Pelvic Floor Dysfunction: What it is and why you need to know!

Female Hip / Sacrum / Pubis / Ischium / Ilium - Anatomy BonesThe pelvic floor is an important part of human anatomy. Considering how important it is, it always amazes me how infrequently the pelvic floor is discussed. It is responsible for correct bowel and bladder function, it is also responsible for normal sexual function. One could think of the pelvic floor as the structure that holds in and supports your insides. If the pelvic floor is weak due to trauma, abnormal muscle recruitment or injury, then the pelvic floor muscles are not equipped to support your internal organs, which can lead to other dysfunctions.

Some of the dysfunctions that can result from pelvic floor weakness is incontinence. That can include bladder and bowel incontinence. Incontinence means that you have diminished, or lack of control of, your bladder or bowel. Symptoms include leakage with coughing, sneezing, laughing or any jarring movement. Other symptoms include increased frequency of going to the bathroom, difficulty starting the flow of urine, or very strong urges to empty your bladder but minimal volume with emptying.

Trauma to the pelvic floor can also lead to weakness. Trauma can include an injury to the hip, pelvis or back, can include sexual abuse, removal of the prostate due to cancer or can result from a very challenging childbirth experience. Sometimes the muscles of the pelvic floor “forget” how to contract again once they have been traumatized. Or, if there is scar tissue, for instance after an episiotomy, then the muscles don’t contract as effectively. Sometimes after injury there is some loss of sensation and so the brain is unable to “find” the pelvic floor muscles in order to contract them and strengthen them.

There is another type of pelvic floor dysfunction that can lead to pain in the pelvic floor. Sometimes the muscles of the pelvic floor get very shortened, tight and weak. This can lead to pain with intercourse, pain with bowel movements or constipation. Many times people with shortened pelvic floor muscles experience radiating pain in their lower back, buttocks or inner thighs and can be confused with a pathology of the back or hips.

While both of these dysfunctions cause problems, they are addressed differently. Both dysfunctions will eventually require strengthening and re-education. The shortened and tight muscles first have to learn to relax before they can be strengthened. Both dysfunctions can be addressed by a physical therapist that specializes in pelvic floor rehab. Men and women can both experience both of these dysfunctions.

For those who do not know how to do pelvic floor strengthening, or who perform the exercises incorrectly, here is a review of how to perform a kegel. Sometimes people read to try to stop and start the flow of urine when emptying their bladder. This is contradictory to how the body should function. I do not recommend that technique. The motion you are going to do is a “lifting” of the pelvic floor. Think of the pelvic floor like a sling or a hammock and when you contract the muscles it is lifting, or tightening the sling.  Once you get more familiar with contracting the muscles you want to perform two types of contractions. You want to hold them for a period of time, say 10 seconds. You can think of these muscles as postural muscles that require more endurance. You also need to perform quick, strong contractions. Think of these muscles as your sneeze muscles, as they help to support your organs when you sneeze.

If you find you have any of the above issues, or questions regarding your pelvic floor, please do not hesitate to contact me for a consultation or evaluation. I look forward to hearing from you!

Taresa Kenens, MPT, COMT
Owner and Pelvic Floor Specialist
Synergy Manual Physical Therapy – North Office

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112

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Herniated Discs (Part 2): Symptoms and Treatment

This blog is the second part of a two-part blog on herniated discs. In the first post we covered the anatomy of your spinal discs and the common injuries to these discs. You can visit that post by clicking this link. Today we will discuss the symptoms and treatment of a herniated disc and what you should expect when you see a physical therapist.

SYMPTOMS OF A DISC

Just as no two people are the same, neither are our injuries. So this is a list of all possible symptoms but even just having one or two could indicate a disc injury, or you could even have a herniated disc without any symptoms. But on the flip side you could have two or more and actually not have a disc injury. (Are you thoroughly confused yet?) An evaluation from a physical therapist or medical doctor would be required to properly diagnose or rule out a herniated disc.  These are the most common symptoms of a disc injury:

  • Forward flexed posture
  • Increased pain in the morning or late at night
  • You don’t love sitting (standing might also not be that great due to more pressure on the disc)
  • Symptoms radiating down your leg or arm such as numbness, tingling, and/or pain
  • Weakness in arms or leg
  • Muscle cramping or tightness in your neck or back

HOW CAN PHYSICAL THERAPY HELP?

Physical therapists can design treatment programs that help the discs heal and address any other associated issues the back and lower body have from compensating. The back will try to protect itself as you still try to function and it can result in muscle tightness and guarding, sacroiliac joint dysfunction, tension in the nervous system, core weakness, and injury to other structures in the spine (ligaments, joints, nerves) as the disc fails to do its job. Treatment of these related issues can help your pain and provide good stimulus for the disc to heal.  Additionally we can design exercise programs so you don’t risk re-injury.  You don’t have to become completely immobile while waiting to heal. For example walking 15-30 min can help pump nutrients to the disc to allow itself to repair.

Therapy can also involve “passive modalities” like traction, ultrasound, electric stimulation, heat and ice. These can help you feel better and promote healing, but you aren’t the type of person who lives your life laying down on a table. You need to lift, reach upwards, pick things off the ground, hike up 14,000ft while carrying a 20 lbs backpack.

Therapy will also include exercises to re-activate the small stabilizers (called the multifidus) of the vertebrae that “shut off” with low back pain. When these don’t work, the large muscles of the back to take over which leads to fatigue and spasm (aka more back pain and tightness). There is a large variety of simple to advanced exercises to work the muscles you need to and these aren’t your weight lifter grandma’s intense sit ups.

You might also be put through exercises to restore motion of the spine, improve the hydration of the disc and to improve flexibility of the lower limbs.  These help combat the stiff and “stuck” feeling of your low back.

Finally, PTs can teach you positions to ease your pain. Remember how I said sitting tends to be a painful position? Try a rolled up towel placed in the low back to maintain the natural curve. Don’t rely on the “lumbar support” from your desk chair or automobile seat. Don’t rely on a “one size fits all” for your specific back anatomy.

Low back bothering you through the day or at home? Try lying on the floor on your back with your hips and knees flexed to 90 degrees such as when you lay on the floor with your legs up on the sofa or a chair.

CONCLUSION

If after reading this you have further questions or suspect you may be suffering from a herniated disc, feel free to call us or stop by one of our offices to schedule an appointment with me or another therapist. One of the keys to a quick recover is to not only beginning to receive treatment right away, but also knowing what to do and what not to do. This is where we take each patient as an individual and create a specific program that matches your symptoms and abilities. So don’t waste any more time, come by and see us to get your back in shape and allow us to help you recover quickly and effectively.

Kacie Rognlie, PT

Clinic Manager – South Office

Synergy Manual Physical Therapy

North Office (map)
4105 Briargate Parkway
Suite 255
Colorado Springs, CO 80920
phone 719.282.2320
fax 719.282.2330

South Office (map)
600 South 21st Street
Suite 130
Colorado Springs, CO 80904
phone 719.634.1110
fax 719.634.1112