Pelvic Floor

The term pelvic floor is now often heard in connection with women’s health issues but also in the gyms and Pilates studios around Canada. Maintaining a healthy pelvic floor can be assisted with specialized physiotherapy which often provides non-surgical solutions to several gynecological conditions.

What is the pelvic floor?
Layers of muscle stretch like a sling from the pubic bone to the tail bone. These firm muscles support some of the pelvic organs like bladder, bowel and rectum. One layer of the pelvic floor muscles even contributes to the movements of the hip. The pelvic floor muscles together with the deepest spine stabilizing muscles contribute to core stability as well as hip joint stability which are important for maintaining a healthy back and hips. These muscles are normally firm and help to control the flow and the control of urine and feces, prevent the prolapse of uterus, bladder and bowel through the vaginal canal in women and also provide the stability for the hips and lower back.

How come pelvic floor muscles sometime do not function properly?
There are several aspects that can cause these muscles to weaken and therefore lose the ability to prevent the above conditions. The muscles of the pelvic floor can become weaker due to the aging process, lack of exercise due to trauma during labour and due to nerve injuries that might also occur during labour, as well as a result of hormonal changes during menopause.

How can pelvic floor physiotherapy help?
Strengthening these muscles can reverse or improve pelvic organ prolapse, urinary or fecal incontinence and even improve hip and back pain. It is important to learn how to strengthen these muscles properly and how to progress the exercises in order to be effective with the strengthening program. Many women have trouble locating these muscles in the first place and do not feel whether they are contracting them correctly or at all when attempting to perform the specific pelvic floor strengthening exercises.

In our clinic, we first evaluate the patient’s ability to “feel” these muscles and to engage them properly. Then we evaluate their strength and their general resting tone as well as their endurance and their ability to produce strong contractions. Based on the evaluation the patient receives a specific home exercise program, which is progressed on subsequent visits. Neuromuscular electrical muscle stimulation as well as manual feedback and resistance can help women who have trouble generating pelvic floor contractions by themselves.

It is a good idea for most women’s future well being to continue with the exercises they learned from their physiotherapist in some capacity for the rest of their life, since unexercised muscles lose their tone relatively quickly.

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