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Pelvic Floor Dysfunction
The muscles of the pelvic floor form a sling from the pubic bone to the tailbone. They assist in supporting the abdominal and pelvic contents; encircle the bowel, bladder, and vagina for closure; and enhance sexual activity.
Causes of Dysfunction:
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Trauma
- Childbirth
- Episiotomy, laceration/tear
- Hysterectomy
- Musculoskeletal imbalances
- Pelvic fractures
- Prior surgeries
- Infection/Inflammation
- Poor posture
- Misuse or disuse of pelvic floor
Types of Dysfunction:
Pelvic floor dysfunctions can be divided into different categories, each producing unique signs and symptoms.
- Supportive dysfunctions: Characterized by a loss of strength and integrity of the pelvic floor’s connective tissue and muscle fiber
- Hypertonus Dysfunctions: Characterized by increased tension in the pelvic floor’s connective tissue and muscle fibers
- Incoordination Dysfunctions: Described as inappropriate use of pelvic floor muscles
- Visceral Dysfunctions: Caused by organs within the pelvis
Typical complaints of pelvic floor dysfunction:
- Bladder and/or bowel problems
- Pelvic pressure and heaviness
- Painful intercourse
- Inability to achieve sexual orgasm
- Frequent urinary tract infections
- Vulvar or clitoral burning or numbness
- Pain in the low back, vagina, rectum, tailbone, and/or thigh
- Lower organ prolapse (may feel like your insides are falling out)
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
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