Learning About Your Pelvic Floor Health
Many of us will go through our daily activities with little thought about the muscular systems supporting our movements – until something goes wrong. The pelvic floor is one such area of the body that often goes unnoticed despite playing a crucial role in our health and well-being. In a sense, the pelvic “floor” gives the rest of the body a strong foundation, and without this strong foundation, issues can arise that impede daily functioning. Here, pelvic floor specialists Meagan Moyers and Dr. Erin Westner demystify pelvic floor health and the treatment options available to all.
What is the Pelvic Floor?
The pelvic floor consists of the connective tissue and muscles that support the many pelvic organs sitting below the abdominal cavity. This group of muscles stretches from the pubic bone to the tailbone, and like any other muscle in the body, pelvic muscles can become strong, weak, or tense. Healthy pelvic floor functioning means an individual can voluntarily contract and relax these muscles for daily functioning. Individuals experiencing pelvic-related issues may be directed to pelvic floor physical therapy for treatment, or occasionally surgery.
“The biggest misconception is that pelvic floor therapy is only for those who are pregnant and have babies,” shares Dr. Erin Westner, physical therapist and owner of The Pelvic Method. “We see all walks of life as pelvic floor specialists: men, women, adolescents, and pediatrics. If you have a pelvis, you may need pelvic health education at some point in your life.”
Common Pelvic Floor Disorders
Pelvic floor dysfunction occurs when these muscles are strained, weakened, or too tight and are unable to effectively support the bladder, vagina, uterus, prostate, or rectum. Although commonly discussed in women’s healthcare, pelvic floor disorders (PFDs) can also affect men. UCLA Health estimates that 1 in 3 women will experience a PFD in her lifetime, and a study cited by Mayo Clinic Health System reports 16% of men have been identified with PFDs. Regardless of gender, age, or individual circumstance, understanding the complexities of PFDs and treatment options can be an essential step in regaining full functioning and daily comfort.
Incontinence. Pelvic floor weakness or injury can lead to bladder and bowel control issues, including leakage, constipation, and the need to frequently go to the bathroom.
Pelvic Organ Prolapse. Prolapse occurs when an organ in the pelvis, such as the bladder, uterus, or rectum, drops from its normal position. Women experiencing prolapse may feel bulging tissue or pressure on the vaginal walls.
Pelvic Pain. Pelvic pain describes pain felt in the region below the belly button, and can be triggered by a variety of activities, such as lifting heavy objects, using the restroom, having sex, menstruating, and exercising.
Meagan Moyers, physical therapist and owner of Resilience Physical Therapy, shares, “Common risk factors for PFDs include history of low back pain and hip pain, pregnancy (either vaginal or cesarean delivery), menopause and post-menopause, bowel dysfunction such as constipation or IBS, hysterectomy, participation in high-impact sports such as running or gymnastics, or sports requiring heavy lifting such as cross-fit. For men specifically, history of prostate cancer or prostatectomy are common conditions that pelvic floor physical therapy addresses.”
Pelvic Floor Physical Therapy
Pelvic floor therapy is a specialized sector of physical therapy designed to treat PFDs in individuals of any age. Those receiving pelvic floor therapy can expect to discuss a history of health, individual goals, and learn about the pelvic region and its relation to the rest of the body. Pelvic floor therapists are trained in assessing the muscles, nerves, and tissue in and around the pelvic region. “We are treating the pelvic floor as part of the whole person and how the whole body functions together,” says Moyers.
Kegels, or Kegel exercises, are what might come to mind for many when thinking about pelvic health. These are popular exercises that aim to strengthen pelvic floor muscles to recover from PFDs, prepare for childbirth, or to improve sexual health. Moyers notes that Kegels are only one option in a diverse array of treatment options for pelvic health. “Kegels may be right for some people in an individualized approach, but oftentimes the pelvic floor is already holding too much tension, and we need to train the muscles how to relax,” she explains. Working with a pelvic floor specialist ensures that you can develop a treatment plan tailored to your unique needs.
Pelvic Floor Health and Aging
Physical needs evolve throughout an individual’s life, and pelvic-related needs are no exception. As we age, pelvic floor muscles – like other muscles in the body – become less plump, mobile, and may potentially decrease in strength, due in part to hormonal influences. Living with discomfort from PFDs, however, is not something every individual must face.
Dr. Westner says, “Most feel that leakage is a normal part of aging, but that is simply not a true statement. Constipation and pain with sexual activities are other areas that patients tend to accept as being a normal part of aging. These are all areas in which we, as pelvic floor therapists, can step in and make a huge impact.”
Maternal Pelvic Floor Trauma
This trauma relates to any pelvic floor problems that can be attributed to pregnancy or childbirth. Expectant mothers can seek pelvic floor therapy to prepare for the most supported labor possible. “The biggest advice I can give is to prepare and set the intention for your birth,” says Dr. Westner. “It’s never guaranteed that your preparation can prevent issues, but it can empower you to make more informed decisions as the time comes.” In pelvic floor therapy, expectant mothers can practice breathing techniques, labor positions, muscle relaxing, and perineal stretching. Pelvic care continues in the post-partum period to support recovery from labor and prevent issues down the line. “It’s important that new moms take adequate time to heal and recover,” Moyers adds, “but starting physical therapy within the first six weeks after birth can assist in healing. Each mom’s recovery is individual. We can address any scar tissue as it heals – either from cesarean incision or perineal tearing – through breath work, pelvic floor strengthening, as well as functional strengthening, to help the mother return to activities that are meaningful to her.”
Seeking Support
Moyers concludes, “Pelvic floor issues can be significantly limiting to quality of life, and the more that people start talking about it, the more normalized these issues will become. Pelvic floor health has long been overlooked and undertreated, and we’re starting to see it become more integrated into the care of men and women of all ages.”
Meagan Moyers, PT, DPT
Center for Sports Medicine and Orthopedics
Owner, Resilience Physical Therapy
Erin Westner, PT, PRPC
Owner, The Pelvic Method PLLC
Founder McCallie Integrated Wellness
Meet the Author
Tory Irmeger, BA, English
Tory Irmeger graduated from Lee University with a Bachelor of Arts degree in English with an emphasis on creative writing. While at Lee, Tory served as head of copy for the school’s biannual publication Vindagua. Since joining CMC Publications as editor, Tory has led ideation, conceptualization, and development of numerous health, wellness, and lifestyle articles published in print and online for HealthScope, CityScope, and Choose Chattanooga magazines – premier publications serving S.E. Tennessee and North Georgia.