The Why and the When of the Pelvic Floor

The Why and the When of the Pelvic Floor

A couple of months ago, we learned all about the Who and the What of the pelvic floor. Today, we will look at the why and when of the pelvic floor.

Why is it important to know about your pelvic floor?

There are so many reasons! Some of them are as follows: to be more aware when things may not be functioning as properly, to not feel embarrassed by anything “down there,” to prevent future pelvic floor dysfunction and to know when to seek help from a pelvic floor physical therapist.

Here is a list of common conditions that we see in the clinic that can be related to the pelvic floor:

  • Urinary or fecal incontinence (leaking pee or poo)
  • Pelvic organ prolapse (organ descending into the vaginal wall)
  • Pelvic or abdominal pain (related to a variety of other conditions or muscular compensatory patterns!)
  • Pain with intercourse, pelvic exams, insertion of tampons
  • Constipation (yes, this can lead to or indicate pelvic floor issues!)
  • Difficulties with bladder emptying fully
  • Bladder pain/Interstitial Cystitis
  • Overactive pelvic floor or bladder
  • Low back pain, SI joint pain, pubic symphysis dysfunction, tailbone pain, pelvic girdle pain, hip pain (pelvic floor and pelvic wall muscles attach to these things!)
  • Endometriosis and menstrual pain
  • Others

A study showed that 49% of gym-going women, with at least one risk factor for stress incontinence, experienced stress incontinence, while another study showed similar percentages in women who participate in Crossfit. A third study showed that pelvic floor disorders have a prevalence of 25%.

I will say, I personally believe the numbers are actually higher.

Women can feel embarrassed about these issues, don’t talk about them with anyone (including healthcare providers), and sometimes just want to pretend they aren’t there.

While we shouldn’t MAKE everyone seek care for pelvic floor issues, my hope is that women aren’t embarrassed by these changes that can occur and instead advocate for themselves, talk to their healthcare providers, seek out a pelvic floor physical therapist, and know there are definite strategies/techniques/treatments that can improve their conditions and symptoms.

When should you pay attention to your pelvic floor and when do I need to see a pelvic floor PT? 

Do you need to pay attention to your pelvic floor at all times? Please no! It’s impossible! There are times and places when it could be helpful. A pelvic floor physical therapist can help determine these for you. The pelvic floor *should* activate on its own without you needing to tell it what to do all of the time. Sometimes this needs retraining, but the ultimate goal is to not have you think about your pelvic floor.

If you start noticing symptoms, that’s a great time to check in with your pelvic floor. Ask yourself “Is there anything I can do to relate what I’m doing to my symptoms?” Don’t worry if you are unable to relate anything! That’s another aspect a pelvic floor PT can help with. If your pelvic floor does really need retraining, then it can be beneficial to set a few minutes in a day to focus on it and to practice activating and/or relaxing it with certain movements.

So when should I see a pelvic floor PT? 

Trust your gut, and don’t be afraid to ask your provider or call your local pelvic floor PT. If you feel like something may not be right but aren’t sure if pelvic floor PT can help, what’s the worst that will happen if you go in for an evaluation? They tell you it’s functioning well and don’t need to go to PT? Great!

If they do tell you seeing a pelvic floor PT would be beneficial, then you can rest easy knowing help is on the way!


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Renee was raised an Iowan before moving to Kansas City to play soccer in college and receive her doctorate of physical therapy degree. She and her husband moved back to Iowa a couple of years ago for her husband's residency at the U of I. Renee recently added "twin mom" to her life resume and is also a proud dog mom to her fur baby, Archie. She works as a women's health physical therapist in Cedar Rapids and has a passion for educating, empowering, and supporting women in all phases of life, especially through pregnancy and postpartum. A few of her other loves include a good cup of coffee, a craft brew, all dogs, the Great British Baking Show, and anything outdoors.

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