By Rebecca Keller, PT, MSPT, PRPC
In the United States, millions of people in all age groups are affected by a pelvic floor disorder that disrupts their daily life, according to the National Institutes of Health (NIH).
And unfortunately many people live with the symptoms for months – or even years – before seeking treatment.
However, once diagnosed, pelvic floor disorders are often able to be managed or reversed with treatment, including physical therapy.
If you have pelvic pain or are concerned about bladder or bowel control, you may have a pelvic floor disorder.
The Center for Pelvic Wellness at Penn Medicine Princeton Medical Center offers highly specialized treatments for people age 7 and older affected by pelvic floor disorders.
Signs and Symptoms
The pelvic floor is a group of muscles that form a sling or hammock across the pelvis.
Together with the surrounding tissues, these muscles hold the pelvic organs in place. The pelvic organs include the bladder, urethra, intestines and rectum. In women, they also include the uterus, cervix and vagina.
A pelvic floor disorder typically occurs when the muscles or connective tissues of the pelvic area are weakened or injured, causing symptoms such as:
• Hesitancy with starting to urinate or emptying the bladder
• Frequent urges to urinate or urinary tract infections
• Leaking urine when sneezing, coughing, laughing or exercising
• Pain when urinating
• Leaking stool or difficulty controlling gas
• Constipation
• Seeing or feeling a bulge or heaviness from the vagina
• Pain in the pelvis, hip, abdomen, thigh or lower back
• Erectile dysfunction
• Pain with intercourse
Although all genders may be affected, women are particularly vulnerable to pelvic floor disorders.
In addition, children can also experience pelvic floor disorders. Common signs of a pelvic floor disorder in children include constipation and bed-wetting.
Causes
According to the American College of Obstetricians and Gynecologists (ACOG), the main cause of pelvic floor disorders is pregnancy and vaginal childbirth.
Other causes, according to ACOG and the NIH, include:
• Conditions that put pressure on the abdomen. These include being overweight or obese, chronic constipation or chronic straining to have a bowel movement, heavy lifting, chronic coughing from smoking or health problems.
• Getting older. The pelvic floor muscles can weaken with age and with menopause.
• Having weaker tissues. Some people are born with conditions that affect the strength of the connective tissues that make up the pelvic floor.
• Surgery. Previous hysterectomy and prior pelvic floor surgery are associated with higher risks of pelvic floor disorders.
• Race. Certain groups of women, such as White or Latina women, appear to be a higher risk for some pelvic floor disorders.
Just as the muscles in the rest of your body can become tight, so can the muscles in your pelvic floor, which can lead to pain and dysfunction. Anxiety, stress, poor posture and the way you breathe can all also affect your pelvic floor.
Treatment
If you experience signs of a pelvic floor disorder, talk to your doctor. Treatment can help relieve symptoms and enable you to take back control.
At the Center for Pelvic Wellness, with locations in Plainsboro and Monroe, treatment includes a comprehensive exam, fluid and dietary education, pelvic floor physical therapy and collaboration with physicians for other treatment options including medication and surgery.
Physical therapy for pelvic floor disorders can help people regain awareness, control, and coordination of their pelvic floor muscles.
Therapy typically involves exercises to stretch and strengthen the pelvic floor and core muscles along with tools like biofeedback, real time ultrasound, lasers, and electrical stimulation to make you more aware of the correct way to use your pelvic floor muscles.
Physical therapists may also teach you breathing techniques to support the pelvic floor and work with you to identify and correct postural problems.
In addition, as part of its ongoing community education programming, Princeton Health Community Wellness offers health, fitness, and pelvic health education for adults and children.
Prevention
Pelvic floor disorders may not be entirely preventable, but there are steps you can take to improve your pelvic function and stay healthy.
• Exercise. Staying physically active can help you maintain a healthy weight and take pressure off your pelvic floor. Exercises that focus on contracting, relaxing, and elongating your pelvic muscles are also beneficial.
• Avoid caffeinated drinks and alcohol, which tend to stimulate the bladder.
• Eat a well balanced diet, rich in fruits and vegetables. Increasing the amount of fiber in your diet and staying hydrated may help relieve constipation.
• Practice mindfulness. Being mindful of your posture, your breathing, and your stress levels can help support your pelvic health. Breathing exercises can also help relax your mind and body, and have a positive effect on the pelvic floor muscles.
Most important, don’t ignore signs of a pelvic floor disorder in the hope they’ll go away on their own. By seeking treatment early, you can regain function and control so that you can return to the activities that you enjoy.
To find an urogynecologist affiliated with Penn Medicine Princeton Health, call 1-888-742-7496, or visit www.princetonhcs.org.
To schedule an appointment at the Center for Pelvic Wellness, call 609-395-3020. The center is accepting appointments at its Monroe location.
Rebecca Keller, PT, MSPT, PRPC, is a certified pelvic rehabilitation practitioner and the rehabilitation coordinator for the Penn Medicine Princeton Medical Center Center for Pelvic Wellness.