The strength of the pelvic floor is a question that patients and health care providers treating pelvic floor dysfunction have; however the standards for what is considered a weak pelvic floor is rather low! It’s as if someone asks how strong your math skills are and the bar is grades D and F being low! Do we want to wait until we have a D to do something about it? How about people who used to be an A and are now are a C? Do we just wait until it drops to a D to get alerted that something is wrong? Frankly, most people look at the pelvic floor as if it is a stand-alone structure that can get fixed by just strengthening IT.

Too much misinformation is out there that needs to be cleared here and this comes from my perspective as a health care provider that works on the neuro-kinesiology of movement and postural correction. Bottom line is that no joint and no muscles will ever work optimally (therefore gets weak) when not in the optimal position or centration. In this blog, you will find out:

• Where is your pelvic floor?
• How does the pelvic floor get weak?
• How do you know if your pelvic floor is strong?
• Can you test it yourself?
• Who do you see to get it tested?
• Does that include an internal exam?

Where is Your Pelvic Floor?

Imagine a bowl with your thighs attached to it. the bottom of the bowl is the pelvic floor and the sides of the bowl are the walls of the pelvis. Can you have a bowl without sides? Then why are we so wrapped up with the floor and not looking at the whole picture? This is why our pelvic floor dysfunction cases are not resolving as they should!

Since the lower back spine and both thigh bones are attached to this bowl, the status of their presence is huge influencers on the state of the pelvic floor. When it comes to the treatment of the pelvic floor, while every health care therapist working on the area is fully aware of this fact, the majority of the work is done on the floor directly. I personally think the reimbursement by insurance companies and what THEY consider medically necessary as well as what the commonly understood regimen by the medical providers are the guiding force in determining the types of treatment rendered to patients with pelvic floor dysfunction. If we are too busy wanting to blend in and not ‘rock the boat’ as health care providers rendering these services, then how is the focus of our attention on our patients. Standards are great but are they complete and up to date? How can we add more steps to the treatment if we are too busy wanting to not be different? That is a whole different blog to write about I guess!

I have written a whole blog on where the pelvic floor is that I invite you to read.

How Does the Pelvic Floor Get Weak?

I have answered this question in my blog: How do pelvic floor muscles get weak. When thinking about the pelvic floor being muscles and what can cause its weakness, there are a few causes that simply make common sense. For instance, trauma to the pelvic floor makes total sense, but when we explore deeper to see what trauma means, we can see pregnancy and childbirth as a couple of reasons but why not every pregnancy and childbirth leads to a weak pelvic floor and how about when we do the splits (as kids or adults, no gender-specific)? Can you imagine playing any sports when you fall sideways and hurt your hip, knee, ankles, or lower back? What do we do about those who were on crutches for an injury? Do we look at those with bunions and hammertoes to see the status of their pelvic floor?

How about no injuries per se but a lifestyle of sitting? Who does not sit for an extended length of time anymore? Frankly, in my practice, I am seeing patients elementary school age with problems that I used to see in much older adults, and all because most of these kids’ lives have been spent in front of a monitor playing video games or engaging in social media. Frankly, regardless of the pandemic and the needed virtual education, our kids are in school using laptops which is actually much worse than desktops. I have done a blog on the pelvic floor and ergonomics that you may want to explore.

How Do You Know if Your Pelvic Floor is Strong?

LOL, I did a search to see what showed up and essentially it was all about incontinence and how you should squat down with a mirror to take a look at yourself ‘down under’ to see if anything pokes out, then feel yourself internally and externally!!

If Pelvic Floor Dysfunction was the name of a book with many chapters, incontinence is only one of them and this is not a one-chapter book, but more of a short story! There are plenty of people with pelvic floor weakness without having any incontinence; why do we wait until things start falling apart before we see the urgency to look into them? Why are we so wrapped up with labels instead of assessing functions?

I propose that everyone be assessed for pelvic floor health at every yearly exam from children to adults regardless of gender; I propose that every patient with lower extremity orthopedic and neurological issues receive pelvic floor treatment; I propose that every postural deviation including those with scoliosis receive treatment with no questions asked; I propose every patient with breathing issues, including asthma receive pelvic floor treatment; I propose all health care providers be educated about the pelvic floor and bring awareness to every patient they come across. It is because of public awareness that we see dentists regularly when the worst-case scenario is to pull all teeth and get a denture or implant. We are doing things backward and so poorly when it comes to the pelvic floor.

How do you know if you have a weak pelvic floor? Browse through my blogs and educate yourself because the health care community is waiting until it is too late. Watch the videos on my Youtube channel to find the answer to some of your questions and explore my website to learn about the pelvic floor and its many faces. You do not need to have internal manual work done to address your pelvic floor dysfunction and most exercises proposed for pelvic floor muscles are not enough. They are great for super weak muscles which led your doctor to refer you to a pelvic floor therapist, but do you want to wait until it is that bad that you get a referral? Do you want to get a D or an F to learn you need to attend classes and study? The choice is always yours but if you want to find out where you stand on the spectrum of function and strength for pelvic floor dysfunction, you can contact me any time.

Dr. Shakib