You may be wondering if you have pelvic floor dysfunction. The pelvis and pelvic floor are just another part of our body and as ‘tension in the neck’ can happen to anyone, pelvic floor dysfunction can happen to anyone as well. The key is to understand what pelvic floor dysfunction feels like, why it happens, what the right treatment looks like, and who renders that treatment. I have done many blogs on the subject of pelvic floor dysfunction that I encourage you to read as the information ‘out there’ is vast and at times confusing.
What Are The Symptoms of Pelvic Floor Dysfunction?
As found in one of my blogs, there are obvious and subtle signs and symptoms of pelvic floor dysfunction that we should pay close attention to given that the subtle signs are easily mistaken as something unrelated!
- “Urinary incontinence
- Fecal incontinence or Bowel incontinence
- Prolapse of uterus
- Bladder prolapse
- Bladder pain syndrome or Interstitial Cystitis
- Hemorrhoid
- Feeling pain in the pelvic area with or without going to the bathroom”
And the subtle signs and symptoms are:
- “Lower back pain
- Pain in the back joints of the pelvis (SI Joints)
- Pain in the front pubic area
- Arched lower back
- Slouched lower back
- Slouched mid-back or hunchback
- Military posture with the chest pushed out
- A V-stance where the torso is positioned behind the hip joints on the side view
- Chronic forward neck
- Inability to bend down below the knees
- Habitually standing on one leg with the other leg bent
- Chronic one-sided pain in the lower extremity
- Hip pain on one or both sides”
You can see how easy it is to have the beginning of a potentially more challenging presentation of pelvic floor dysfunction so many months and years before the full-blown obvious pelvic floor dysfunction symptoms. Your posture is a great indicator of the health of your pelvic floor dysfunction in general.
Why Does Pelvic Floor Dysfunction Happen?
This question is fully answered in a blog titled the same!
“Pelvic floor dysfunction occurs because the ‘house’ called pelvis no longer provides a stable anchor for the muscles and organs that line it and are attached to it, and/or for the nerves that run through it. The parts of the body that are connected to the pelvis (hips and the spine) are not able to stabilize the pelvis or their instability makes the pelvis unstable. It is like a table with legs that are not steady so unless the whole table and all legs are secured, the whole structure continues being unstable.” You may read more about this by referring to the blog, “Why does pelvic floor dysfunction occur”.
What Is The Comprehensive Treatment for Pelvic Floor Dysfunction?
As stated in ‘Is Pelvic Floor Dysfunction Painful?”, the following should be noted when treating pelvic floor dysfunction:
- “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.
- Nutrition: Avoid Citrus, caffeine, soda, artificial sweeteners, spicy foods and take collagen, Vit. C, Vit. D, Omega 3, protein if no conflict with any other conditions that suggest their avoidance.
- Ergonomics: Sit on an exercise ball vs a chair, get a keyboard that is as wide as your shoulders, limit your sitting to no more than one hour and alternate with standing, and make sure the middle of your monitor is at eye level to name a few.
- Postural Awareness: It is important to pay attention to the posture and catch yourself when not standing on both feet, slouching, shifting the pelvis forward and in front of the ankles. Best to associate the increase in attention with activities done each day; for instance, when talking to someone pay attention to the feet and pelvis positioning.
- Sleeping habits: do not sleep on the stomach and if you are a stomach sleeper, get a body pillow to minimize that.”
Who Treats Pelvic Floor Dysfunction?
Depending on the specific level of pelvic floor dysfunction, a urologist, urogynecologist, neurologist, and orthopedist may be the first line of providers that you may be referred to. Most often, medication is prescribed which may or may not relieve the symptoms but you should not forget that symptoms don’t show up to go away for no reason. They have a purpose to serve and that is to alert you of something else.
From what I have seen, it is a small group of physical therapists, occupational therapists, nurses, and chiropractors trained in the field of pelvic floor who focus on the rehabilitation treatment of pelvic floor dysfunction. Even within the group, with the exception of the chiropractic group, it seems that the majority of the practitioners focus only on internal manual treatment of the muscles of the pelvic floor with some attention to the postural presentation.
As a chiropractor with training in the realm of pelvic floor dysfunction, my focus is stabilizing the pelvis, which is the ‘house’ that the pelvic floor is the ‘floor’ of. What is important is to note that all aspects of treatment outlined in the previous section are addressed in detail by whomever you seek treatment from. The comprehensive and holistic treatment may take longer than you may wish given that most people in today’s society are accustomed to fast speed in everything and are impatient. It is important that the provider communicates the treatment plan and take measurements of your progress along the way.
If you have pelvic floor dysfunction, or have had treatment but are not seeing the results you wish to see, do not hesitate to contact me.
Dr. Shakib
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