Happy Mother’s Day! (Sorry For What I Did To Your Pelvic Floor)

By: Jennifer Heiligman, PT, MPT

We all love our Mothers and we owe them a lot.  Like, for instance, the fact that they gave us life!  Taking that into consideration, we also owe them an apology for unintentionally wreaking havoc on their pelvic floor muscles.  In celebration of Mother’s Day we want to bring attention to the prevalence of Pelvic Floor Dysfunction and how successful treatment for the condition can be provided by specially trained physical therapists.

First, what is the pelvic floor and why is it important?  The pelvic floor consists of a group of muscles, ligaments, connective tissue and nerves that support the organs located within your pelvis.  These organs include the bladder, uterus (for women), prostate (for men) and rectum.  When damage or weakness occurs to these structures, individuals can experience urinary and fecal incontinence, pelvic organ prolapse, and pelvic pain.  While these disorders can affect both women and men, we are going to focus on women’s health since we are celebrating Mother’s Day.

In a study funded by the National Institutes of Health (NIH), it was found that almost a quarter of women suffer from pelvic floor disorders.  That number increases with age.  Pelvic floor dysfunction affects approximately 10% of women age 20-39, 27% of women between the ages of 40 and 59, increasing to 37% between 60 and 79 years of age and nearly half of all women 80 and older experience these issues.  

Pregnancy and childbirth are the main causes of pelvic floor dysfunction (again, sorry Mom).  The prevalence of this disorder was found to be 24% for women who had 2 children and found to have increased to 32% for women who had 3 or more children.  Other contributing factors include hormonal changes such as what occurs during menopause, heavy lifting and straining, pelvic radiation and obesity.

Historically, disorders affecting the pelvic floor have not been widely discussed, even between patient and doctor.  Unfortunately, this has led to a lot of women thinking that it is just something they will have to live with because nothing can be done.  The good news is, this topic is making its way into the mainstream.  There have been a number of articles published in women’s health magazines and on social media sites recognizing the importance of pelvic floor health and decreasing the misplaced shame and embarrassment of suffering from such things as incontinence and pelvic pain during intercourse.  Pelvic floor exercises including Kegels and yoga poses intended to increase the strength of those muscles are being publicized more and more. In addition, non surgical treatment for pelvic floor disorders has improved and become more widely advertised and accessible.  

Physical therapy can be a very successful treatment method for pelvic floor disorders.  Physical therapists specializing in treatment of these conditions will teach their patients specific strengthening exercises to help decrease muscle weakness and teach their patients how to properly relax those muscles. The most common exercises are Kegels, named for the American gynecologist who invented them in the 1940s.  These exercises target the muscles of the pelvic floor specifically.  Other strengthening exercises targeting the hips, buttocks and surrounding pelvic region can also be given to patients.  Pilates and yoga, when performed correctly, have also been shown to be effective in strengthening the core, which in turn, helps to strengthen and relax the pelvic muscles. 

Pelvic Health Physical Therapists also utilize biofeedback which is an instrument that provides visual and/or auditory feedback to the patient while performing specific activities.  This tool aids in the correct performance of the activities, such as Kegels, to help retrain those muscles.  Biofeedback has been shown to help approximately 75% of patients.  Behavioral changes including bladder retraining, fluid management and changes in diet are also utilized by PTs to assist with incontinence. 

How do you find a physical therapist that specializes in treatment of pelvic floor dysfunction?  Speak to your OB/GYN physician.  They should be able to recommend a physical therapist in your area.  In addition, Herman & Wallace Pelvic Rehabilitation Institute, one of the leading resources for continuing education, has created a directory of specially trained therapists.  Their directory can be found at Pelvicrehab.com. 

As we celebrate the women who gave us life, let’s also recognize that the act of pregnancy and childbirth can very often result in some form of pelvic floor dysfunction. This topic should not be considered taboo and we need to make women, including our own mothers, aware that there is treatment available.  For this Mother’s Day as you are thanking your mother for all that she has done for you, you may also want to give her the link to the pelvic rehab directory as an apology for any dysfunction you or your siblings may have caused.