What Is Pelvic Floor Dysfunction?

Tamarah Calyniuk-Nerreter

MScPT, CAFCI, Special interest in Pelvic Floor Dysfunction

Pelvic floor diagram for women's health in VancouverYou may have heard of the pelvic floor referred to as your ‘kegels’. Many of you may be practicing your ‘kegels’ because someone mentioned that you should, especially as a female in the childbearing years of your life.
Much research has been done in the past few years on the pelvic floor, advancing our knowledge as to what these ‘kegels’ maintain for both females and males throughout the lifetime.  Research suggests it provides a much more complex array of functions then initially expected. The practice of specific pelvic floor exercises help maintain visceral bodily function (ie. continence) and stability of the back and pelvic regions. These muscles are not easy to recruit without appropriate cueing and practice with awareness, therefore visiting a physiotherapist specialized in training these muscles is necessary for optimal recruitment.

What is the pelvic floor?

The pelvic floor is in the pelvis forming a floor from pubic bone to tail bone. You can think of it like a bowl or sling that floats within the pelvis. If you cup your hands together this is what it looks like in the pelvic bowl.

The Role of the Pelvic Floor

- support the pelvic organs
- facilitates increases in intra abdo pressures
- fecal continence & support for defication
- inhibitory effect on bladder
- assists in unloading the spine
- assists in pelvic-spinal stability
- involved in sexual arousal and performance

Muscles of the Pelvic floor

Levator Ani - A group of 3 muscles working to elevate the pelvic organs and compresses the rectum and vagina

Ischiococcygeus- Provides support for pelvic contents and contributes to SI joint stability

Pelvic Floor Dysfunction

Pelvic floor dysfunction involves any sensations or symptoms that are abnormal to ‘normal function’ for example urinary incontinence, pelvic organ prolapse or pelvic pain or symptoms of sexual dysfunction. These dysfunctions are common, (ie. Urinary incontinence is prevalent in every 1 in 3 women) however it is NOT a normal part of aging. It can be dealt with. These dysfunctions of the pelvic floor can be a result of pain, poor movement patterns, surgery, hormonal changes premenstrually, changes during pregnancy, postpartum (labor/delivery trauma), or menopause with ageing. More often than not we see overactivation occurring of deep posterior muscles (ie. ischiococcygeus and piriformis) and underactivation of the anterior pelvic sling (levator ani). This imbalance results in the aforementioned dysfunctions.

Pelvic floor assessment and development of an appropriate pelvic floor re-training regime can cure or improve these aforementioned dysfunctions. Retraining of the pelvic floor requires one to produce a very specific isolated contraction of these ‘sling’ muscles. Although you may think you are activating your pelvic floor (aka. kegels) properly, it has been noted 65% of you are not. This isolation step is important to give you the ability to produce a co-contraction of these pelvic floor muscles with other muscles of ‘the core’ that help stabilize your pelvis, lumbar spine and trunk.

It is important to address any issues you feel may be prevalent regarding your pelvic floor with a physiotherapist who is certified and trained in providing the appropriate assessment and treatment. There is a solution to urinary/fecal incontinence and pelvic pain!