Ask the Experts: Your Pelvic Floor and You
Hannah Mulder, DPT
For this month’s Ask the Experts, we asked Orthopedic 360 Physical Therapy to help answer our questions on pelvic floor health. Physical therapists Hannah Mulder, DPT, and Catherine Veeser, PT, WCS, chatted with us about how to keep our pelvic floors healthy and functioning. Both therapists have extensive training in pelvic health. The pelvic floor is a very important part of our body that is unfortunately not addressed as much as it should be. Pelvic floor issues can occur in men, and women, and are especially important in pregnancy.
Catherine Veeser, PT, WCS
By Catherine Veeser, PT, MSPT, WCS and Hannah Mulder, PT, DPT
What is a pelvic floor?
● The Pelvic Floor refers to the layer of muscles that span the bottom of the pelvis.They stretch like a muscular trampoline from the tailbone to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side).
● The pelvic floor muscle layer has holes for passages to pass through.There are two passages in men (the urethra and anus) and three passages in women (the urethra, vagina and anus). The pelvic floor muscles (PFM) wrap around these holes to help keep the passages shut. The PFM also need to be able to relax to allow the openings to stretch during toileting and other functional activities.
● The PFM help support the position of the pelvic organs, which include the bladder, bowel, and uterus (for women). Just like a trampoline, the pelvic floor should move up and down in response to breathing, moving, and changes in pressure like coughing and jumping.
● The PFM do not work alone. They are a part of a system of many muscles that keep your body stable and regulate pressure over your pelvic organs.
● The PFM have 4 main functions:
○ They play a role in normal sexual function during arousal and climax.
○ They close or release the pelvic openings for bladder and bowel control.
○ They quiet the bladder and bowel during an urge if you are not near a toilet.
○ They support of the pelvic organs and improve postural support of the body.
2.What should I be doing before birth and after birth for my pelvic floor?
● Understand what it is and how to use it.
● Use it functionally (during coughing, sneezing, lifting, etc).
● Recognize signs of dysfunction and seek help sooner than later.
● Minimize factors that can lead to dysfunction, such as having a slouched posture, straining with exercise, lifting or toileting, or squeezing it tight all the time.
● Increase awareness of pelvic floor muscles to allow for improved relaxation during childbirth.
3. HOw can I strengthen my pelvic floor?
● Breathing exercises: Practice relaxing the abdomen and pelvic floor as you breathe in, and then gently contract the pelvic floor as you breath out.
● Kegel exercises:
○ See if you can keep the muscles contracted as you take 5 breaths. If you can, work on performing up to 10 repetitions.
○ See if you can contract and relax the muscles quickly 10x.
● Use the pelvic floor muscles functionally: Contract them whenever you cough, sneeze or clear your throat. Exhale and contract as you lift, push, or pull objects, and as you get out of bed and up off the floor.
● Not everyone needs strengthening; some people with signs & symptoms of PFM dysfunction actually need to learn to relax their pelvic floor to make it work better. Seeing a pelvic floor specialist can allow you to identify and address the dysfunction correctly.
4. What are some signs that could indicate I have pelvic floor issues and when should I seek help from a professional?
● Signs of dysfunction include bladder or bowel leakage, urinary/bowel urgency and frequency, constipation or difficulty urinating, a sense of heaviness in the pelvis or something “falling out,” pain in the pelvic region, or a change in sensation in the pelvic region. The sooner you can address the issue, the better the outcome.
● Pelvic floor therapists also assist with pregnancy related pain and often see patients prior to, during, and after pregnancy. We also assist with regaining and improving abdominal control to allow for return to desired activities.
Should only pregnant women be concerned about their pelvic floor? Who else can be affected?
● Every human has a pelvic floor, which means that men, women, and children can all experience pelvic floor muscle dysfunction. Aside from pregnancy and childbirth, the pelvic floor can be injured through falls, pelvic surgery, radiation treatments, bladder or prostate infections, chronic bladder and bowel holding, endometriosis, hip or spine problems, and neurologic conditions such as having a stroke or multiple sclerosis. Sometimes the pelvic floor bothers and there is no injury or specific cause.
5.Pelvic floor pearls:
● Research has shown that many people perform pelvic floor muscle contractions incorrectly, even if they think they know how to do them, so get checked by a trained professional.
● Urinary leakage, even in small amounts, is common but NEVER NORMAL. It is a sign the pelvic floor muscles are not working properly.
● Good posture helps the pelvic floor work normally. Avoid slouching and standing with the buttocks clenched or tucked under.
● The pelvic floor is made up of muscles and we have voluntary control over those muscles, sometimes they just forget how to work the way they are supposed to and need some attention. This is not uncommon and there is help.
● Pelvic health physical therapists can help! We are specially trained in assessment and treatment of pelvic floor disorders. Our passion is educating patients with strategies that will keep them moving and improve their quality of life.
Contact info:
Check Orthopedic 360 Physical Therapy’s website, or give them a call if you have further questions, or are seeking pelvic treatment.
Orthopedic 360 Physical Therapy
830 Cottageview Dr. #204
Traverse City, MI 49684
Phone: 231-486-6368