Maintaining Your Pelvic Floor Health

Pelvic pain is com­mon, affect­ing near­ly a third of women in the Unit­ed States, and can be the result of peri­od cramps, endometrio­sis, uter­ine fibroids or mus­cle weak­ness. When pelvic pain is caused by strain on your pelvic floor mus­cles, uri­nary symp­toms can also occur. While it may be uncom­fort­able to dis­cuss pelvic pain and/​or uri­nary symp­toms with your obstetrician/​gynecologist (OB/GYN), it is impor­tant to iden­ti­fy the cause and begin treat­ment if need­ed. In some cas­es, you may be able to reduce symp­toms with cer­tain lifestyle mod­i­fi­ca­tions. Your OB/GYN may also rec­om­mend phys­i­cal ther­a­py in order to strength­en weak­ened pelvic floor mus­cles. Phys­i­cal Ther­a­py can also help reduce pelvic pain by relax­ing over-con­tract­ed mus­cles to pro­vide symp­tom relief and pre­vent more seri­ous pelvic health issues from developing.

Most of us have heard the term ​“pelvic floor”, but may not know what the pelvic floor actu­al­ly does. Your pelvic floor is a sling-shaped group of mus­cles that sup­ports your spine, pelvis and repro­duc­tive organs includ­ing your blad­der, colon and rec­tum. These mus­cles expand and con­tract to help stop and start the flow of urine and stool, as well as to pro­mote the pas­sage of gas.

Over time, or dur­ing cer­tain activ­i­ties, your pelvic floor mus­cles may weak­en. In women, this is most com­mon dur­ing preg­nan­cy and after child­birth. Women who have had mul­ti­ple vagi­nal births, or have birthed babies weigh­ing more than 10 pounds, are at an even high­er risk. Oth­er fac­tors can con­tribute to the weak­en­ing of pelvic floor mus­cles including:

Age

Your pelvic floor mus­cles nat­u­ral­ly weak­en as you age.

Con­sti­pa­tion

Repeat­ed­ly strain­ing to use the bath­room can affect your pelvic floor muscles.

Chron­ic coughing

If you have lung or breath­ing dif­fi­cul­ties such as asth­ma, emphy­se­ma or recur­rent bron­chi­tis, you are at an increased risk.

Genet­ic factors

Pelvic-relat­ed health con­di­tions often run in families.

Heavy lift­ing

Jobs or hob­bies that require fre­quent heavy lift­ing can cause pelvic and back strain, weak­en­ing your pelvic floor mus­cles over time.

High-impact exer­cise

Reg­u­lar­ly engag­ing in high-impact activ­i­ties, includ­ing bas­ket­ball or run­ning, can increase your risk.

Weight

Being over­weight or obese, espe­cial­ly car­ry­ing extra weight in your abdomen, can strain your pelvic floor muscles.

Signs that your pelvic floor mus­cles may need strength­en­ing include:A feel­ing of heav­i­ness or pres­sure in your pelvic area

• Lack of blad­der and/​or bow­el control
• Uri­nary leak­age with phys­i­cal exer­tion or dur­ing activ­i­ties such as cough­ing, sneez­ing and laughing
• Increased fre­quen­cy and/​or urgency to urinate

If you are expe­ri­enc­ing pelvic floor-relat­ed symp­toms, your OB/GYN can help you devel­op a treat­ment plan to strength­en your pelvic floor mus­cles and address any asso­ci­at­ed symp­toms. Cer­tain lifestyle mod­i­fi­ca­tions may reduce your risk and pro­vide symp­tom relief including:

• Avoid­ing heavy lifting
• Con­sum­ing ade­quate amounts of flu­ids and fiber each day to address chron­ic constipation
• Eat­ing a bal­anced diet to help main­tain a healthy weight and sup­port healthy bow­el habits
• Emp­ty­ing your blad­der reg­u­lar­ly (try to use the bath­room every two to four hours)
• Exer­cis­ing regularly
• Not smok­ing as it leads to res­pi­ra­to­ry issues includ­ing chron­ic coughing
• Lim­it­ing your intake of alco­hol and caffeine
• Strength­en­ing your pelvic floor mus­cles with Kegel exercises

