How to Treat Pelvic Floor Dysfunction

Pelvic Health Mini Series

Part One: Understanding Pelvic Floor Anatomy

Part Two: Signs & Symptoms of Pelvic Floor Dysfunction

Part Three: How to Treat Pelvic Floor Dysfunction

Part Four: Kegels are NOT the Answer to Pelvic Floor Dysfunction

Most people aren’t aware of the importance of their pelvic floor or even pay attention to it, and if they develop common issues like bladder leakage or sexual concerns, they ignore or hide their symptoms due to shame and taboo. If you are experiencing any common symptoms of pelvic floor dysfunction, like bladder leakage or sexual concerns, there’s no need to suffer in silence anymore! There are a lot of things you can do to resolve pelvic floor dysfunction.

In part 3 of this 4 part series, I’d like to dive into more detail about exactly how to treat pelvic floor dysfunction.

Get Help from an Expert

If someone is experiencing the symptoms of pelvic floor dysfunction, they often will first go to their primary care doctor. The primary care doctor will then refer them to a gynecologist, urologist, OB, or gastroenterologist. These providers are trained to offer pharmaceutical and/or surgical interventions, so thats what they do. If the doctor is open minded and supportive of behavioral intervention and conservative management strategies, sometimes, the patient will get a referral to a pelvic floor physical therapist. This can be a long, expensive and arduous process for the patient, so I’d like to cut to the chase. If you have any of the signs and symptoms of pelvic floor dysfunction, first seek help from a pelvic floor physical therapist.

Pelvic floor physical therapists are experts in rehabilitating the pelvic floor muscles and treating all kinds of pelvic health conditions. Seeking help from an expert in the pelvic floor is often one of the quickest ways to resolving pelvic floor dysfunction. The truth is, there is a wide range of treatment approaches in the field of pelvic health and pelvic floor physical therapy. There are also a lot of misconceptions about what treatments result in true and complete resolution of pelvic floor dysfunction. The field of pelvic health is evolving fast, and not every provider is “up-to-date” in what works and what doesn’t.

Last week on the blog we discussed how the most common pelvic floor muscle problem is muscle spasm. So the treatment of pelvic floor dysfunction needs to be targeted at normalizing pelvic floor muscle tone, in other words, getting rid of pelvic floor muscle spasm. If you are being offered medication and surgery for your pelvic symptoms- remember pharmaceutical and surgical interventions do not resolve pelvic floor muscle dysfunction, and therefore often do not provide lasting relief because they don’t address the root cause. If your pelvic floor physical therapist doesn’t talk about how pelvic floor dysfunction is most often caused by pelvic floor muscle spasm, then look for another one.

When selecting a pelvic floor physical therapist, it is important to identify if they are able to provide you with the comprehensive approach that is necessary in resolving pelvic health issues. To help you determine whether your pelvic floor physical therapy is going to be a good investment, I’d like to explain some key components that must be present in your plan of care.

6 Key Components to Effectively Treat Pelvic Floor Dysfunction

1. Restore optimal posture and breathing patterns. Since the pelvic floor muscles are comprised of primarily involuntary muscle fibers, the majority of their functional activation throughout our day is triggered by reflexes in our bodies. And the reflexes that trigger proper pelvic floor muscle activation are POSTURE and BREATHING. So in order to rehabilitate a pelvic floor that is dysfunctional, postural and breath training are absolutely non-negotiable. Without posture and breath training, pelvic floor and core exercises will not transfer functionally to your day to day life.

2. Focus on lifting and centering your pelvic organs. Organ position is often not taken into consideration in medicine and rehab, but it is a major contributing factor to all pelvic health issues! The position of your pelvic organs will influence their function, as well as the function of your pelvic floor muscles. When your pelvic organs are in their best position in your body- they receive optimal blood flow, lymph flow and nerve flow- and therefore, their function will improve. If your pelvic organs are sitting too low, and/or are leaning to one side of your pelvis or the other- they pelvic floor muscles become compressed, they don’t get as much oxygen, and overtime become weak. So lifting and centering your pelvic organs will greatly improve the function of your pelvic floor muscles.

