Hi there! Welcome to Tuesdays with?! Today our very special guest blogger is blogging all the way from her home in Australia! Her name is Mary O’Dwyer. Mary is a pelvic floor PT with more than 30 years of experience treating women’s health issues. She’s dedicated her life to not only treating pelvic floor dysfunction, but educating other PTs on how to best treat PFD. Mary is also the author of a wonderful book titled: “ My Pelvic Flaw: Preventing Pelvic Floor Problems Throughout Life ”. Mary, you have the floor—pardon the pun.
Much of our present epidemic of pelvic floor problems is underpinned by a general lack of knowledge about this most central part of our female body. What did your mother tell you about preventing leaky bladders, prolapse, correct bowel and bladder habits, exercise after birthing, pain with intercourse etc? Not much because women just don’t have the correct knowledge to pass onto their daughters. So, I thought today I’d answer a few questions about the basic functions of the pelvic floor.
What’s the role of your pelvic floor muscles? Your pelvic floor muscles have about four major roles:
• Your muscles tension to close the sphincters to keep you continent. • Your muscles tension and hold up your bladder, vagina and bowel against the downward intra-abdominal pressure happening every time you lift a child, cough, pull down the lat. bar at the gym or run. • Your pelvic floor automatically tensions with your deep abdominal muscles to provide stability for your lumbar spine when you move. Research shows a high correlation between pelvic floor problems and spinal problems. • Your pelvic floor muscle strength is related to the strength of your sexual response, sensation and orgasm.
Are all pelvic floor’s the same?
No way! So far, apart from the normally functioning floor, I have identified four different types—as I continue this aspect of my research, I may isolate additional types, but to date, here’s what I’ve found:
• The Weak Pelvic Floor: this pelvic floor has no idea of how to tension, may have been damaged during pregnancy or childbirth, experienced neural damage from straining to open the bowel, been damaged from continued heavy lifting or an injury. The owner of this floor has a poor idea of how to tension the muscles which may be slack and stretched. The owner may even bear down instead of tensioning upwards. Thinking about the levels in a building, this floor sits in the basement.
• The Uncoordinated Pelvic Floor: researchers have shown the pelvic floor and deep abdominal are the first muscles to tension milliseconds before we move. The owner of this floor may have learned to switch on the strong waist muscles first due to overuse and incorrect abdominal exercises, so their pelvic floor switches on after the waist muscles. When this owner exercises, lifts or coughs they have learned an incorrect pattern of strongly switching on their waist and rib cage muscles to do the action. So, this pelvic floor may travel from the basement up to first floor in the attempt to overcome the strong intra- abdominal pressure down onto the floor.
• The Overly Tight Pelvic Floor: this pelvic floor becomes switched on too frequently at too high a level of contraction. If you bend your fist to your shoulder to hold your biceps tightly clenched, this keeps the biceps contracted. Imagine how dysfunctional your biceps would become if you held you biceps clenched for hours on end. The owner of this floor is likely a gym junkie or elite athlete and has developed dysfunction in their core muscles due to the high level of muscular tension. The owner of this floor typically holds too much tension at the waist and ribs like a self-imposed muscular corset and has an abnormal breathing pattern due to the constant waist tension. Prescribing strength exercises for this pelvic floor will only aggravate the owner’s symtoms.
• The Chronically Painful Pelvic Floor: This owner has learned a pattern of continually holding tension in their pelvic floor as a learned response to stress, and tension. Since the muscles surround sensitive nerves and blood vessels, these structures are constantly irritated by this ongoing tension. This owner walks around with their floor held up at the second floor and with periods of added stress even draws it up to the third floor. This excessive muscular tension is the breeding ground for pain producing trigger points. Add to this an injury or a triggered immune response and the brain misreads nerve signals and upgrades them to intense pain that’s out of proportion to the condition or injury. Prescribing strength exercises for this floor will also aggravate symptoms. In addition, to having their trigger points treated, the owners of this type of pelvic floor needs to learn the skill of letting go of tension before gently coordinating pelvic floor muscle action.
Most women I treat with pelvic floor problems have never learned to correctly tension and coordinate their pelvic floor and core muscles with everyday bodily functions and activities. Their brain literally does not recognize the action of these muscles or they may have learned an incorrect pattern.