Addi­tion­al­ly, your OB/GYN may rec­om­mend phys­i­cal ther­a­py to learn exer­cis­es and tech­niques you can use to strength­en your pelvic floor and sur­round­ing mus­cles. It is impor­tant to keep your pelvic floor strong in order to pre­vent con­di­tions such as uri­nary incon­ti­nence and pelvic organ pro­lapse (POP) from devel­op­ing. Spe­cial­ly trained wom­en’s health phys­i­cal ther­a­pists are avail­able at DuPage Med­ical Group to help you improve the flex­i­bil­i­ty and coor­di­na­tion of these mus­cles, pro­vid­ing bet­ter sta­bil­i­ty in your pelvic floor. They offer sev­er­al pelvic health ser­vices including:

Pos­ture and child care techniques

Being mind­ful of your pos­ture, and learn­ing how to engage and uti­lize your neu­tral spine, can help min­i­mize (or pre­vent) pelvic and back pain. Pay atten­tion to your pos­ture when per­form­ing cer­tain activ­i­ties such as push­ing a stroller, car­ry­ing a car seat and get­ting out of bed. Your ther­a­pist can rec­om­mend ways to reduce dis­com­fort with activ­i­ty mod­i­fi­ca­tions like using a back­pack instead of a dia­per bag or plac­ing an infant tub in a sink or on a counter.

Strength­en­ing your core

Dias­ta­sis Rec­ti (DrA) affects almost two-thirds of women dur­ing preg­nan­cy and near­ly 60 per­cent of women after child­birth. DrA devel­ops when the space between your right and left stom­ach mus­cles widen. The addi­tion­al pres­sure in your abdomen while preg­nant makes it dif­fi­cult for your abdom­i­nal mus­cles to keep their shape and the lack of sup­port caus­es your stom­ach to stick out. Symp­toms of DrA include abdom­i­nal and low­er back pain, con­sti­pa­tion, incon­ti­nence and pain dur­ing inter­course. Your phys­i­cal ther­a­pist can help you strength­en cer­tain mus­cles with­in your core with breath­ing tech­niques com­bined with ways to acti­vate your pelvic floor mus­cles, as well as the mus­cles respon­si­ble for your core and hip sta­bil­i­ty. In some cas­es, these tech­niques may not resolve DrA symp­toms and surgery may be required.

Pelvic floor exercises

Kegel exer­cis­es and oth­er sup­port tech­niques are often an effec­tive way to strength­en the mus­cles in your pelvic floor. Your ther­a­pist will instruct you on how to per­form each exer­cise cor­rect­ly so that you can do them on your own at home.

In some women, espe­cial­ly if left untreat­ed, a weak­ened pelvic floor can lead to oth­er pelvic and uri­nary con­di­tions, most com­mon­ly stress-relat­ed uri­nary incon­ti­nence and pelvic organ pro­lapse (POP).

Stress-relat­ed uri­nary incontinence

Stress incon­ti­nence is com­mon dur­ing preg­nan­cy and after child­birth. Near­ly 50 per­cent of women will expe­ri­ence stress incon­ti­nence dur­ing their preg­nan­cy. Of those women, a third will con­tin­ue to expe­ri­ence incon­ti­nence symp­toms after giv­ing birth. This is because of the ele­vat­ed hor­mones and weight gain that occurs dur­ing preg­nan­cy which places increased pres­sure on pelvic floor mus­cles, as well as the stretch­ing in the pelvic area that hap­pens dur­ing labor.

Pelvic Organ Pro­lapse (POP)

POP can devel­op when the mus­cles and lig­a­ments that sup­port your pelvic organs weak­en, allow­ing them to slip out of their nat­ur­al posi­tion. Signs of POP include:

• Pres­sure in the vagi­nal area
• A vis­i­ble bulge or protrusion
• Dif­fi­cul­ty uri­nat­ing or defecating

In some cas­es, despite con­ser­v­a­tive treat­ment and lifestyle mod­i­fi­ca­tions, your symp­toms may per­sist or wors­en. To address ongo­ing pelvic health con­cerns, your OB/GYN can refer you to a urol­o­gist who spe­cial­izes in pelvic health con­di­tions. Addi­tion­al treat­ment options can include pes­sary (a soft, flex­i­ble device that is placed inside the vagi­na to assist in sup­port­ing pelvic organs) and surgery. Your OB/GYN, ther­a­pist and urol­o­gist will work togeth­er to help you estab­lish a treat­ment plan that is right for you.

To dis­cuss your pelvic health and any symp­toms you may be expe­ri­enc­ing, sched­ule an appoint­ment with an OB/GYN online or by call­ing your pre­ferred location.