You suffer from Pelvic Floor Dysfunction and nothing seems to be working. You are considering surgery but are not sure if that is going to put an end to your complaint. If your question is should you have surgery or are there alternatives? This blog is for you.

What Is Pelvic Floor Dysfunction?

Pelvic floor dysfunction is the dysfunction of the floor AND what influences and impacts the floor. Most people associate pelvic floor dysfunction with incontinence, either urinary or fecal incontinence, and think that is separate from Pelvic Floor Dysfunction. If pelvic floor dysfunction were the name of a book, it would have many chapters, most of which I think you would not associate with. You can read about the subtle and not-so-subtle signs of pelvic floor dysfunction in my blog.

Who Should Consider Pelvic Floor Surgery?

The groups of people who likely end up with Pelvic Floor Surgery are women who have experienced pregnancy, childbirth, and delivery with forceps, those who are obese, smokers, experienced trauma to the area, and the elderly. 

Bear in mind that you may not be a part of any of these groups and yet need reconstructive surgery. The main complaints are typically:

  • Moderate to severe urinary or fecal incontinence
  • Uterine or bladder prolapse
  • Severe hemorrhoids 
  • Interstitial cystitis (also known as pelvic pain syndrome)

While surgery may be the best first step to correct a prolapse, the treatment is not complete without strengthening the balance of your pelvis. An unstable pelvis means dysfunction and pain in the joints attached to it (spine, hips, and the joints that comprise the pelvis itself), and undue stress and pressure on the internal organs that the pelvis holds. (intestine, bladder, prostate/uterus, and ovaries)

The Most Missed Fact About Pelvic Floor Dysfunction

You ought to understand that the pelvic floor muscles are only one component of pelvic floor dysfunction, and the condition of the muscles inside the pelvis (pelvic floor and pelvic walls) is directly related to what is happening on the outside of the pelvis!! Look at the muscles inside your pelvis as a second layer of stability of your pelvis, working with the outside of your body like 2 bookends holding the contents packaged nicely in between.

What we need to ask is why these muscles inside the pelvis are tight or weak. I am not talking about what incident caused it but what did that incident do to make these muscles get tight or weak? We have to chase the why behind what we see to get to the root of the problem.

Internal manual work seems to be the main line of approach in treating pelvic floor dysfunction but how far do you think the index finger of the pelvic floor therapist is going to reach? What is the natural way to strengthen and relax those muscles? How does nature address the issue of balance between strength and tension? 

The answer is breathing and walking and this only happens correctly when we are posturally functional. Just because we can move does not mean we are moving functionally just as a drunk driver and a sober driver both drive but obviously, the quality of drive and the potential for accidents are changed with each type of driving.

What To Look For In A Pelvic Reconstructive Surgeon?

In my podcast, I interviewed Dr. Sam Siddighi, a Female Pelvic Reconstructive Surgeon from Loma Linda Hospital whom I strongly encourage you to listen to. We covered all major grounds related to the surgery, what to look for in a surgeon, and how to find a reliable and expert surgeon. I strongly recommend you pause and listen to this podcast interview.

What To Do After Surgery?

What people do after surgery typically is wait for the tissue healing to take place. Remember, there are tissues that have been cut and sewed and as such, it is highly important to take the nutrients necessary to facilitate the recovery of the tissue.


That typically includes an increase in protein and Vitamin C intake. Unless you have conditions that prevent you from taking them, that in my opinion is a good start.

Pelvis and Postural Stability:

This is a 2 layer approach, outside and inside muscles related to your posture. The type of muscles you find in your torso is referred to as musculoskeletal muscles. The only part of your body- on the inside- that holds the same type of muscles are your diaphragm and the inside of your pelvis. That is because we can control their function just as we have the ability (though most have forgotten how) to control the movement of our muscles on the outside.


As explained above, pelvic stability is the KEY to prevent future issues related to its instability such as other pelvic floor conditions, lower back pain, hip mobility and pain, knee pain, and poor posture to name a few. Strengthening of the lower ab, lower back, hips, and sacroiliac joints is a must BUT I am not talking about isolating the muscles or regions to work them out. For example, I am FULLY against doing abdominal crunches. My go-to exercises are those of developmental movement methods such as Dynamic Neuromuscular Stabilization or DNS.


The inside approach for the diaphragm at our clinic is the breathing therapy explained in the video below.


If you think you got this one down, you may be incorrect. Watch this video to see if you are doing the breathing this way. This is how all babies, you and I when we were babies too, our generations before and the generations to come breathe. We are programmed to do it this way and when we deviate from this way of breathing, the foundation is changed and the issues start and get fed!

When we breathe in biologically, we relax the muscles of the pelvic floor and when we breathe out biologically, we strengthen them which our attempt to do Kegels is all about. In my opinion, what we think we are doing with Kegels is wrong, and our sad attempt to fix something and not succeeding at it.


Strengthening The Inside Of The Pelvis Muscles:

I suggest you visit my blog page to read more about pelvic floor dysfunction and the most commonly asked online inquiries and contact my team for any questions you may have.

Dr. Shakib