Pelvic Floor Dysfunction is on the rise and the ‘generic’ treatments are not working long-term. The reason is 2-fold: There is a rise in the number of cases of Pelvic Floor Dysfunction and that has to do with an increase in our sedentary lifestyle. Then there is the incomplete treatment of this condition because most pelvic floor dysfunction treatments involve internal manual treatment primarily. This blog is going to explore why the internal manual work is not sufficient and in most cases should not be the first line of treatment approach.

The muscles of the pelvic floor and pelvis wall are the same kind of muscles as those in your trunk; they are called musculoskeletal muscles. The question we should ask is why are they tight or weak. We are not talking about what incident made them tight or weak because the incident you may recall is most likely the ‘straw that broke the camel’s back’! It is not pregnancy, being a woman, being old, being overweight, being a smoker, and other excuses that make the muscles weak or tight. There are plenty of people who belong to those categories who do not have pelvic floor dysfunction issues. What are the differences?

There may be similarities in many presentations but we should look into the cause and the reason behind what we are seeing. If the issue with the pelvic floor dysfunction is let’s say a neurological issue or even an infection, then what did the alteration in the neurology behind the cause or the infection do that is leading to the issues present?

From my perspective, regardless of what else is contributing to the health of the pelvis, its stability is a huge player in the cause (lack of stability) or the solution (balancing stability) of the pelvis.

Let’s Talk Sense About the Standard Pelvic Floor Treatment

The floor is only a part of the pelvis and is not suspended in the air. Some muscles go to the walls of the pelvis as well as the floor. Using manual work through the vagina and/or penis can only have so much reach and frankly what exactly are we doing? Are we working on reducing the tendon in those muscles? What caused them to become tense? If they are weak, then what caused the weakness? Is the solution now, trying to squeeze the index finger that is inserted in the vagina and/or anus to practice getting strong?!

Conditions such as pregnancy, childbirth, age, smoking, and trauma to the pelvis are known potential contributory factors but again, how about the ones who belong to the same stereotype who don’t have any pelvic floor issues? Frankly, we are seeing more men, and younger people with this issue than ever before and our lifestyle is playing a huge role in this rise. Individuals with hypermobility, EDS, and joint hypermobility all have pelvic floor dysfunction, and yet not all of them have incontinence!

What I see to be more accurate is the fact that in our sedentary lifestyle, conditions such as chronic lower back pain, sacroiliac pain, hip pain, pelvic pain, and poor posture are present as well but are not looked at as preludes to pelvic floor dysfunction!

The reason the muscles inside the pelvis are the same type as those outside the pelvis is because they are all involved in helping you keep your pelvis stable and functioning together. Any alteration in any of those muscles’ functions impacts the whole area; in fact, any alteration to what is connected to the pelvis (that is your spine and both lower extremities) impacts the muscles on the inside AND the outside. Manually treating the muscles on the inside, as far as the index finger can reach seems to be incomplete and questionable.

Naturally speaking, breathing in correctly (the way babies breathe) and breathing out cause relaxation and contraction (strengthening ) of the muscles inside the pelvis so nature has designed biological breathing as the best method to provide both relaxation and conditioning of the muscles of the floor and therefore the whole inside of the pelvis. Why don’t we focus on that as the foundation of treatment? Thankfully, at our office we do and I am hoping by reading this blog, you will too.

How to Start treatment For Pelvic Floor Dysfunction

As you can see from the image below, what keeps the pelvis together is more than just the muscles of the floor that happen to be the inner lining of the pelvic inlet (the bowl-shaped part of the pelvis). The first portion of the treatment of Pelvic Floor Dysfunction has to do with stopping the things that contribute to the problem. That means biological breathing, better ergonomics (I advise you to visit my YouTube channel playlist on ergonomics), incorporating walking into your daily routine, and sitting on an exercise ball vs a chair to name a few.

Pelvis ligaments front side

Next, start evaluating and tackling the functionality of your movement. Let me explain: Just as when your knee hurts, you shift your weight onto the opposite side, over time, the ‘blueprint’ of your movement becomes the modified one that you resumed when the pain started. This dysfunction is so unnoticeable that you won’t see it until a series of issues come up over time. This is done through a proper evaluation done by the right rehab clinician which btw may hold the same license but won’t have the same training. To understand Functional Movement, please make sure to pause to visit my page.

At our clinic, somewhere along the path of movement correction, we start addressing the muscles inside the pelvis and we use the Emsella chair which is FDA-approved for incontinence to activate the muscles inside the pelvis at its claimed frequency of 400 Kegels a minute. Our protocol calls for proper sitting (we monitor the sitting position), biological breathing, proper activation of the lower extremity (we monitor that for the duration of the session), and overall posture. It is then and only then that the machine’s Kegel stimulation is going to produce the desired outcome we are after.

Emsella Chair

Pelvic Floor Dysfunction and Emsella Chair

To correct pelvis stability, all of these steps are necessary, and understanding how to maintain what you have managed to finally correctly create is crucial. Many claims are made about pelvic floor dysfunction treatments but it is the long-term outcome and common sense that have to be in place before the treatment is considered effective and the right method.

If you have pelvic floor dysfunction, you think you may have it or are not happy with your current care, contact us.

Dr. Shakib

Recommended Reading:

Pelvic Floor Dysfunction Symptoms

What Is Pelvic Floor Dysfunction?