Tag: pelvic floor muscles

Why Pelvic Health Matters

Pelvic health is essential for overall well-being as the pelvic floor muscles play a critical role in:

• Core strength
• Bladder and bowel control
• Sexual function
• Circulation and fluid exchange 
• Posture and skeletal support

As Peinado-Molina et al. (2023) state, strong pelvic floor muscles are essential for supporting your spine, preventing incontinence, and enhancing sexual health. Moreover, pelvic floor health is crucial during pregnancy and postpartum recovery, as it helps prevent pelvic organ prolapse, perineal tearing, and incontinence. Furthermore, optimizing your pelvic health can lead to a smoother recovery overall.

Pelvic Health & Mental Wellbeing

Additionally, addressing pelvic health issues can improve mental health by alleviating anxiety and social isolation caused by conditions such as incontinence or pelvic pain (Peinado-Molina et al., 2023). Prioritizing your pelvic health can lead to a healthier, more confident, and fulfilling life.

Dispelling Myths and Misconceptions

However, even though we recognize the importance of pelvic health for overall well-being, it remains shrouded in shame, misconceptions, and myths. Understanding the truths about pelvic health can lead to better care and treatment for those experiencing pelvic-health-related issues. Now, let’s debunk five common myths about pelvic health!

Myth #1: Pelvic Health Issues Only Affect Women

Myth: Pelvic health concerns exclusively affect women or those assigned female at birth. 

Fact: Men and children can also experience pelvic health issues, including pelvic pain, incontinence, and pelvic floor dysfunction including long term hip and low back pain!

Everyone has a pelvis!  And that means, pelvic health can affect every body, at any age, and all genders.

While it’s true pelvic health issues are often associated with women or individuals assigned female at birth (Davis & Kumar, 2003), because they experience childbirth and menopause, it doesn’t mean men and children are immune. Men can suffer from conditions like persistent pelvic pain, erectile dysfunction, prostatitis, and incontinence.

Even children can experience pelvic floor dysfunction such as constipation, incontinence, bed wetting, and core-related conditions. Recognizing pelvic health is not gender or age-specific helps in addressing and treating these conditions across the lifespan.

Myth #2: Kegels or bust!

Myth: Kegels are the only type of pelvic floor exercise.

Fact: Pelvic floor exercises consist of more than Kegels (and in some instances, Kegels may worsen a condition!)

Kegels are exercises designed to strengthen the pelvic floor muscles, which support the bladder, bowels, and reproductive organs. By contracting and relaxing these muscles, Kegels can improve function and provide relief for various pelvic health issues in both men and women. 

However, Kegels are just one part of pelvic floor exercise training, and they aren’t always the best fit for everyone. A comprehensive approach includes a thorough assessment with a pelvic floor physiotherapist and often goes beyond Kegels for effective results.

In some cases, like pelvic pain, certain sexual health conditions, or post-birth issues, Kegels can actually make things worse. These problems often come from overly tight pelvic floor muscles. A more holistic approach is needed. This might include lengthening exercises, muscle release, and targeted strengthening.

The key takeaway? There’s much more to pelvic floor exercise training than just Kegels, and a personalized approach with an experienced pelvic floor physiotherapist is essential for optimal results.

Myth #3: Leakage Is a Normal Part of Aging

Myth: Urinary or fecal incontinence is an inevitable part of getting older.

Fact: Although incontinence becomes more common with age, it is not normal and can often be treated or managed with pelvic floor therapy and lifestyle changes.

Leakage should not be accepted as a normal part of aging. Although aging does increase the risk of incontinence due to factors like weakened pelvic muscles, hormonal changes, medications, and chronic conditions (Goepel et al., 2010), effective treatments are available. These include pelvic floor exercises, bladder training, dietary adjustments, and, in some cases, medical interventions such as surgery, medications, or devices like the Uresta or a pessary. (Goepel et al., 2010).

Pelvic floor therapy is a minimally invasive option that can significantly improve the quality of life for older adults by reducing or even eliminating leakage symptoms (Goepel et al., 2010). In fact, pelvic floor physio is the gold standard treatment for incontinence, rated more effective than surgery. It’s essential to seek help rather than assume incontinence is something to live with. Your quality of life will thank you for it!