3. Be sure to regularly reduce intra-abdominal pressure. The mis-management of pressure in your abdomen is the biggest leading cause of pelvic floor muscle spasm and subsequent pelvic floor dysfunction. The diaphragm and the pelvic floor are the two structures responsible for management of intra-abdominal pressure. Their coordinated movement is what keeps the pelvic organs in place and stabilizes the spine when the pressure increases in our abdomen. As humans walking around upright against gravity, the pressure is constantly increasing in our abdomen. The pelvic floor and the diaphragm need to manage this pressure appropriately, and if they don’t, a host of pelvic floor dysfunctions can occur. So in order to successfully treat pelvic floor dysfunction, the pressure in the abdomen must be reduced on a regular basis.

4. Treat the entire Core. Don’t isolate the pelvic floor. The pelvic floor is only one part of a whole system that contributes to the pelvic health. The other muscles that play a major role in pelvic floor dysfunction are: the diaphragm, the abdominals, the spinal muscles, the muscles of the rib cage and shoulder blades, the muscles of the hips, and the glute muscles. Treatment of pelvic floor dysfunction needs to address all of these other muscles and ensure they are working in unison with the pelvic floor- to manage pressure in the abdomen, keep the organs in their ideal position, and stabilize the spine.

5. Eliminate trigger points in the core and pelvic floor muscles. Trigger points are areas in a muscle where the muscle fibers are stuck in a “knot.” Trigger points deprive the muscle of adequate blood flow and oxygen, reduce the muscle’s ranges of motion, decrease the muscle’s strength, and can cause pain other sensory symptoms. So eliminating trigger points in the core and pelvic floor muscles will lead to improved neuromuscular function and strength. Trigger points can be eliminated through a variety of methods including manual therapy, rolling and stretching.

6. Strengthen the core muscles and core fascia through reflexive coordinated rhythmic activation. Targeting the involuntary nervous system through breath work is the absolute key to successfully treating pelvic floor dysfunction. Since the pelvic floor has very unique anatomical characteristics - it’s primarily involuntary and mostly fascia- the way we strengthen it needs to reflect that. Breathing is the way we create reflexive core and pelvic floor muscle activation, and posture is how we unload the pelvic floor and strengthen its fascia. When core and pelvic floor muscle activation is rhythmically elicited through these reflexes, while optimal postural endurance is strengthened - true pelvic floor rehab occurs.

When these 6 components are implemented together to treat pelvic floor dysfunction - pelvic floor muscle spasm is resolved, optimal tone of the pelvic floor muscles is restored, and pelvic floor dysfunction is truly rehabilitated because the root cause of pelvic floor dysfunction is addressed.

Unable to find a Pelvic Floor Physical Therapist in your area?

For those of you who are unable to find a pelvic floor physical therapist in your area, or prefer to treat your pelvic floor dysfunction independently from the comfort of your home, there is another option. The Core Recovery Method® Online Program teaches you all of the necessary knowledge, behavioral strategies, self-care techniques and core exercises to heal pelvic floor dysfunction.

The Core Recovery Method® resolves pelvic floor dysfunction by targeting the involuntary nervous system to elicit reflexive activation of the pelvic floor muscles through posture and breathing. It resolves pelvic floor muscle spasm, and therefore pelvic floor dysfunction, by treating the root cause. A focus of this protocol is the lifting and centering of the pelvic organs to improve their blood flow, nerve flow and lymph flow, and thus their function. Lifting of the pelvic organs unloads and strengthens the fascia of the pelvic floor, and allows pelvic floor muscle tone to normalize on its own. Elimination of trigger points in other core muscles allows the pelvic floor to receive the structural support, circulation and neural input it needs to be the foundation of your core.

Questions about this protocol? Click here