Most people associate pelvic floor dysfunction with incontinence or pain with intercourse. If pelvic floor dysfunction was the name of a book, incontinence, pelvic pain, pain with intercourse (anally and/or vaginally), hip pain, sacroiliac pain, lower back pain, hemorrhoid, prolapse, chronic urinary tract infection (in some cases) would be examples of different chapters of that book. If we address these issues when they first occur or towards the beginning of them becoming symptomatic, most pelvic floor dysfunctions would not get escalated to what we see these days.
Is it Just the Pelvic Floor?
No!!. You cannot have a pelvic floor issue by itself without the involvement of the pelvic walls. While the pelvic floor is the muscles lining the inside of the pelvic inlet (inside part of your pelvis where the intestine, bladder, ovaries, and prostate reside), the walls are lined up with muscles and the whole pelvis is attached (therefore impacted) by what it is attached to, being the lower back and the hips. Then we have to look at the pelvis itself which is comprised of two bones named ilium attached to the sacrum (the lower tip of which is the tailbone).
What Influences the Pelvic Floor Muscles?
- Soft Tissue
All soft tissues going to and coming from the pelvis play a role in the health of the pelvic floor. Soft tissues are muscles, ligaments, tendons, blood vessels, connective tissues, and nerves. Anything that interferes with the optimal function of these structures will impact the health of the pelvic floor.
- Bony Alignment
It is only obvious that if the bones attached to the pelvis are not aligned perfectly, the structure of the pelvis is compromised. The pelvis is the foundation for all those muscles to connect to, contract with, and move; but do we have a perfect alignment of it all the time? NO, but there are different levels of misalignment too and frankly, that is the reason why attending to the pelvic floor health should be as critical and important as brushing the teeth and dental hygiene. Later in this blog, I will show you what my go-to regimen is and how utilizing Developmental Kinesiology (DNS) exercises is the best fit for such a goal.
- Nutrition
It is a given fact that nutrition plays a role in our health no matter what health concern we have. When it comes to nutrition, we need to think about foods that irritate and those that support the bones, cartilage, nerves, blood vessels, muscles, tendons, and ligaments. In general, when it comes to tissue healing, Vitamins C, Zinc, Vitamin D, and proteins are the basic nutrients, bear in mind co-morbidities such as gout for instance change the safety of taking proteins despite its positive impact on tissue healing. Then there are foods such as caffeine, chocolate, citrus, tomato, artificial flavors, alcohol, spicy foods that cause irritation.
- Lifestyle and Habits
The worst thing you can do is have a sedentary lifestyle because it de-conditions the muscles of your pelvis, lower back, lower extremities, and whole body in general. A lifestyle of heavy lifting is also counterintuitive to a healthy pelvic floor and pelvic wall because of the increased chances of increased inter-abdominal pressure while having issues related to the lower back, lower mid-back, sacroiliac joints, and hips.
Certain professions and jobs tend to occupy the time so much that at times, we postpone going to the toilet and THAT plays a huge role in the dysfunction in both the urinary and fecal elimination process. In the video below, I discuss how constipation and pelvic floor dysfunction feed each other!
- Hobbies and Sports
Certain sports such as cycling and running have more risk of pelvic floor weakness. I have done a full blog on the two topics that I suggest you read. How you exercise can make matters better or worse and to understand how something as good as exercise may be making your pelvic floor weaker and more dysfunctional, you will need to visit my website.
- Breathing
Perhaps one of the least addressed factors in the treatment of pelvic floor dysfunction and all associated symptoms and complaints is breathing. While there seem to be many different methods of breathing each with valuable insight, frankly when it comes to breathing and its role on our innate health, no breathing is better than what all babies do!! After all, all babies on this planet, regardless of the many differences, without any training or coaching breathe the same way. That must be what is the best fit and most compatible way of breathing. We tend to complicate things more than they need to be and certainly simplify things that need to be looked into more. I look at breathing authentically as the way we humans are ‘programmed’ to breathe. In this video, I explain it in detail.
- Posture
Your posture influences everything when it comes to pelvic floor dysfunction. For instance, with poor posture comes a compromise in breathing and an increase in intra-abdominal pressure with undue stress on all of the pelvic floor muscles. With poor posture come misaligned lower back, sacroiliac joints, hips, mid-back, and diaphragm which directly impact the pelvic floor. Our posture is influenced by our lifestyle and the overuse or underuse of our body parts; for instance, a sedentary lifestyle leads to the shrinkage of PMRF which is the part of the brain that dictates the upright command (referred to as digital dementia and the postural label of tech neck). Now we are talking about Postural Neurology and positive or negative neuroplasticity explained in my blog on the subject of posture.
- Functional Movement
How we move plays a huge role in the integrity of the pelvic floor. When it comes to movement and rehabilitation of any dysfunctions in movement, there is no method better than what we are programmed to do. If all babies on this planet go through the same developmental stages to progress from infancy with 100% reliance to a toddler running around effortlessly, then we must be programmed to move that way. This method is the foundation of the developmental kinesiology regimen of DNS or Dynamic Neuromuscular Stabilization which is what we use at our clinic to help all of our patients including those with a weak pelvic floor. We do not use weights, bands, dumbbells, kettlebells, or straps to develop muscles or strengthen them and with the movement progressions, we generate the nerve pathways necessary to relay the proper commands to the muscles. There is a blueprint of movement that we are born with that if we use, regardless of when or why, we will get to duplicate the same design of the movement.
If movement was a concert, the brain would be the conductor, the musical notes would be the blueprint we can assess based on the postural neurology exam, and the body parts would be the musicians. The musicians not only need to know their musical instruments but also need to know when to chime in and phase out. THAT is only practiced by following the concepts of Dynamic Neuromuscular Stabilization. Here is an example of what these exercises may look like.
How Do I Find the Best Pelvic Floor Therapist?
The best pelvic floor therapist is the one that has the most comprehensive approach to the treatment of pelvic floor dysfunction. While most people may think this means internal manual therapy, this video explains why that is not necessarily true.
Thanks to google, you should read the websites, perhaps call the clinic to speak to the therapist who may or may not be a physical therapist to find out why they are a better fit for your needs.
If you have any questions or think you need help with your pelvic floor dysfunction, do not hesitate to contact me.
Dr. Shakib