Myth #4: Pain During Sexual Activity Is Normal

Myth: Experiencing pain with sexual activity is normal, especially after childbirth.

Fact: Pain with sexual activity is not normal and can be a sign of underlying pelvic floor issues, which can often be addressed with proper treatment and pelvic floor physiotherapy.

Many women believe that pain during intercourse, especially postpartum, is something they just have to live with. However, while painful sex may be common it is not normal and should be addressed (Tayyeb & Gupta, 2023). 

According to Sorensen et al. (2018), pain with sexual activity can be caused by various factors, including:

• Pelvic floor muscle tension
• Scar tissue from childbirth
• Hormonal changes
• Infections

Pelvic floor physiotherapy can be a valuable treatment for pain with sexual activities. Your pelvic health physio can work with you to:

• Release scar tissue
• Retrain pelvic floor muscle mechanics
• Lengthen your pelvic floor muscles
• Discuss options for vaginal dryness as a result of hormonal changes
• And more

Pelvic floor physical therapy can identify and treat the underlying causes of pain with sexual activities, leading to more enjoyable sexual experiences. 

Myth #5: Pelvic Floor Issues Are Always Obvious

Myth: Problems with the pelvic floor will always present with clear and noticeable symptoms.

Fact: Pelvic floor dysfunction can sometimes have subtle or unrelated symptoms, such as lower back pain or hip discomfort, and may not always be immediately recognized as a pelvic floor muscle issue. 

Pelvic floor muscle dysfunction does not always manifest with obvious symptoms like bladder leakage or pelvic pain. In fact, sometimes the signs can be more subtle, such as persistent lower back pain, hip discomfort (Zhao & Zhao, 2013), or even digestive issues (Wang et al., 2010).

Because these symptoms can be mistaken for other conditions, pelvic floor muscle problems often go undiagnosed. It’s important to consider that your pelvic floor muscles may contribute to your concern when experiencing unexplained pain or discomfort in the lower torso. A thorough assessment by a pelvic health physiotherapist can uncover issues that might otherwise be overlooked, leading to appropriate treatment and relief.

Last Thoughts

Debunking these common myths is a crucial step toward better understanding and treating pelvic health issues. Moreover, it also brings social awareness about the impacts and importance of your pelvic health. Pelvic health concerns aren’t limited to any gender or age group. Addressing them can significantly improve the quality of life across the lifespan.

If you or someone you know is experiencing pelvic health issues, seek help from a qualified pelvic health physiotherapist. They can assess your specific concerns and provide tailored treatment. Prioritizing pelvic health positively impacts all aspects of your well-being, making it an essential part of your health and self-care routine.

If you have questions relating to your pelvic health, please book an appointment with one of our experienced pelvic health physiotherapists, click here.

~The Bump Team

Bump Physio & Co is a community of health care providers dedicated to changing the way pelvic health and obstetrical services are delivered. Our two clinics locations are Port Moody and Langley BC, where we treat beyond the Bump and welcome clients from all stages and phases of life. Our team has advanced training in Pelvic Health, Orthopedics, Obstetrics, Clinical Pilates, and Active Rehabilitation.

Please follow us along on our socials @bumpphysio.co keep updated on all that is going on and for more information about how the Bump Community can help YOU!

Citations

Bi X, Zhao J, Zhao L, et al. Pelvic floor muscle exercise for chronic low back pain. Journal of International Medical Research. 2013;41(1):146-152. doi:10.1177/0300060513475383

Cho, S. T., & Kim, K. H. (2021). Pelvic floor muscle exercise and training for coping with urinary incontinence. Journal of Exercise Rehabilitation, 17(6), 379-387. https://doi.org/10.12965/jer.2142666.333

Davis, K., & Kumar, D. (2003). Pelvic floor dysfunction: A conceptual framework for collaborative patient-centred care. Journal of Advanced Nursing, 43(6), 555-568. Retrieved from: https://doi.org/10.1046/j.1365-2648.2003.02754.x

Dorey, G., Speakman, M., Feneley, R., Swinkels, A., Dunn, C., & Ewings, P. (2004). Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction. The British Journal of General Practice, 54(508), 819-825. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1324914/

