Ask A Therapist - Pelvic Floor Dysfunction

This week we received a great question about pelvic floor dysfunction in women.  There are many manifestations of this problem, not the least of which are episodes of incontinence.  Did you know that pelvic floor dysfunction is very common in female athletes?  Did you know that pelvic floor issues can occur in men and that women who have not had children are also susceptible?

Conventional medicine often treats this problem with Kegal exercises, which may have their place in certain circumstances.  Kegals are designed to "strengthen" the pelvic floor through contraction of the group of muscles that stop urine flow.  That said, the issue is more complex than simply strengthening a muscle or muscle group.  Consider how incomplete a rehabilitation program would be if we only strengthened the quadriceps muscle for everyone with knee pain or the hamstring muscle after a hamstring pull.  Rehabilitation for those issues requires us to look at flexibility, muscle balance, muscle control, and even other areas of the body to ensure the pain isn’t due to a compensation for something else.

Contracting the pelvic floor muscles repeatedly (i.e. kegals) might "strengthen" the muscles supporting our abdominal contents but it does not teach them "how and when to fire" and it does not improve local flexibility if that is an issue.  Thus, kegals alone may not provide relief or improvement of pelvic floor dysfunction.

In the same way, pelvic floor dysfunction may come about for a variety of reasons that are unique to the individual.  There are two excellent articles below to learn the basics as well as helpful exercises to consider if you suffer from any sort of pelvic floor dysfunction.  The articles are concise and to the point, well worth a short amount of time to read if this topic interests you.  Also be aware that there are physical therapists who specialize in women’s health and pelvic floor dysfunction.  If you don’t see results on your own these specialists are well trained to give you individualized attention.

Runner's World article with background and helpful exercises.

Breaking Muscle article on why kegals are not a comprehensive program for pelvic floor dysfunction (and what to do instead).

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