Today I want to talk about a health issue that appears as a common occurrence to so many people, yet is not normal for our health and wellness. Common complaints such as urinary urge and frequency, chronic urinary tract infections (UTIs), urinary incontinence (UI), constipation, painful sex, erectile dysfunction, and pelvic pain are often blamed on age, drinking too much water or caffeine, having a small bladder, child birth and breastfeeding, or being told “it’s all in your head.” Well I have news for you: your pelvic floor muscles, nervous system, and other pelvic health conditions are the underlying factors.
Pelvic health encompasses the function of your pelvic floor muscles, urinary and bowel systems, and reproductive system. When everything “down there” is working in harmony, our bodies can happily pee, poop, have sex, carry babies, and go through menstrual cycles or menopause. The pelvic floor muscles are skeletal muscles, just like the muscles in our arms and legs. The pelvic floor muscles also constantly work together with some of those larger muscles like the abdominals, gluteals, spinal extensors, and diaphragm. They make up the bowl of your pelvis, kind of like a hammock to hold everything in place. They have to counteract increases in intra-abdominal pressure during activities such as coughing, sneezing, laughing, and jumping. Can you see how complex this is getting? No wonder so many things can go wrong.
What if you never had an injury or don’t know how those pelvic floor muscles could have gotten stressed in the first place? Pelvic health conditions such as chronic pelvic pain syndrome (CPPS), endometriosis, vestibulodynia, interstitial cystitis, irritable bowel syndrome, and vaginismus have common underlying factors including inflammation, psycho-social factors (stress, lifestyle, diet, sleep, etc), and trauma (physical or emotional). Many of us also have at least one of the many chronic medical conditions (eg. diabetes, autoimmune disease, high blood pressure, heart disease) troubling the Western world since the 20th century thanks to processed food, sedentary lifestyles, and stress. Modern society has growing pressures to remain on-the-go, stimulated by screens and social media, and forgo routine exercise and nutrition.
Our nervous systems start to become chronically stressed, which keeps the sympathetic nervous system on overdrive. AKA the “fight or flight”response that helps us to avoid danger – like running from predators as our ancestors once did- never shuts off. The pelvic floor muscles are constantly under battle, and tighten up to protect your body. This vicious cycle continues and the body begins to develop one or more of the following physical symptoms:
- Urinary symptoms:
- urinary urge and/or frequency
- urinary hesitation or retention
- urge and/or stress incontinence
- post-void dribbling or leaking
- burning during or after urination
- Bowel symptoms:
- fecal incontinence
- pain before, during, or after bowel movements
- abdominal pain
- Sexual dysfunction:
- pain during, or after sex
- diminished or absent orgasm
- erectile dysfunction
- post-ejaculatory pain
- Pelvic pain symptoms:
- pelvic girdle pain
- perineal pain
- low back pain
- sacroiliac joint dysfunction (SIJ)
- tailbone pain (coccydynia)
Side note: pregnancy and postpartum women can experience any one of the above symptoms. The “normal” label is often applied to these symptoms simply because we are lead to believe that having a baby changes you for good. Yes they are common, but any mother should not have to live with them. Spread the word and seek care of a pelvic health physical therapist if you are looking to become pregnant, are currently pregnant, or are a postpartum (no matter how long ago you gave birth) mother.
If you have think you may be struggling with any of the above symptoms, whether they are new or ongoing, do not hesitate to talk with a medical provider who can guide you in a treatment method. Getting an evaluation from a pelvic floor physical therapist will determine if you have tension in the pelvic floor muscles, how you can control and move the pelvic floor muscles, which other muscles are contributing, and if posture, breathing, or exercise plays a role. A pelvic floor physical therapist can also provide a treatment plan to address your specific goals. Be sure to discuss underlying factors with your physical therapist or other medical provider in order to tackle the root of your symptoms and eliminate triggers. At Physical Therapy Edge, we can provide physical therapy and wellness coaching to tease out the pieces and guide you to achieving your goals.