Pelvic Health 101
Knowledge of the importance of pelvic health is on the rise, but many people still haven’t heard of pelvic therapy. Even those who are aware it exists often aren’t clear on what it is or how it can help.
Dr. Lindsay Moses shares how participating in Pelvic Therapy can be life changing.
By Dr. Lindsay Moses, DPT
Knowledge of the importance of pelvic health is on the rise, but many people still haven’t heard of pelvic therapy. Even those who are aware it exists often aren’t clear on what it is or how it can help.
Many women worry about sharing something so personal and potentially embarrassing with a stranger. Let me offer reassurance through my own personal journey and explain how pelvic floor therapists help women optimize their pelvic health.
It is important to me that as many people as possible gain awareness of the pelvic floor - where it is, what is does, and why it is so darn important!
Most women can recount the moment they first got their period.
I was 12 and had just returned home from a softball game. My mother was in the bathroom with me moments later, handing me a giant maxi pad which ran from my belly button, straight back towards my spine. I waddled around for days until we found a better fit.
For the next 2 decades, I assumed the only time I would need those lovely pads would be once a month for 3-5 days. Never did I imagine that I would go through pack after pack following childbirth, and then need to wear them before a run, before an exercise class, or before a fun night out with friends because I knew I would likely be laughing extra hard. For years, pads and liners alike became a staple on my shopping list. That is until my OB said, “GO GET HELP!”
At that point in time, I had been a physical therapist for almost 10 years working in orthopedics, and I had never even heard of pelvic floor rehab.
When my doctor suggested I get treatment for the incontinence and pain I was having, there was only one provider in the Chicago area taking on new patients (who I had to wait months to see).
Working with this therapist shifted the direction of my life, both personally and professionally.
Working with this therapist shifted the direction of my life, both personally and professionally.
Personally, my incontinence and pain resolved, which enormously improved my quality of life. Professionally, I was so inspired that I became a pelvic floor therapist and have now spent the past six years helping patients who suffer from pelvic floor dysfunction.
It is important to me that as many people as possible gain awareness of the pelvic floor – where it is, what is does, and why it is so darn important!
The pelvic floor (PF) is a group of muscles, ligaments, nerves, and connective tissue at the base of the pelvis.
The PF has 4 primary functions, the first being support – the PF is like a hammock that supports the pelvic organs resting above (i.e. uterus, bladder, and rectum).
The PF also makes up our sphincters and so keeps us continent (but – spoiler alert – it also needs to fully relax when we want to urinate or defecate).
In addition, the PF plays an important role in sexual function, and finally, it is an important stabilizer for the pelvis and spine (part of the infamous core).
Do men also have one? YES! So many men also have pelvic floor muscle dysfunction and related symptoms.
Clinically, we tend to see two different categories of patients: those with weakened PF muscles and fascia, and those with a tight or hypertonic PF.
To complicate matters, it is possible to have an irritable or tight PF while ALSO lacking sufficient strength! This is why an evaluation by a trained pelvic therapist is so crucial in determining the right plan for you.
If the PF and connective tissues are weak, associated issues typically include urinary or bowel incontinence as well as possible pelvic organ prolapse (POP). POP occurs when pelvic organs such as the bladder, rectum, and/or uterus, “drop” down from their normal anatomical position. This often creates pelvic pain or pressure, which typically worsens with certain activities or towards the end of the day. Difficulty fully emptying the bladder and/or bowel is another common symptom.
On the other hand, tight or overactive PF muscles often result in pain, which can occur in the pelvic/genital area, back, hips, groin, or abdominal area. Many people even experience pain during intercourse. Overactive PF muscles can also contribute to urinary issues such as urgency, frequency, and retention. In addition, tight pelvic muscles can “block” the exit of the rectum and be a large contributor to constipation.
Remember, many people have a combination of these issues, which is why we strongly recommend an evaluation by a skilled pelvic therapist instead of following magazine directions for “Kegels!”
In fact, the postpartum period is a common time to have issues with both overactivity and weakness. Pelvic floor rehab is standard postpartum care in most European countries but is sorely lacking in the US.
Increasing women’s awareness of potential issues and intervening at the right time can prevent some problems, quickly resolve others, and reduce the likelihood of problems as one ages. This is why I feel so strongly about simply making sure that women know that their pelvic floor exists and that incontinence, for example, is common but NOT NORMAL.
As a pelvic therapist, who has experienced some of these issues firsthand, I can assure you that the treatments available are very effective and potentially life-changing.
If you have any questions, any symptoms or concerns, please know help is available at Grace Physical Therapy and Pelvic Health.
We are a strong, compassionate team of all-female providers who are trained to help women, men and children navigate pelvic floor dysfunction. We are even happy to offer you a free 10-minute Telehealth consultation, so please feel free to reach out so that we can ensure that you and your pelvic floor are having a happy and relaxing day!
Dr. Moses is the Clinic Director of Grace Physical Therapy & Pelvic Health’s Raleigh location. She received her Doctorate of Physical Therapy from Northwestern University and holds a Bachelor’s degree in Kinesiology/Exercise Science from Indiana University. She completed sub-speciality training at Herman and Wallace Pelvic Rehabilitation Institute and has extensive experience treating a variety of musculoskeletal injuries.
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