Here at OSR in Kailua we find more and more women having discomfort, difficulty with muscle control and muscle weakness in the pelvic floor area especially during pregnancy and following childbirth. For a condition that is hard to diagnose, pelvic floor dysfunction is very common. Since the pelvic floor connects the upper and lower body, the pain can always be changing in location: low back area, buttocks area, inner thigh, side of (B) hips and sometimes with radicular symptoms that shoots down the leg.
Anatomy of pelvic floor:
1) Pelvic Diaphragm- AKA pelvic floor. Is made up of muscles the levator ani and coccygeus, that line the inside of the pelvis from the pubic bone to tailbone. This bowl-shaped muscles supports the pelvic area, reproductive and urinary organs. Within this layer are openings for the vagina, urethra and anus.
2) Pudendal Nerve – located on both sides of the pelvis which carries sensation to and from the genital area, urethra and anal area. It also helps the structures to function.
3) Hip Muscles – the obturator internus and piriformis make up part of the muscular wall of the pelvis. The levator ani connects to the obturator internus.
Pelvic floor muscles works day and night. Here are some of the things the pelvic floor muscle does:
1. Its counter balances —the diaphragm, abdominals and pelvic floor regulates pressure in the abdomen. When the diaphragm lowers on inhalation, the pelvic floor and abdomen lengthens
2. Balance — the pelvic floor works with your abdominal and hip muscles to stabilize the pelvis and core whether running, sitting at work, stretching or doing household chores.
3. Relax — the pelvic floor also need to release or relax so it can function effectively when you use the bathroom or having sex.
4. Contract — the pelvic floor muscles must work to prevent accident from happening when going to the restroom
Sources of pelvic floor dysfunction:
-Pregnancy and Delivery — not only does the weight of the fetus add pressure to the pelvic floor, but the muscles and nerves below your navel also stretch with pregnancy and delivery. Pelvic muscles are slow to contract after birth which may cause incontinence or pelvic organ prolapse.
– High-Impact Sports — activities like jumping rope, running, lifting weights all increases intra-abdominal pressure and fatigues the pelvic floor muscles. Women can experience leakage during high-impact exercise.
-Menopause — as women gets older and hormone level shifts, muscle mass and tone decreases. The same happens with the pelvic floor muscles just like in the arms and legs.
– Inactivity — sitting all day on a tucked pelvis results in the sacrum bearing most of the work and weight . Pelvic floor can get weak with moving less and inactivity.
Exercises to strengthen pelvic floor musculature: