Pelvic Floor: Fact and Fiction
I'm going to go out on a limb and make an assumptive statement, which is that you have a pelvis. And if you have a pelvis, you have a pelvic floor, which are the muscles on the underside of the pelvis between your legs. And if you have a pelvic floor (and you do) then at some point in your life you may experience pain or dysfunction of the pelvic floor, which are symptoms like sneeze pee, stress incontinence, painful intercourse, and organ prolapse. In fact, 1 in 3 women will seek medical help for a pelvic floor related problem, and approximately 16% of men. And that's just the folks who needed help enough to overcome the embarrassment of talking about their undercarriage. Pelvic floor problems are chronically under diagnosed because people are uncomfortable talking about it, even to their medical professional. As I've learned more about the body and what I fondly call the 'bottom of the grocery bag' (cause the pelvic floor is the bottom of the abdominal contents) I've also discovered there's a lot of confusion about it, and some misinformation too. So let's real about the pelvic floor for a moment, shall we?
True or False: Only women have pelvic floors.
False! Everyone with a pelvis has a pelvic floor, as we previously discussed. I just wanted to really make sure we're all on the same page here.
True or False: Only women have pelvic floor problems.
False! If you have a pelvic floor (and you do), then you can experience pelvic floor dysfunction. Yes, men, this includes you. Pelvic floors are not genitalia, nor are they the sexual organs, though they can affect these. Sexual performance issues such as erectile dysfunction can actually be a symptom of a pelvic floor disturbance, as well as prostatitis.
True or False: You can experience pelvic floor dysfunction even if you've never been pregnant or given birth.
True! I just want to be REALLY clear about this, because this is one of the most prevalent myths out there. While childbirth can be traumatic for the pelvic floor, childbirth itself is not inherently pelvic floor wrecking. And you do not need to have experienced childbirth to experience pelvic floor disorders. Again, men. Just saying. And women who have not given birth. And children. We have pelvic floors, all of us. And they can be affected by far more things than just pushing a baby out.
True or False: Pelvic floor dysfunction is always caused by a single traumatic event.
False! As we said above, childbirth gets blamed for most women's pelvic floor symptoms, and while it certainly can be a contributing factor it is possible that other symptoms of pelvic floor disharmony may have been occurring beforehand. For so many of us what amounts to dysfunction of the pelvis is the cumulative effect of habits over time. What habits? Sitting a lot, and sitting with our pelvis tucked, which puts pressure on the tailbone and sacrum, leading to shortening of the pelvic floor muscles. Chronic tucking of the pelvis in posture is another, as well as sucking in our guts and tensing our abdomen excessively.
True or False: A tight pelvic floor = a strong pelvic floor
FALSE!!!! Repeat after me - TENSION DOES NOT EQUAL STRENGTH. And then say it again, louder, for the people in the back. We've really got to get this myth out of our heads. Here's the truth - if a muscle is so tight that it cannot contract any further, it cannot produce force. Force is generated when the muscle fibers shorten and contract. But there's a limit to the amount of contraction a muscle can do. Then, if you keep the muscle short and tight and never let it relax, it gets tired and stressed out. And then when you ask it to give more, it's got nothing left to offer, and may even fail altogether. This is the pelvic floor, friends. Very often (VERY) a hypertonic (too tight) pelvic floor is involved in pelvic floor dysfunction. A tight pelvic floor that is short and tense will be weak. It's got nothing left to give.
True or False: Kegel exercises are the solution for pelvic floor dysfunction
False, for all the reasons we just talked about. If you are holding the pelvic floor too tightly and can't let it relax, asking it to tighten more may actually make the situation worse. It's not that Kegels never work, it's that they are not the cure for all pelvic symptoms. So if you've been Kegeling like your life depends on it and it's not helping, don't panic. There's so much more to a healthy pelvic floor than being able to disrupt the flow of urine.
True or False: Back pain and hip pain can be a sign of a hypertonic pelvic floor
True! The pelvic floor muscles are interwoven with the muscles and functionality of our hips and back, so if the pelvic muscles are clenched and won't let go then it will affect how the surrounding parts move and function. If you've had symptoms of hip or back pain and haven't experienced relief from other means, it may be time to have your pelvic floor examined. Also, if you're a woman who experiences really painful periods, please do yourself a favor and have your pelvic floor muscles assessed.
So if you think your pelvic floor is in need of some attention, what to do? Well most importantly, don't be afraid to talk to your doctor about it! There are pelvic floor physical therapists that can do you a lot of good. And if you are interested in how posture, alignment, and whole body function contribute to pelvic floor symptoms, come in and see us!