Goepel, M., Kirschner-Hermanns, R., Welz-Barth, A., Steinwachs, C., & Rübben, H. (2010). Urinary Incontinence in the Elderly: Part 3 of a Series of Articles on Incontinence. Deutsches ÄRzteblatt International, 107(30), 531-536. https://doi.org/10.3238/arztebl.2010.0531

Grimes WR, Stratton M. Pelvic Floor Dysfunction. [Updated 2023 Jun 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559246/

Lee, B. A., Kim, S. J., Choi, D. K., Kwon, O., Na, H. R., & Cho, S. T. (2017). Effects of Pelvic Floor Muscle Exercise on Urinary Incontinence in Elderly Women With Cognitive Impairment. International Neurourology Journal, 21(4), 295-301. https://doi.org/10.5213/inj.1734956.478

Mayo Clinic. (2008). Kegel exercises for men: Understand the benefits. 

Retrieved from: https://www.mayoclinic.org/healthy-lifestyle/mens-health/in-depth/kegel-exercises-for-men/art-20045074

Peinado Molina, R. A., Martínez, A. H., Vázquez, S. M., & Martínez Galiano, J. M. (2023). Influence of pelvic floor disorders on quality of life in women. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1180907

Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629477/

Tayyeb M, Gupta V. Dyspareunia. [Updated 2023 Jun 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK562159/

Wang, J. Y., Varma, M. G., Creasman, J. M., Subak, L. L., Brown, J. S., Thom, D. H., & Van Den Eeden, S. K. (2010). Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 31(3), 424.

Retrieved from: https://doi.org/10.1111/j.1365-2036.2009.04180.x

Zivkovic V., Lazovic, M., Vlajkovic, M., Slavkovic, A., Jovanovic, Z. (2010). The Role of Pelvic Floor Rehabilitation in the Treatment of Children with Dysfunctional Voiding. Journal of Pediatric Urology, 6.

Retrieved from: https://doi.org/10.1016/j.jpurol.2010.02.126

Endometriosis and your pelvic health 

Did you know that pelvic health physiotherapists can help treat the symptoms of endometriosis? Currently, endometriosis affects 1/10 people with a uterus in Canada and is severely misunderstood, mis or poorly diagnosed and takes a long time to diagnose. The average time from symptom onset to receiving a diagnosis can range from 6-12 years.

In this post, we are going to review what is endometriosis, its signs and symptoms, how the pelvic floor muscles are involved and provide some insights into how pelvic health physiotherapists can help. 

What is Endometriosis?

Endometriosis is a condition in which the tissue that normally lines the inside of the uterus (the endometrium) grows outside of the uterus. This can cause inflammation, scarring, and adhesions in the pelvic region, which can lead to pain and other symptoms.

Symptoms of Endometriosis

The symptoms of endometriosis can vary from person to person, but they often include:

• Pelvic pain, especially during menstruation or sex
• Painful bowel movements or urination
• Heavy periods or irregular bleeding
• Infertility or difficulty getting pregnant
• GI and bowel symptoms including bloating, gassiness, cramping, diarrhea, constipation 

If you experience any and/ or all of these symptoms, please check in with your primary care medical provider for an assessment. 

Endometriosis and your pelvic floor muscles 

Did you know that Endometriosis can have a significant impact on your pelvic floor muscles? When the endometrial tissue grows outside of the uterus, it can cause inflammation and scarring in the pelvic region. This can lead to a range of pelvic floor problems, including:

1. Pelvic Pain: This pain can be felt in the lower abdomen, pelvis, and lower back, and can be worsened by activities such as sex, exercise, or bowel movements.

2. Urinary and Bowel Problems: Individuals might experience pain with urination or bowel movements, or difficulty emptying the bladder or bowels (ie urinary retention or constipation). 

3. Sexual Dysfunction: Endometriosis can lead to painful or uncomfortable sexual activities including orgasm and pain with receptive intercourse. 

4. Pelvic Floor Muscle Dysfunction: Ongoing and persistent pain and inflammation in the pelvic region can cause the pelvic floor muscles to become tight or weakened. This can lead to problems such as pelvic floor muscle spasms, urinary or fecal incontinence, pain with sexual activity and generalized pelvic achyness and pressure to suggest a few. 

