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Pelvic Floor Disorders Part A

Mrs. Vicky Musyoka
Physiotherapy, Hydrotherapy, Lymphedema/ Lymphatic Drainage, Women Health
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What is pelvic floor Pelvic floor is composed of bones, muscles, ligaments, nerves and connective tissues. Pelvic floor is a hammock-like group of 14 thin muscles intertwined with nerves and surrounded by connective tissues that support the abdominal organs while playing a key role in urinary, bowel, sexual function, stability and postural support. The pelvic floor muscles stretch like a muscular trampoline from the tailbone (coccyx) to the pubic bone (front to back) and from one sitting bone to the other sitting bone (side to side). These muscles are normally firm and thick. Just like a trampoline, the pelvic floor is able to move down and up. Pelvic floor muscles are the only group of muscles in the body that never get to rest. They work all the time to maintain continence, support pelvic organs and contribute to our posture and stability. When you consider the many extraordinary tasks the pelvic floor plays a role in (child birth, sex, bowel movements, urination, continence, sitting, walking) it’s difficult to understand why it’s such an under recognized part of our human body. Men and women have pelvic floor the only difference is that women have 3 passages (urethra, vagina, anus) and men have 2 (Anus and Urethra). Although the pelvic floor is hidden from view, it can be consciously controlled and therefore trained, much like our arm, leg or abdominal muscles. Q: What are pelvic floor disorders? A: Pelvic floor disorders occur when the "trampoline" or "hammock" that supports the pelvic organs becomes weak or damaged. These include: 1. Urinary /fecal incontinence 2. Pelvic organ prolapses 3. Tight pelvic floor (OAB) 4. Pelvic pain For many people, particularly women, the pelvic floor does not work as well as it should. Almost one-quarter of women face pelvic floor disorders. According to National Institutes of Health Studies Pelvic floor disorders affect about 10% of women ages 20 to 39, 27% of women ages 40 to 59, 37% of women ages 60 to 79 and nearly 50% of women age 80 or older. Q: What causes pelvic floor disorders? • Childbirth • Pelvic surgery • Overweight or obese • Repeated heavy lifting • Chronic constipation • Frequent UTIs • FGM • Scar tissue • Female / Male sexual abuse • Sitting for long • Hormonal issues in women • Disease such as endometriosis, IBS • Biomechanical abnormality e.g. short leg Q: What are the symptoms of pelvic floor disorders or how does one get to know has a pelvic disorder? People with pelvic floor disorders may experience: • Leakage of urine or stool • Difficult starting urine stream • Post void dribble • Perineal pain • Pain or pressure in the rectum or vagina • Pain in the vulva • Pain during intercourse • A heavy feeling in the pelvis or a bulge in the rectum. • Muscle spasms in the pelvis. • Pain in the tail bone • Pain in the pelvic region • Pain along the scar tissue • Pain with bowel movements • Unexplained pain in the lower back, pelvis, genitals or rectum. • A frequent need to urinate. Q. How is pelvic floor dysfunction treated? Treatment can have a dramatic effect on pelvic floor dysfunction. For most people, this usually involves: • Pelvic floor awareness • Behavior changes, such as avoiding pushing or straining when urinating and having a bowel movement. • Learning how to relax the muscles in the pelvic floor area using abdominal breathing exercises and down training • Connective tissue release • Strengthening exercises i.e kegels • Biofeedback, which can help you learn how to relax and coordinate the movement of your pelvic floor muscles. • Dietary changes Q. Are Kegels good for everyone? Kegels are bad for tight pelvic floor muscles. If you are carried away with kegels you can end up with pain, urinary urgency or frequency. Most people have the wrong perception of kegels. They stop the flow of urine and that causes harm to the sphincteric muscles.