There is a common misconception that the pelvic floor is only relevant for women who have had kids. I’m here to tell you this is bonkers. Sure, having a child tends to lend to more obvious pelvic floor dysfunction, but there are many signs of impairment that aren’t recognized as coming from the pelvic floor. Also, why has it been deemed acceptable to completely neglect a part of the body until a baby is shoved out of it or cancer shows up in the prostate? We wouldn’t ignore a person’s right leg until it needed amputation right? And yes, males have pelvic floors too! There is definitely more talk about the pelvic floor within the perinatal population which is progress, but male pelvic health continues to be taboo leaving most men to suffer quietly not knowing there is any other option. I can’t bring up quiet suffering without also acknowledging the fact that those who don’t identify with the genitalia they were born with and those who have experienced physical and/or emotional abuse or trauma are even more likely to be silent. This can come from not knowing there is something that can be done, feeling uncomfortable or too ashamed to bring it up and/or not trusting that a medical professional will listen and actually hear them which is unfortunately a valid concern. Each one of these barriers to pelvic floor health can, should and will be a blog post of their own but my main purpose here is to just convince you that it’s time you introduced yourself to your pelvic floor if you haven’t already.
The pelvic floor is a group of muscles that are responsible for poop and pee control, all sexual functions, lymphatic drainage, support of the organs that lie above it and stability of the spine, hips and pelvis. Do I need to say more? All of these functions are absolutely essential to our ability to be functional and happy people in the world.
Even further, the pelvic floor is our emotional holding place and our energetic center. Did I lose you with that one? I never thought these words would be a part of my western-based practice either but when you specialize in the pelvic floor they have to be. Again, I’ll save most of my words and RESEARCH to back it up for another blog but for now, just think about how the root chakra has been a part of many ancient practices that still hold true and effective in today’s modern world.
The most obvious signs of dysfunction include: peeing yourself, pooping yourself, erectile dysfunction, pain with penetration, feeling like your organs are falling out of your vagina and/or butthole, and inability to sit because of tailbone pain.
The not so obvious signs include: peeing too frequently, always feeling like you have to pee, having to rush to the bathroom, difficulty initiating voiding, non-continuous urine stream, post-pee dribble, not feeling like you empty poop or pee all the way, waking up at night to pee, feeling like you have a urinary tract infection when you don’t, interstitial cystitis, overactive bladder, not being able to hold a fart in, not being able to discern whether its a fart or poop that is waiting to come out, having to bear down to get poop or pee out, pooping taking longer than 10 min, not pooping everyday, clinically diagnosed constipation, constipation-diarrhea yo-yo, irritable bowel syndrome, hemorrhoids, premature orgasm, inability to orgasm, decreased natural lubrication, decreased libido, enlarged prostate, fibroids, cysts, endometriosis, the feeling of pressure or heaviness, peeing/pooping/farting a little when you laugh/cough/sneeze/run/jump, poop getting stuck in a pocket, having to splint to poop (if you have to do this you will know what I mean), pain with pooping or peeing, painful menstrual cycles, perineal, testicular, scrotal, sacroiliac and pubic pain. Whew! Anyone else winded from that?
And the signs that you wouldn’t guess had anything to do with the pelvic floor include: abdominal pain, hernias, diastasis recti (abdominal separation), hypersensitive nervous system, PTSD, piriformis syndrome, sciatica, groin pain, hip pain, low back pain and get this…even knee, neck and shoulder pain! How can this be? It’s because the pelvic floor is the bottom of our core which stabilizes the spine. Without spinal stability, nothing works right. You can read more about this in my previous blog post, “Spinal Stability”.
SOOOOOO MUCH! As I mentioned right off the back, the pelvic floor is a series of muscles. As with all muscles of the body, their strength can be improved leading to more functional capacity and decreased symptoms. Sometimes this has to start with learning how to relax the pelvic floor (again, needs to be another blog…I have created quite the list for myself), sometimes it has to begin with posture and breath, and other times its pressure management, loading the system and introducing impact. It never ever ever ever, is just kegels. I will save that soap box for another day.
When the dysfunction is beyond what can be fixed through muscle strength, there are many surgeries to fix any ligamentous or tissue damage. This is the equivalent of when leg strengthening isn’t enough to return to soccer without an intact ACL. The surgery replaces the ACL but then rehabilitation after the surgery is a must. Same goes with any pelvic floor surgery (having a kid counts as such). The post-op rehabilitation is absolutely imperative to gaining proper function afterwards. Scar tissue doesn’t magically disappear and muscle strength doesn’t miraculously pop back.
I encourage everyone to start using the words poop, pee, vagina, penis and sex in their day to day conversations. I think part of the problem here is that we aren’t comfortable saying or hearing, let alone discussing these things with anyone, especially doctors.
If you are experiencing any of the above signs or symptoms, don’t sit and wait for your doctor to bring up the topic. While it should be part of their routine screen, it’s often forgotten or breezed over. If your doctor asks you the questions, feel comfortable answering them honestly. It does nothing for you to lie and say no just because it’s an uncomfortable conversation. It doesn’t have to be!
When you do bring it up or answer honestly, don’t be surprised if your doctor goes straight to prescribing a medication or giving you a urologist or gynecologist referral. This is when you need to be your own advocate and ask for a pelvic physical therapy referral first. Pelvic physical therapy is a relatively new thing in America so it still isn’t the go to for most doctors. Heck, we are still trying to get some doctors to refer to physical therapy for back pain. It will definitely be some time before doctors routinely refer to PT for incontinence. So ask for it yourself. You wouldn’t sign up for a back surgery before trying to strengthen your core first nor would you choose to be addicted to narcotics for pain before trying to improve your musculoskeletal impairments. Same goes for the pelvic floor. Address the muscles first before signing up for bladder surgery or viagra.
I gotcha covered. Shoot me an email here. Let’s work through it.