‘Why does pelvic floor dysfunction occur’ is probably the best question to ask because once we understand the answer, then we can prevent pelvic floor dysfunction from happening. Let me first start by removing some of the stereotypes about pelvic floor dysfunction. Pelvic floor dysfunction is not limited to women or old men, to pregnancy and childbirth, to smokers, obese, people with trauma or chronic infection. In fact, there are plenty of people that belong to each one of those categories that do not have pelvic floor weakness. There are also plenty of young men and women, young children, non-smokers, and thin individuals that have pelvic floor dysfunction and frankly, my own practice is almost all pelvic floor dysfunction patients that are there, but not because they think they have pelvic floor dysfunction!
The Problem With Most Pelvic Floor Dysfunction Treatments
The issue with pelvic floor dysfunction is that by the time it is diagnosed, too many structures are unstable and yet, we go after the weak pelvic floor muscles as if that is the full answer to the dysfunction. In the table analogy, it is as if all legs are unstable, the attachments of the legs to the table are in need of attention and we go after resurfacing the tabletop in an attempt to make it look good. No pelvic floor dysfunction should stop at the internal pelvic work and over 90% of the pelvic floor dysfunction treatment seems to involve just the internal pelvic work! Is that why there are so many people with continuous pelvic floor complaints? Are we not diagnosing pelvic floor dysfunction early enough? Are the point of entry physicians making the right diagnosis and pointing the patients in the right direction early enough? What are the differences between the pelvic floor and pelvic floor dysfunction?
Why Does Pelvic Floor Dysfunction Occur?
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 become 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.
There are many factors that contribute to this instability with the most non-intentional being our lifestyle of sitting. You have no idea how damaging that is and how much we are deteriorating in front of our computers each and every day. Look around you and you will see that children much rather sit and play video games or watch TV than go outside to play. This contributes to an earlier and earlier onset of pelvic floor dysfunction. It does not matter how new the metaphoric ‘table’ is; if it is not treated well, it will become unstable.
Playing sports and getting injured go hand-in-hand but the problem is the extent of treatment we get to rehabilitate the area. So many times people hardly get any physical therapy and then when they do, it is to the injured area only. We fully disregard the modification in movement that had to take place while the injured area was being healed. That modification in movement happens at the brain, the command center; you see, if movement was a concert, the brain would be the conductor, the musical notes to play the music by would be the homunculus (the blueprint of movement we are born with which gets added on specifically during the first 2-3 years of life), and the musicians would be the body parts. While the ‘pianist’ is working on their part, the rest of the concert still goes on and gets modified without the pianists’ part. When the pianist is recuperated and back to ‘playing’ the modified notes need to be adjusted accordingly. THAT is where we fail!!!
For example, your left knee hurts and you start favoring it by shifting your weight to the right side. The imbalance continues despite the pain being gone. Now let’s look further to see how imbalanced walking creates an imbalance in the structures above and below and how the knee problem becomes a hip dysfunction and how the hip imbalance means imbalance in the pelvis and how that means a weakened pelvic floor.
Does that mean every injury sets the ground for the pelvic floor to become weak and the answer is pretty much yes!! Take a look at the picture below and then tell me how it can not!!
What is the Solution for Pelvic Floor Dysfunction?
Regardless of the ‘why’ story behind your pelvic floor dysfunction and the types of issues you have that feed your pelvic floor dysfunction, you need to make sure that your movement is functional. It makes no sense to think of bettering or perfecting the ‘floor’ of your house when the ‘walls’ of the house are unstable. Just because you attend to the ‘plumbing’ or ‘electrical’ part of your house, does not mean that the integrity of the “walls” of the house should not be addressed. In fact, without the walls, there is no ‘house’.
I strongly advise you to read my blog on The Cure for Pelvic Floor Dysfunction to understand what needs to be done to address pelvic floor dysfunction correctly.
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 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.
Dr. Shakib
