Pelvic Floor Dysfunction: More Common than you think
Do you experience leakage with running or jumping activities? If so you are not alone. Urinary leakage affects millions of American women aged 18 to 55; as a nation we spend an estimated $28 billion because of it. It’s not just a concern for new moms or senior ladies as more and more female athletes are experiencing pelvic floor dysfunction, a diagnosis that includes both pelvic pain and urinary leakage.
According to a Norwegian University study, a high prevalence of pelvic-floor muscle dysfunction is seen in high-impact athletics such as gymnastics and track & field. Activities such as running and jumping place an increased strain on the pelvic floor, which can cause dysfunction: pain, weakness, and/or incontinence. Before we can talk about pelvic-floor dysfunction we need to talk about the pelvic floor.
The pelvic floor is composed of a group of muscles, fascia, and ligaments that attach to the front, sides, and back of the pelvis. These muscles form a hammock that supports the internal organs including the bladder. These muscles work together in a beautifully coordinated fashion to ensure core strength and stability, healthy bowel and bladder function ,and healthy sexual activity. When the muscles do not work together the way they should, we see pelvic floor dysfunction.
Pelvic-floor dysfunctions occurs when the muscles of the pelvic floor are weak, tight, or are simply not working together in that coordinated fashion. There could be accompanying hip, lumbar, sacroiliac-joint, or coccyx (tailbone) pain. Pregnancy and childbirth are two acute events that can stretch the muscles of the pelvic floor. In fact, research shows that giving birth increases the risk of pelvic floor dysfunction by 18% after the first child and 32% by the third child.
Incontinence is the most common type of pelvic floor dysfunction. Urinary incontinence is the involuntary loss of urine and comes in a number of varieties. Stress incontinence is the loss of urine resulting from activities such as sneezing, coughing, laughing, running, or jumping. Urge incontinence is the strong and sudden need to urinate, the bladder squeezes or spasms and you lose urine. With urge incontinence there are often triggers, such as pulling into the driveway or turning the key in your front door that set off the condition. Mixed incontinence -the most common in older women – is a little of both types.
Pelvic Pain anywhere in the pelvic region can result from muscular dysfunction in this area. Tight or shortened muscles resulting in a spasm or a painful tightening of the connective tissue can cause significant pain.
Pelvic-floor dysfunction is a growing field within women’s-health practices. Sufferers are talking about it and recognizing that there are more treatment options than ever before. Pelvic- pain specialists including OB/GYNs,, urogynocologists, and physical therapists are all part of the specialized field that treats bladder and pelvic-floor health issues. Patients will often see a combination of professionals to determine the cause of their pelvic-floor dysfunction, and to implement a therapy and monitoring plan.
Talking about pain, incontinence, and other issues “down there” can often be embarrassing to discuss with friends, family or even your primary-care doctor.
A women’s health physical therapist (pelvic floor specialist) can discuss your history and symptoms with you and develop a treatment plan that may include manual therapy, home exercises, and behavior modification. Pelvic-floor physical therapists want to educate and empower women so they have the tools necessary to help themselves get stronger, reduce pain, improve leakage, and meet other health and fitness goals.
There is help ladies! With the support of a specialized medical professional you can gain control of your pelvic floor again.
By Lauri K. Friedman, MS, PT