How to manage Endometriosis and associated pelvic health symptoms

Pelvic health physiotherapists are a great resource and can be a helpful ally on your health care team in navigating endo symptoms. Pelvic health physiotherapists are here to support you in providing education, resources, exercises and manual therapies to alleviate pelvic and abdominal pain, improve bladder and bowel function, hands on myofascial release techniques to the abdomen, hips, low back, glutes, pelvic floor and inner thighs to relieve tension, dry needling or IMS techniques, advocate on your behalf for ongoing therapeutic and medical treatments and providing community referrals to other providers who would be a welcomed addition to your care team. 

Many individuals diagnosed with endometriosis can benefit from breath work and pelvic floor muscle lengthening activities. If you are feeling tension or pain in your pelvic floor, here are a few suggestions of exercises to try. When in doubt or if you would like a tailored program to you, a registered pelvic health physiotherapist can help!

Breathwork and pelvic floor lengthening exercises for Endometriosis

Pelvic health products to support those living with Endometriosis

There are also a few products that could be helpful in managing symptoms, including period underwear designed for heavy flows, the Ohnut for pain with receptive intercourse, vaginal dilators or a pelvic wand to decrease pelvic floor muscle tone. If you are curious about how any of these products might be able to help you, please consult with a pelvic health physiotherapist prior to incorporating them into your self care routine.

Endometriosis is a challenging condition to diagnose and treat, which can lead to a significant delay in diagnosis and can impact an individual’s physical and mental health and quality of life. Management of endometriosis requires a multi system, integrated and holistic approach.  If you are experiencing symptoms of endometriosis, we encourage you to discuss your concerns with a trusted medical provider.

Community connections for individuals living with Endometriosis

If you have been diagnosed with Endometriosis and are looking for community connections and resources, here are a few blogs and social media pages to check out. 

1. Endometriosis Network Canada– The Endometriosis Network Canada is a non-profit organization that offers education, support, and advocacy for individuals with endometriosis in Canada. Amongst their many resources, they host twice monthly online support group meetings for those living with Endo.

2. Endometriosis UK – Endometriosis UK is a charity organization that offers support and information to individuals with endometriosis. Click on “Get support”, for access to an online community, support groups, a help line and more resources. 

Instagram pages to follow for connection, information and support! 

• @endometriosissociety 
• @theendo.co
• @endogirlgang 
• @endowarriors 
• @theendometriosisfoundation

Questions about Endometriosis and the pelvic floor? Ask us in the comments below. 

Lacey Forsyth, MPT 

Founder and Registered Physiotherapist at Bump Physio & Co

Bump Physio & Co is a community of health care providers dedicated to changing the way pelvic health and obstetrical services are delivered. Our two clinics locations are Port Moody and Langley BC, where we treat beyond the Bump and welcome clients from all stages and phases of life. Our team has advanced training in Pelvic Health, Orthopedics, Obstetrics, Clinical Pilates, and Active Rehabilitation.

Please follow us along on our socials @bumpphysio.co keep updated on all that is going on and for more information about how the Bump Community can help YOU!

References 

Agarwal SK; Chapron C; Giudice LC, Clinical diagnosis of endometriosis: a call to action. American Journal of Obstetrics & Gynecology; 2019: 354-364.

dos Bispo, A.P.S., Ploger, C., Loureiro, A.F. et al. Assessment of pelvic floor muscles in women with deep endometriosis. Arch Gynecol Obstet 294, 519–523 (2016). https://doi.org/10.1007/s00404-016-4025-x

Gehrich AP, Aseff N, Iglesia CB, Fischer JR, Buller JL. Chronic urinary retention and pelvic floor hypertonicity after surgery for endometriosis: A case series.

Orr NL, Noga H, Williams C. Deep Dyspareunia in Endometriosis: Role of the Bladder and Pelvic Floor. J Sex Med 2018;15:1158-1166.

Vilasagar S, Bougie O, Singh SS. A Practical Guide to the Clinical Evaluation of Endometriosis-Associated Pelvic Pain. The Journal of Minimally Invasive Gynaecology. (2020) 27, 270−279.

Websites

http://www.bcwomens.ca/our-services/gynecology/pelvic-pain-endometriosis/

https://endopain.endometriosis.org/