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

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

Pelvic Floor Treatment Options

Because pelvic floor dysfunction and pain involve muscles, they can be safely and effectively treated without surgery or other invasive interventions. Treatment is likely to be multi-modal in nature, with the goal of restoring function and eliminating pain.
Some common treatment approaches include:
  • biofeedback
  • manipulation of viscera and connective tissue
  • myofascial release
  • extra corporeal shock wave therapy (ESWT)
  • muscle strengthening exercises
  • postural retraining

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 goal is to restore optimal pelvic floor function, so you can enjoy an improved, pain-free quality of life.

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