in the case of sacroiliac and even chronic lower back pain, hardly anyone thinks of pelvic floor dysfunction treatment to get rid of these common conditions.

What Are the Symptoms of Pelvic Floor Dysfunction?

Pelvic floor dysfunction symptoms are so wide that most often unless it ‘screams’ to be a pelvic floor issue, they get missed. They can include:

• Weak pelvic floor muscles
• Painful intercourse
• Erectile dysfunction
• Urinary incontinence
• Fecal incontinence
• Pain in the testicle
• Pain in the vulva
• Pain around the anus
• Pain in bladder
• Chronic bladder dysfunction
• Interstitial cystitis (aka painful bladder syndrome)
• Chronic UTI or urinary tract infection
• Lower back pain
• Sacroiliac pain
• Lower mid back pain
• Hip(s) pain
• And bad posture

So many of these symptoms are fully missed by the general family practitioner, urogynecologist, urologist, or gynecologist because unfortunately recommendations and referrals are mostly made based on the specialist’s area of specialty. For instance, a woman with urinary incontinence may have a history of a chronic lower back condition that had it been treated correctly as a symptom of pelvic floor dysfunction, she would not have developed urinary incontinence.

Then there is a hush-hush attitude about painful intercourse or erectile dysfunction that ’no-one’ talks about and yet, they are all symptoms of something bigger. Here is a video on pelvic floor dysfunction that explains it all.

So now you may be surprised to hear that your chronic lower back pain BEFORE that incontinence actually needed more attention than it was given and are wondering what to do about your incontinence (or fill in the blank from one of the symptoms listed above).

First Step in Treating Pelvic Floor Dysfunction

The first step after finding out you have pelvic floor dysfunction is NOT to seek a pelvic floor therapist! As someone who treats pelvic floor dysfunction, I can tell you that there are plenty of therapists that charge an arm and a leg to essentially manually get into the pelvic inlet through the vagina or anus and do a mediocre job of working on those muscles (sort of like what a massage therapist does for lower back pain) in an attempt to work on Kegels with the patients to strengthen the pelvic floor muscles.

Then there are therapists that do a bit more than just ‘massaging’ the area and practicing Kegel exercises with their patients by incorporating breathing into the exercise. I am all for that but that is still NOT enough!

There are therapists that bring in tools and gadgets into each session to bring awareness to the area of the pelvic floor so patients can understand what they are asked to do. I am all for that too- after all, if the brain can’t see or understand what you demand of it, it can’t make it happen!

…so what is the first step in treating your pelvic floor dysfunction? It is to find the right therapist! The right therapist is the most comprehensive therapist! That means the one who has been in practice for a long time, who knows how to extrapolate the subtle clues and signs in consultation and is used to the little ‘sneaky’ telltale signs of pelvic floor dysfunction. When it comes to pelvic floor dysfunction, just know the internal manual treatment is NOT enough.

While most pelvic floor therapists are physical therapists, chiropractors, and registered nurses trained in the field are also other great resources to seek care from. Be aware that not all physical therapists, chiropractors, and registered nurses are qualified therapists to treat your pelvic floor dysfunction so do your due diligence to find the right therapist with the holistic approach to treating your pelvic floor dysfunction.

Uncomfortable About Manual Treatment of the Pelvic Floor?

Most people are not crazy about the manual treatment of their pelvic floor dysfunction. After all., manual treatment means going inside through the vagina and/or penis to address the area. In our practice, almost always, we treat patients with pelvic floor dysfunction without having to go ‘inside’ to work on the muscles of the pelvic floor. To understand more about what the anatomy of the area looks like, I suggest you read this blog. 

At my clinic, I understand how uncomfortable it is for my patients to endure the manual work on the most private part of their body; since historically, most patients with pelvic floor symptoms have had a bad experience in their past which the treatment can exacerbate the emotional burden as well, I skip the ‘internal’ work to bring relief to some of the symptoms patients experience.

For instance, while we can manually address the internal oblique muscles of the pelvis through the vagina or anus (in men), it is also easily accessible on the outside and therefore has no requirement to do the internal work.

In teenagers and young adults, this is essentially the only method of treatment I use to address the pelvic floor dysfunction and get great results. Please understand that the external or internal work doesn’t provide the full value without incorporating breathing into the picture. The type of breathing I am talking about is NOT what we see quite a bit of on social media, teaching people how to strengthen the pelvic floor.

My go-to type of breathing is what we all did as babies. No baby got the memo to breathe a specific way; no training was done to learn how to breathe. We breathed a certain way, AUTOMATICALLY, which is seen all over the world despite our many differences. This type of breathing is discussed in this video!

What is the Best Treatment for Pelvic Floor Dysfunction?

The best and most comprehensive treatment for pelvic floor dysfunction regardless of the symptoms must include posture and movement. If your pelvic floor is weak, or spastic, if the internal organs within the pelvic girdle are prolapsed or prone to chronic infection due to the positioning of them inside the girdle, the integrity of the ‘bottom’ portion of your body, the pelvic floor, absolutely and positively depends on the areas the floor is connected to. This is explained clearly in the blog by Irvine Spine and Wellness Center: The Best Treatment For Pelvic Floor Dysfunction. The anatomy of the area, the areas that directly influence the area, and the proper approach to strengthening the area are clearly explained. You cannot maintain a strong ‘floor’ without building strong walls and that is exactly why internal manual treatment of the area is not enough.

At our clinic, after carefully listening to the patient during consultation, reviewing the patients’ history of treatment (most patients have gone through multiple providers and have had many procedures done), the patient’s pelvis is examined externally, that includes the adductor muscles and the hip stabilizers that are known to contribute to a weak pelvic floor but are hardly assessed and treated for dysfunction. Postural Neurology, to find out what portions of the brain with regards to movement and posture are weak and therefore not producing the stronghold in posture, as well as functional movement and developmental kinesiology assessments are performed.

Let me digress for a little bit: Your brain controls everything including your posture and movement. If we find out what part of your brain with regards to movement and posture are weak, with specific exercises for those areas, we can strengthen them. Now, think about how every baby on this planet goes through the same developmental stages of movement regardless of what part of the world they are from. That is because we are hardwired that way and the blueprint of movement is uploaded to our brain as fetuses.

You see, we are born with a blueprint of movement called Homunculus which gets detailed the first 2 -4 years of our lives. This map can change depending on our lifestyle, habits, injuries, and needs. Once, through postural neurology, we see what parts of the brain command for balance and posture are compromised and fix them, we need to go through the movement process to bring back the synchronicity and harmony in movement back.

If movement is a concert, the brain is the conductor, the map of posture and balance, the homunculus is the musical note that the conductor goes by and the body parts are the musicians. The musicians have to practice together to know when to come in and when to chime out. Regardless of ‘who’ is playing, the other musicians still play in the background! Right?

The best treatment for pelvic floor dysfunction must include movement and posture. At our clinic, we assess, if strengthening of the floor itself is needed, we may do myofascial release of the pelvic floor muscles, we strengthen the pelvic floor using the Emsella chair, we teach biological breathing, and go through postural neurology and developmental kinesiology exercises to tackle the pelvic floor dysfunction for good.

Pelvic floor dysfunction has impacted way too many people and we are seeing patients as young as teens. We have seen a drastic rise in men and non-pregnant women, the underweight, and non-smokers. The old stereotype is no longer applicable. The treatment should not have to be internal manual work and should never stop at the pelvic floor area.

For any questions, please do not hesitate to contact me.