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Pelvic floor dysfunction is much more prevalent than most people realize and it no longer stays within the stereotype of woman, pregnant, given birth, obese, smoker, and elderly. I see plenty of people who are active, fit (on the surface), young, all genders, and have never smoked. In today’s day of age, it is the lifestyle that is heavily contributing to pelvic floor dysfunction.

In order to fix this problem we first need to understand the anatomy of the area and its subtle and not-so-subtle signs and symptoms of it. This allows us to catch it early on vs thinking it is something else, treating it as if it is ‘that’ thing, just to realize that we were wrong. Then we can answer the question that is the subject of this blog.

Please visit my other blogs on the subject of pelvic floor dysfunction to better understand the very thing you are trying to avoid and overcome.

The Anatomy of the Pelvis and Pelvic Floor

As mentioned in my blog: Are Pelvic Floor Exercises the Same as Kegels, “The pelvis is the ‘house’ that the pelvic floor is the ‘floor’ of. This is very important to remember because we seem to be too busy thinking of the ‘floor’ when the ‘house’ is not stable by any means. We will come back to this later on in this blog but keep this in mind for now.

The pelvis consists of 3 bones: 2 ilium and sacrum with the 2 ilium coming together in the front to form the pubic bone. The pelvis is attached to the spine via the sacrum at the top and connected to the leg bone at the bottom to form the hip joint. In fact, in the hip joint which is a ball and socket joint, the socket is offered by the pelvis.

Pelvis bones
courtesy of https://orthoinfo.aaos.org/

Where Is The Pelvic Floor?

The pelvic floor muscles line the bottom and the walls of the pelvis and are more than what is along the vagina or penis. The floor itself consists of 3 layers and the mistake in treating pelvic floor dysfunction is that the majority, if not the full focus, is on the floor but the floor does not sustain itself alone! It is attached to the wall and influenced by what is attached to the pelvis. Focusing just on the floor is the reason why benefits from pelvic floor treatments don’t last long.”

Where Is The Pelvic Wall?

The pelvis is like a bowl and the walls are called the pelvic wall. There are 2 primary muscles, the piriformis and obturator internus  (both hip stabilizer muscles) that are located there. Working internally on the pelvic floor, the piriformis is more than likely not reachable because of its location and depending on the length of the therapist’s finger. The obturator internus however may be reached. These muscles can have symptoms that resemble other conditions and are easy to miss when the provider you seek advice from does not look at the whole picture holistically. This is a problem that is unfortunately too frequently seen.

What Are Common Signs and Symptoms of Pelvic Floor Dysfunction?

In the blog, “Alternative to Manual Treatment for Pelvic Floor Dysfunction“, you will find the list below. Note that they are not in any order of prevalence or importance. You may also have more than one symptom or sign and are being treated for them as if they are separate conditions.

  • “Weak pelvic floor muscles
  • Painful intercourse
  • Erectile dysfunction
  • Urinary incontinence
  • Fecal incontinence
  • Pain in the testicle
  • Pain in the vulva
  • Pain around the anus
  • Pain in bladder
  • Chronic bladder dysfunction
  • Interstitial cystitis (aka painful bladder syndrome)
  • Chronic UTI or urinary tract infection
  • Lower back pain
  • Sacroiliac pain
  • Tailbone pain
  • Lower mid-back pain
  • Hip(s) pain
  • Chronic foot pain
  • Chronic ankle instability or lack of proper mobility
  • And bad posture”

In order to avoid the things that aggravate your pelvic floor dysfunction, you need to make sure you are enlisting the lifestyle, habits, and ergonomics contributing to the pelvic floor dysfunction which takes us to the main question.

What Should I Avoid If I Have Pelvic Floor Dysfunction?

Here is the list of the common things to avoid or pay attention to that can help you with your pelvic floor dysfunction when the musculoskeletal component of pelvic floor dysfunction is being addressed:

  • Sitting on a hard surface
  • Prolonged sitting
  • Prolonged standing
  • Slouched torso
  • Forward or backward tilting pelvis
  • Improper breathing
  • Standing on one leg vs both legs
  • Small keyboard
  • Improper height of the desk to the elbow and wrist level
  • Leaving the hand on the mouse when using digital devices
  • Looking down at the digital devices vs eye level
  • Working (sitting or standing) for more than 45-50 min at a time, staring at the digital devices
  • Keeping the elbows in a restricted position when typing
  • Using armrest on the chair
  • Standing up urinating
  • Bearing down to defecate
  • Exercises that require challenge the pelvis and hips while combined with balancing)
  • Exercises when keeping the spine neutral is missed
  • Deep squatting without keeping the spine neutral
  • Doing exercises in isolation vs holding the form correctly
  • Ignoring the symptoms because they go away
  • Focusing on the pain vs function

What Is The Best Treatment For Pelvic Floor Dysfunction?

As stated in the blog, Is pelvic floor dysfunction painful?, ” The treatment of pelvic floor dysfunction regardless of the cause must include:

  • Behavior modification which is always part of the solution list to all issues (your behavior about life changes how you do everything in life), is not going to correct any dysfunction fully but addresses some of the feeders of the problem.
  • Postural Neurology: Movement is like a concert and the body parts are like the musicians; in that the musicians not only need to know their part but to know when to chime in and phase out. That means the pelvis and pelvic floor need to know how to ‘play’ with the rest of the body if they are to sustain their strength and integrity. This is what Postural Neurology is all about.
  • Functional Movement: Common sense says that the most authentic way to move is the way babies move. After all, all babies from all over the world go through the same developmental stages of movement (Developmental Kinesiology) which means that we are hard-wired to move that way. So if the issue is movement-related or supported, then we should see how we compare to the way we moved as babies. All discrepancies are then highlighted and can be corrected through Dynamic Neuromuscular Stabilization (DNS) exercises which are baby movements.
  • Kegels? There are machines like the Emsella Chair that do 400 Kegels per minute involving all of the muscles of your pelvic floor and not the ones that you hope to be engaging. Note that Kegel exercises are not for all types of incontinence and pelvic floor muscle issues.
  • Breathing is what babies do automatically and that is what we need to do in order to sustain the bottom of the breathing apparatus, the pelvic floor!
  • Internal manual work which ideally should be done to assess the muscles inside the pelvis BUT does not have to be done in all cases.”
  • And addressing the lifestyle, habits, and ergonomics that contribute to its existence.

If you have pelvic floor dysfunction that persists, the treatments have brought relief but not lasting or you suspect you have pelvic floor dysfunction, don’t hesitate to contact me.

Dr. Shakib

Recommended Reading:

What Causes Male Pelvic Floor Dysfunction?

What Happens When Pelvic Floor Muscles Get Weak?