Incontinence & Pelvic Floor Dysfunction
Pelvic floor dysfunction (PFD) is a term used to describe pain and disruption of bladder, bowel &/or sexual function due to restrictions of the muscles and nerves of the pelvis. Millions of Americans are suffering from PFD yet for most, the disease goes unidentified and untreated. Some research says that as many as 1 out of every 5 Americans (of every age) suffer from some type of pelvic floor dysfunction at some time in their life, with urinary incontinence being one of the most common symptoms. And, it is not just a "women's" disorder, men and children can have pelvic floor dysfunction as well.The pelvis is a bowl-shaped bony structure which holds the organs of digestion, elimination (bladder & bowel) and sexual function. The pelvic floor muscles (PFM) are located at bottom of the bowl, attaching like a hammock from the front pubis to the back coccyx bones. The PFM supports the viscera, maintains continence (bladder and fecal), assists in core/trunk stability and enhances sexual function. The pudendal nerve and its branches also travel through the PFM and can sometimes be a source of pain or dysfunction.
Injury to both muscle and nerves can result in the following symptoms:
- Leaking of urine, stool and/or gas
- Urinary or fecal urgency and frequency
- Obstructed defecation
- Constipation
- Painful intercourse (Dysparunia)
- Vaginal Pain (Vulvodynia)
- Pubic Bone Pain
- Coccyx Pain
- Chronic Pelvic Pain
- Pelvic Organ Prolapse (Bladder, Rectum)
- Low sexual desire/sexual distress
- Diastasis Recti (abdominal separation)
- Rectum/Anal pain
- Core weakness
- Poor erection/ejaculation
- Prostatitis
- Groin or genital pain
Potential Causes of Dysfunction:
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How physical therapy can help:
During your initial evaluation, your physical therapist will complete an extensive evaluation and conduct a variety of tests to assess the strength, coordination, and integrity of your pelvic floor muscles. An individualized program will be developed based on these findings.Treatment interventions may include:
- Muscle re-education
- Muscle strengthening and/or relaxation exercises
- Functional activities of daily living alternatives
- Postural education
- Soft tissue mobilization
- Spinal and pelvic malalignment corrections
- Biofeedback/surface EMG
- Electrical stimulation, TENS, heat, cold, or ultrasound for pain relief