Pelvic Floor Dysfunction symptoms can range from subtle to severe with incontinence being the most commonly associated symptom. While symptoms such as urinary incontinence and fecal incontinence (also known as bowel incontinence), may be caused as a result of pelvic floor dysfunction, the most common cause of pelvic floor dysfunction seems to be the most ignored one when it comes to its treatment. In this blog, we will review:

  • Where the pelvic floor is
  • What pelvic floor dysfunction even means
  • How to recognize pelvic floor dysfunction by understanding the subtle and not-so-subtle signs and symptoms of pelvic floor dysfunction.

Where Is The Pelvic Floor?

While the focus of pelvic floor dysfunction is the pelvic floor generically speaking, the floor is not suspended in air and is a part of something bigger- the pelvis. Your pelvis on the inside has the floor and the wall and the two work together to provide stability of the INSIDE of the pelvis. The inside works with the outside to act like a bookend, keeping the content secure and stable. Unfortunately, when it comes to its treatment, the focus is put on relaxing or strengthening the inside muscles as if that will solve the problem!

To simplify and make you see the overall image of the connection, imagine a paper bag with a top. The OUTSIDE of the bottom of the bag is the area between the anus, the vagina/penis with muscles and sphincters, and the area in between them. The INSIDE of the bottom part is where quite a few muscles, connective tissues, and ligaments that hold the pelvis together lie. 

Pelvic floor model

(courtesy yourpaceyoga.com)

The front of the bag is the abdominal muscles, the sides of the bag are the oblique abdominal muscles, and the back of the bag is the lower back and the lower part of the mid-back muscles and spine.

The top of the bag is the abdominal diaphragm, and the contents inside the pelvis are:

  • The bladder
  • The uterus
  • The ovaries
  • The prostate
  • The intestines

Finally, the 4 corners of the bottom of the bag are the front and back part of the hips connected to the pelvis.

Diagram of the abdominal muscles

Side and Front of the ‘bag’

What Is Pelvic Floor Dysfunction?

Now that you know what the pelvic floor looks like, you can see that pelvic floor dysfunction is not always related to the bottom of the bag!! Anything that impacts all the parts of the bag including the connection of the sides of the bag to the bottom influences the integrity of the bag, lack of which is pelvic floor dysfunction. With that said, let’s explore some obvious and not-so-obvious symptoms associated with pelvic floor dysfunction so you can see that while it may be your incontinence, pelvic pain, or painful intercourse may be the leading factors to the diagnosis of pelvic floor issues, there is a high likelihood of having other symptoms that you and your provider did not connect as the preludes to pelvic floor dysfunction.

Pelvic Floor Dysfunction Obvious Signs and Symptoms

Pelvic floor dysfunction can be caused innocently from an accident, injury to other parts of your body, hypermobility which is a connective tissue disorder, or trauma (childbirth or not); it is not age or gender specific (yes, that is not what the literature says and that is because the info is old and outdated!).

Let’s say you had an accident that involved your knee which may have even been rehabilitated but the fact that only the knee was rehab’d (assuming that even took place) the seed for pelvic floor dysfunction is planted! You see, while the knee was hurting, you learned to move differently, your “blueprint “of movement got changed; how your knee had to ‘dance’ with the rest of the body, and how the rest of the body had to ‘dance’ with each other got altered. Just because the knee injury is addressed does not mean the ‘dance’ mechanics are restored to the original blueprint. 

In my opinion, it is our lack of complete treatment vs isolated body part treatment that is the leading cause of the vast number of people with pelvic floor dysfunction who walk around with different degrees of symptoms and not even being aware of it. The following symptoms are what most people either know or associate with pelvic floor disorder or pelvic floor dysfunction with the next section going over the subtle presentations of pelvic floor dysfunction.

  • Urinary incontinence
  • Fecal incontinence or Bowel incontinence
  • Prolapse of uterus
  • Bladder prolapse
  • Bladder pain syndrome or Interstitial Cystitis
  • Hemorrhoid
  • Feeling pain in the pelvic area with or without going to the bathroom

Pelvic Floor Dysfunction Subtle Signs and Symptoms

  • Lower back pain
  • Pain in the back joints of the pelvis (Sacroiliac Joints)
  • Pain in the front pubic area
  • Arched lower back
  • Slouched lower back
  • Slouched mid-back or hunchback
  • Military posture with the chest pushed out
  • A V-stance where the torso is positioned behind the hip joints seen on the side view
  • Chronic forward neck
  • Inability to bend down below the knees
  • Habitually standing on one leg with the other leg bent 
  • Chronic one-sided pain in the lower extremity
  • Hip pain on one or both sides

Addressing pelvic floor dysfunction by internal manual work is working on the floor when the ‘house’ is unstable. It is only a matter of time before the ‘house’ instability demands alteration of the tension and strength of the muscles inside the pelvis. An effective treatment is not just resolving the pain but removing the cause AND all that feeds the cause of the problem.

You don’t have to suffer from pelvic floor dysfunction and submit yourself to the limiting lifestyle that comes with it. If you have pelvic floor dysfunction and are not happy with your treatment results, if you don’t want to have internal pelvic treatment, and if this blog makes sense to you, contact me.

Dr. Shakib

Recommended Reading:

Can I Do Pelvic Floor Therapy On Myself?

What Is The Best Exercise For Pelvic Floor Dysfunction