When it comes to health, many of us focus on big-ticket items like heart health, diet, and exercise, but there’s one area that often gets overlooked: the pelvis and pelvic floor dysfunction. The pelvic floor plays a crucial role in our overall well-being, and dysfunction in this area can lead to a variety of issues beyond just incontinence. You don’t have to be a woman who has given birth and now is having pelvic floor issues. That might have been the stereotype of the past but today, due to our lifestyle and habits, there are plenty of women who have never given birth and certainly people of all ages and gender that experience pelvic floor dysfunction. In this blog, we’ll explore how you can tell if you have pelvic floor dysfunction, with a focus on the musculoskeletal system and posture.
What is Pelvic Floor Dysfunction?
Before we dive into the signs of pelvic floor dysfunction, let’s get a clear understanding of what it is. Your pelvic floor is a group of muscles that form a hammock-like structure at the base of your pelvis. These muscles support your bladder, bowel, and uterus (in women). Pelvic floor dysfunction refers to a range of problems involving the pelvis and its floor. While incontinence is one common symptom, it’s important to know that pelvic floor dysfunction includes a broader range of issues, including pain, discomfort, and musculoskeletal problems. You may want to pause and read the blog on pelvic floor dysfunction and what it is all about that I have written.
What Are The Symptoms of Pelvic Floor Dysfunction?
Most clinicians and patients associate pelvic floor dysfunction with incontinence, pelvic pain, erectile dysfunction, or issues with urination and defecation and the majority don’t realize that the following list are also indications of pelvic floor dysfunction. In fact, how to tell if you have pelvic floor dysfunction is one of the most commonly asked questions in my office. So here we go with the comprehensive checklist:
Pelvic Pain:
One of the primary signs of pelvic floor dysfunction is pelvic pain. This can manifest as a dull ache, sharp pain, or discomfort in the lower abdomen, pelvis, or genitals. The pain may be constant or come and go.
Lower Back Pain:
Pelvic floor dysfunction can affect your lower back as well. If you’re experiencing chronic lower back pain, especially if it’s accompanied by pelvic discomfort, it could be a sign of this condition.
Posture Problems:
Pay attention to your posture. Poor posture means unstable pelvis and once the ‘house’ is unstable, the ‘floor’ instability is present.
Pain During Intercourse:
Pain or discomfort during sexual intercourse can be a sign of pelvic floor dysfunction. The position and the timing of the pain with the sexual position allows the trained pelvic floor therapist (not necessarily and physical therapist) to see more into what exactly is happening.
Frequent Urination or Urgency:
While incontinence is a well-known symptom, frequent urination or a sudden urge to urinate can also indicate pelvic floor dysfunction. You might feel like you have to rush to the restroom frequently. You may visit my blog posts to learn about the different types of incontinence.
Difficulty Emptying the Bladder or Bowels:
Struggling to fully empty your bladder or bowels can be another indication of pelvic floor dysfunction. You might feel like you can’t completely empty these organs, leading to discomfort. This is an indication of the muscles of the inside of the pelvis not being relaxed due to several reasons. The biggest mistake is when we address ‘massaging’ these muscles (to the best of reach) vs. addressing the cause of their tension as the solution.
Pain While Sitting:
If sitting for extended periods becomes painful, especially around the pelvic area, it could be related to your pelvic floor muscles not functioning correctly. This may be a sign of Pudendal Neuralgia where the nerve and one or more of its branches are irritated. You will find blogs written on Pudendal Neuralgia among my other blogs on my website.
Muscle Tension:
Some people with pelvic floor dysfunction experience increased muscle tension in the pelvic region. This tension can contribute to pain and discomfort. The question to always ask is why are these muscles tense to begin with! Unless we find the cause of tension, the solution is temporary because the tension and the weakness of the pelvis are the cause of pelvic floor dysfunction when it comes to the musculoskeletal component of pelvic floor dysfunction.
Hip Pain:
Chronic or recurring hip pain can be an indirect sign of pelvic floor dysfunction. The pelvic floor muscles are closely interconnected with the hip muscles. Your hip joint is comprised of the lower extremity and pelvis; in fact, the socket part of this ball and socket joint IS your pelvis. While not every hip pain means pelvic floor dysfunction, if you have chronic hip pain, you most likely have pelvic floor dysfunction.
Sacroiliac Joint Pain:
The sacroiliac (SI) joint connects the base of the spine to the pelvis and is crucial for stability during movements like walking and standing. Pelvic floor dysfunction can disrupt the alignment and stability of the SI joint, causing pain and discomfort in the lower back, hips, and buttocks. This pain might be sharp or throbbing and can radiate down the legs. Chronic SI joint pain means pelvic floor dysfunction with or without the obvious signs that you may know about pelvic floor dysfunction.
Hip Mobility Issues:
Pelvic floor dysfunction can impact hip mobility and flexibility. If you find it challenging to move your hips freely, experience stiffness, or notice a limited range of motion, it may be related to musculoskeletal issues linked to the pelvis. These restrictions can affect your daily activities, such as walking, climbing stairs, or bending down, and not your age which gets blamed often.
Tailbone Pain:
Discomfort or pain in the tailbone region or coccyx can also be indicative of pelvic floor dysfunction. The coccyx is like the tip of a teepee with many attachments that are crucial in the stability of the pelvis which is the ‘house’ that the pelvic floor is the ‘floor’ of. Sitting for prolonged periods may exacerbate this pain.
Sciatica-Like Symptoms:
Some individuals with pelvic floor dysfunction may experience symptoms similar to sciatica. This includes pain, tingling, or numbness that radiates down the back of one or both legs. This sensation can be attributed to the pressure and tension on the nerves in the pelvic region due to muscle dysfunction or trigger points on specific muscles of the pelvis that are involved in its stability. How can you spare the ‘floor’ when the ‘house’ is unstable? You can’t!
Pelvic Misalignment:
Anatomical misalignment of the pelvis is a common consequence of pelvic floor dysfunction. You may visit your chiropractor for an adjustment, you may arrange your workouts to include the legs and back because they are weak, or you may even visit a physical therapist for knee and ankle issues but what you are missing is the fact that the functionality of these areas directly influence the pelvis and its floor.
At our clinic, we look into the ‘blueprint’ of movement that each patient has for their movement patterns by performing postural neurology exams and assessing their movement performance to see how functional or dysfunctional they are. It is through developmental kinesiology exercises such as Dynamic Neuromuscular Stabilization that we help bring stability back to the pelvis so the ‘floor’ has a better chance of becoming and staying stable and strong.
If you have pelvic floor dysfunction and want to be assessed to see the root of your issue, contact me.
Dr. Shakib
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