In order to answer this question, we need to first understand what pelvic floor dysfunction is. While I have written a blog on that, I would like to use an example that better clarifies some commonly missed facts about pelvic floor dysfunction that has led to an increased number of patients with ongoing pelvic floor dysfunction issues.
If pelvic floor dysfunction was a book, weak pelvic floor, urinary incontinence, fecal incontinence, chronic constipation, pelvic pain, pressure in the rectum, fullness in the back of the pelvis, pain during sex, sexual pain at the point of insertion, erectile dysfunction, lower back pain, hip pain, lower mid-back pain, and poor posture would be different chapters of it. Just as each chapter does NOT define the book, just treating the pelvic floor muscles internally will not treat the condition and THAT is what you need to keep in mind.
Common Sense Question to Ask Yourself
Unfortunately, while every pelvic floor therapist (trained physical therapists, chiropractors, nurses to name a few) get the same education on the facts related to pelvic floor dysfunction, it seems that most focus on the internal manual work of the pelvic floor area which is important but is not the majority of the work that needs to be done. Let me ask you a question:
Would you work on the kitchen floor if the whole room or the building is unstable?
The answer is the big obvious, NO!! Then why is it that when patients come in with different presentations of pelvic floor dysfunction, most therapists jump on the pelvic floor internal manual work with very little (if any) attention to the treatment of the pelvis, lower back, hips, and the related muscles?
The Common Treatment for Pelvic Floor Dysfunction is Wrong!
I have written so many blogs on the different aspects of the pelvic floor and currently see patients with all different types of movement dysfunction. Pelvic floor dysfunction has to do with the pelvis itself and what is attached to it. Therefore this dysfunction impacts the pelvis, muscles, tendons, connective tissue, and all that resides in those areas. Pelvic floor dysfunction is a whole-body dysfunction that ‘speaks the loudest’ in the pelvis.
The common treatment focuses on the pelvic floor, its’ relaxation and strengthening primarily, some work on the outside part of the same vicinity, some coordination of breathing with the internal work, and then working with someone doing the generic back and hip exercises. I am not trying to minimize the importance of that work- it is absolutely necessary to work on those but the issue is the lack of a proper sequence of action plans to tackle pelvic floor dysfunction.
In my blog titled: “Why does pelvic floor Dysfunction occur and how to fix it’ I discuss the areas that are being missed how and this involves the following, and I strongly suggest you click on each section to understand what they each mean.
“The areas that are being missed the most when treating pelvic floor dysfunction are:
- Postural Neurology
- Baby exercises vs the generic exercises prescribed
- Biological breathing vs the supposed abdominal breathing
- Impact of ergonomics on the pelvic floor
- Impact of sleep on the pelvic floor”
Pelvic floor dysfunction can have a neurological root, but when that is attended to, we can’t just think the problem is solved. It can be from a trauma, so when the bone is broken or the injured muscle heals, we can’t think the problem is solved. We can’t blame pregnancy on incontinence and then use devices to prevent leakage and then think the problem solved. We have to dig deeper to see what else is involved that we are missing and THAT is the part of treatment that is not happening.
We cannot focus on the symptoms and think the disappearance or decrease in symptoms is the end of the problem. The ultimate test for pelvic floor dysfunction is the quality of functional movement. We can’t build a ‘floor’ when the house is unstable and an unstable house is shaken by every movement you make.
What Makes Pelvic Floor Dysfunction Worse?
Dysfunctional movement makes every effort made to resolve your specific pelvic floor dysfunction symptom be wasted. In my office when a patient walks in, my exam includes postural neurology, functional movement, spinal movement, breathing technique, muscle performance assessment, proprioceptive assessment, walking assessment, postural assessment, and balance assessment just to see where the patient is.
At the end, and along the way, I reassess all of those components to make sure the whole ‘house’ is stable so you can hold on to the strong ‘floor’ that you now have.
Pelvic floor dysfunction is like a weed that can take over your whole yard if not addressed on time and correctly. If you have any questions or are tired of life with pelvic floor dysfunction, contact me.