Pelvic Floor Dysfunction and Pelvic Pain

Your pelvic floor is made up of muscles and connective tissues that form a sling from your pubic bone to your tailbone, separating your pelvic cavity above from the perineal region below. The pelvic floor supports your viscera, including bladder, intestines and the female uterus. The muscles help control bladder, bowel and sexual activity, and they facilitate childbirth by resisting the fetus as it descends, causing the baby to rotate forward as it passes through the pelvic girdle. Your pelvic floor also helps you maintain optimal intra-abdominal pressure.
Pelvic floor dysfunction is typically marked by constipation, incontinence, diarrhea or other problems associated with bowel and bladder storage and elimination. Elite athletes in sports like gymnastics, basketball, running and other high impact sports often experience damage to the pelvic floor due to constant downward pressure. Childbirth is a common cause of pelvic floor pain and dysfunction.
Some common symptoms of pelvic floor dysfunction include:
  • Leaking urine during exercise, or while coughing, laughing or sneezing
  • Urgency and/or frequent need to use the toilet
  • Difficulty emptying the bladder or bowels
  • Accidental loss of bowel control
  • Frequently passing wind
  • Organ prolapse
  • Pelvic pain
  • Pain or lack of sensation during sex
  • Leaking urine during sex

Incidence and Prevalence of CPP

CPP is defined as pelvic pain that persists for 6 months or longer, and is severe enough to interfere with normal daily function.
  • Chronic pelvic pain (CPP) is a frequent gynecology complaint, accounting for about 10% of visits to the gynecologist.
  • It is estimated that CPP affects about 5% of American women. The prevalence increases to 20% in women with a history of pelvic inflammatory disease.
  • CPP is the most common urologic complaint in men younger than 50 years.

Causes of Pelvic Floor Dysfunction

The pelvic floor can become dysfunctional when the muscles become weak or tight, or when the sacroiliac joint, low back, coccyx and/or hip joint are impaired. Tissues surrounding the pelvic organs may become sensitive or irritated, causing pelvic pain.
Common causes of pelvic pain and dysfunction include:
  • Infections
  • Pregnancy and childbirth
  • Poor posture associated with low back or SI dysfunction
  • Trauma
  • Surgery
  • High impact sports
  • Obesity
  • Sedentary lifestyle

Diagnosis of Pelvic Floor Dysfunction

Diagnosis of pelvic floor dysfunction begins with a thorough medical history and physical exam, including an examination of the pelvic floor. It is important to obtain a thorough history of pregnancy and childbirth, including difficult deliveries, forceps deliveries, prolonged labor, and tearing.
Surgeries including C-section, hysterectomy, hernia, laparoscopy, appendectomy, prostate surgery and episiotomy can affect pelvic floor function. Bowel patterns should be noted, including diarrhea or constipation, and the presence of pain with bowel movements. Nutrition, physical activity and lifestyle habits should also be taken into consideration.
Subcategories of pelvic floor dysfunction include:
  • Bladder disorders
  • Bowel disorders
  • Pelvic pain
  • Sexual dysfunction
  • Post-surgical problems

Diagnosis with Rehabilitative Ultrasound Imaging (RUSI)

At NYDNRehab, we use rehabilitative ultrasound imaging (RUSI) to visualize the structures within the pelvis. RUSI enables both the clinician and the patient to view the pelvic muscles in motion, in real time, to assess for anomalies that may contribute to CPP.
RUSI helps us to diagnose and treat a number of pelvic conditions, including:
  • Low back pain
  • Chronic pelvic pain
  • Hip and groin pain
  • Post-partum rehabilitation
  • Urinary incontinence
  • Recovery from abdominal

Traditional CPP Treatment Options

Most traditional treatment approaches for CPP center on pain management and coping strategies.
Some common traditional treatment approaches include:
  • pain relievers
  • hormone treatment
  • antibiotics
  • antidepressants
  • physical therapy
  • spinal cord stimulation
  • psychotherapy
  • laparoscopic surgery
  • hysterectomy
However, traditional approaches rarely attempt to get to the root cause of CPP and correct it. Because pelvic floor dysfunction and pain involves muscles, the condition can be safely and effectively treated without surgery or other invasive interventions.

Pelvic Floor Treatment at NYDNRehab

At NYDNRehab, we take a holistic and non-invasive approach to treating pelvic floor dysfunction. We use cutting edge therapies and state-of-the-art technologies to diagnose and treat your condition.
Our unique corrective approach to treatment sets us apart from other rehab clinics and medical practitioners whose primary focus is pain management.
Some treatment methods at NYDNRehab include:
  • biofeedback
  • neuromuscular re-education using RUSI
  • manipulation of viscera and connective tissue
  • myofascial release
  • extra corporeal shock wave therapy (ESWT)
  • muscle strengthening and stretching exercises
  • muscle relaxation therapy
  • postural retraining
  • gait retraining
At NYDNRehab, our goal is to restore optimal pelvic floor function, so you can enjoy an improved, pain-free quality of life.
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