Pelvic Floor Dysfunction: Signs, Causes & How Physio Can Help
Pelvic floor dysfunction is a condition that affects both men and women, though it is more commonly discussed in the context of women’s health. It refers to a range of issues that arise when the muscles of the pelvic floor do not function properly—either being too weak, too tight, or uncoordinated. These dysfunctions can lead to a variety of symptoms including urinary incontinence, pelvic pain, bowel problems, and even sexual dysfunction.
Though often underdiagnosed due to stigma or misunderstanding, pelvic floor dysfunction is highly treatable. Early intervention, particularly through physiotherapy, has been shown to significantly improve outcomes and enhance quality of life. A key component in treatment often includes the strengthening of pelvic floor muscles, guided by a trained physiotherapist who specialises in this area.
This article explores the signs, causes, and treatment approaches for pelvic floor dysfunction, with a particular focus on how physiotherapy plays a vital role in recovery and long-term pelvic health.
Understanding the Pelvic Floor
The pelvic floor is a group of muscles and connective tissues that span the bottom of the pelvis, forming a supportive “hammock” for the bladder, uterus (in females), prostate (in males), and rectum. These muscles play an essential role in maintaining continence, supporting pelvic organs, enabling childbirth, and contributing to sexual function.
When the pelvic floor is functioning well, it contracts and relaxes in coordination with other muscles in the body. Dysfunction occurs when this balance is disrupted.
Pelvic floor dysfunction is not a single condition but rather a term that encompasses various disorders including:
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Pelvic organ prolapse
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Urinary incontinence
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Faecal incontinence
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Pelvic pain syndromes
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Difficulty with bowel or bladder emptying
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Painful intercourse
Common Signs of Pelvic Floor Dysfunction
Because pelvic floor dysfunction presents differently depending on the individual and type of dysfunction, recognising the signs is crucial. Some of the most common indicators include:
1. Urinary Issues
These may include leakage during physical activity (stress incontinence), sudden strong urges to urinate (urge incontinence), or difficulty starting the stream of urine. Frequent nighttime urination can also be a sign.
2. Bowel Dysfunction
Symptoms may include constipation, straining during bowel movements, or faecal incontinence. In some cases, people feel as though their bowel is not fully empty after going.
3. Pelvic Pressure or Heaviness
This is especially common with pelvic organ prolapse, where one or more pelvic organs descend and press into the vaginal wall.
4. Pelvic or Lower Back Pain
Pain in the lower abdomen, pelvis, or tailbone region can be linked to overly tight or uncoordinated pelvic floor muscles.
5. Sexual Dysfunction
This can include pain during intercourse (dyspareunia), reduced sensation, or difficulty achieving orgasm.
It is important to note that these symptoms can overlap with other medical conditions. Therefore, seeking assessment by a healthcare professional is critical for accurate diagnosis and effective treatment.
What Causes Pelvic Floor Dysfunction?
Pelvic floor dysfunction can develop due to a wide range of factors, both physical and lifestyle-related. Some of the most common causes include:
1. Childbirth and Pregnancy
Vaginal deliveries, especially those involving forceps, prolonged pushing, or large babies, can strain or tear the pelvic floor muscles and connective tissues.
2. Ageing
As people age, muscle tone and elasticity naturally decrease, including in the pelvic floor. Hormonal changes during menopause can also affect muscle strength and support.
3. Chronic Constipation or Straining
Frequent straining to pass stools can place repetitive pressure on the pelvic floor, contributing to dysfunction.
4. Heavy Lifting
Whether due to occupational demands or certain forms of exercise, repeated heavy lifting can strain pelvic support structures.
5. Pelvic Surgery
Procedures involving the bladder, uterus, or rectum can sometimes lead to nerve or muscle damage that affects pelvic function.
6. Obesity
Excess body weight increases abdominal pressure, which can weaken pelvic floor muscles over time.
7. Neurological Conditions
Disorders such as multiple sclerosis or spinal cord injuries can interfere with the brain’s communication with pelvic floor muscles, leading to dysfunction.
The Role of Physiotherapy in Treatment
One of the most effective, non-invasive treatments for pelvic floor dysfunction is physiotherapy. Specialised pelvic health physiotherapists use targeted exercises, biofeedback, manual therapy, and education to improve the function of these muscles.
1. Pelvic Floor Assessment
Before starting any treatment, a detailed assessment is performed. This may include internal and external examinations, postural evaluation, and discussion of symptoms and history. Based on findings, the physiotherapist tailors a program specific to the individual’s needs.
2. Pelvic Floor Exercises
Often referred to as Kegel exercises, these target the muscles responsible for controlling the bladder and bowel. They may involve contractions and relaxations performed in various positions and intensities. Proper technique is essential—doing these incorrectly can worsen symptoms.
3. Education and Bladder/Bowel Retraining
Physiotherapists often provide advice on toileting habits, fluid intake, and posture to support healthy pelvic function.
4. Manual Therapy and Release Techniques
For those with tight or overactive pelvic floor muscles, hands-on techniques and stretches may be used to release tension and reduce pain.
5. Use of Equipment
Biofeedback and electrical stimulation devices may be used to help patients better understand and activate their pelvic muscles.
For more information on where to find pelvic health physiotherapy providers and how these techniques are delivered, you can view this website from certified practitioners or allied health clinic of RedoHealth.
Who Should Consider Seeing a Pelvic Health Physiotherapist?
Pelvic floor dysfunction is not limited to any one demographic. However, people experiencing any of the following may benefit from seeing a specialist physiotherapist:
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Postnatal women, particularly after vaginal delivery
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Women entering menopause or experiencing changes in bladder/bowel habits
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Individuals recovering from pelvic or abdominal surgery
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People experiencing chronic pelvic or lower back pain
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Athletes with core dysfunction or pelvic pressure during training
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Men following prostate surgery
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Anyone with unexplained urinary or faecal leakage
It’s a common misconception that pelvic health physiotherapy is only for women after childbirth. In fact, it plays a critical role across the entire lifespan and for all genders.
Prevention and Long-Term Management
Pelvic floor health should be treated as a long-term investment, much like cardiovascular fitness or joint mobility. Here are some tips to maintain pelvic floor integrity and prevent dysfunction:
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Engage in Regular Pelvic Floor Exercises: A well-rounded program that includes both contraction and relaxation phases can help maintain tone and function.
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Avoid Constipation: Maintain a high-fibre diet and stay hydrated to reduce the need for straining.
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Use Proper Lifting Techniques: Always engage the core and exhale when lifting heavy objects.
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Stay Active: Low-impact exercises such as walking, swimming, and Pilates can support pelvic health without placing undue strain on the pelvic floor.
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Manage Weight: Maintaining a healthy body weight reduces pressure on the pelvic region.
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Address Symptoms Early: The earlier pelvic floor issues are identified, the easier they are to manage and treat.
Pelvic floor dysfunction is a common yet often misunderstood condition that can significantly affect quality of life. From incontinence and prolapse to pain and sexual dysfunction, its symptoms can be varied and complex. However, the good news is that physiotherapy offers a safe, effective pathway to recovery.
Through targeted assessment, personalised exercises, and ongoing education, physiotherapists can help restore proper function to the pelvic floor. This, in turn, can lead to improved bladder and bowel control, reduced pain, better posture, and enhanced well-being.
If experiencing symptoms or simply looking to proactively support pelvic health, seeking guidance from a qualified physiotherapist is a crucial step. With the right support, pelvic floor dysfunction can be managed, treated, and often reversed—restoring confidence and comfort to everyday life.
