Pelvic floor physiotherapy

What is the pelvic floor?

The pelvic floor refers to a group of muscles that attach to the front, back and sides of the pelvic bone and sacrum closing the bony pelvis basket.  Like a hammock or a sling they support the viscera, bladder, uterus, prostate and rectum. Pelvic floor consist of several layers, where the most cranial is peritoneum and the most caudal is perineum. Middle layer is mainly muscle and connective tissue and nerve endings. Pelvic floor muscles consist of small muscles which are anatomically separated into three layers: pelvic diaphragm, urogenital diaphragm and intestinal and genital muscles.

Pelvic floor muscles play a very important role together with diaphragm and core muscles controlling the intra-abdominal pressure and supporting lower back. By activating pelvic floor muscles it activates transverse abdominal and multifidus muscles which role is to stabilize lumbar spine via thoracolumbar fascia. Correctly working kinetic control chain is the base of our movement, especially during heavy lifts and jumps.

Pelvic floor physiotherapy as a treatment

The aim of pelvic floor physiotherapy is to help recognize, prevent and treat pelvic floor dysfunction. Pelvic floor physiotherapy is always based on carefully inspection and individual treatment. Using external and internal techniques to evaluate and treat the function of the pelvic floor muscles, educated pelvic floor physiotherapist first assess your ability to contract and relax pelvic floor muscles and with EMG you will have visual biofeedback.

If pelvic floor muscles are tight and weak, the tension is treated before the weakness. Pain in pelvic floor is also common problem and need to be treated. Manual techniques (e.g. internal trigger point release TPR) and electrical stimulation to relax pelvic floor muscles and/or activate the muscles is used. Progressive exercises are prescribed. Electrical stimulation can be used to relax over active bladder. Pelvis and connective tissue of abdomen, thighs, groins and low back are often very tight and may disturb pelvic floor muscles activation, the kinetic control, lumbar stability. The connective tissue forms the container of the muscles, and this tissue often needs to be relaxed, e.g using. myofascial techniques.

When the pelvic floor therapy is used?

Pelvic floor dysfunction is usually related to the presence of too much tension (HYPERTONICITY), the opposite of the too-relaxed state (HYPOTONICITY), or combination of these. Anyone can have pelvic floor dysfunction in some point of life, irrespective of age and sex. Overweight, lack of exercise but also sports can cause pelvic floor dysfunction. Women pregnancy, childbirth and menopause cause extra-stress in pelvic floor and core. Men pelvic floor dysfunction is associated with low-back pain and prostate problems. Neurological conditions, like MS and spinal cord injury, may cause dysfunction in pelvic floor muscles.

Pelvic floor physiotherapy is used to:

-urinary and fecal incontinence

– mild prolapses

– pelvic floor over-tension and/or hypo-tension

– pelvic pain syndromes (for example vulvodynia, chronic prostatitis)

– diverse of rectus abdominal muscles (stretching of the linea alba)

– low-back pain

Training pelvic floor muscles affect also positively in males and females sexual functions.

You can also book appointment in pelvic floor muscle condition survey. There we can individually assess condition of your pelvic floor muscles and function with other core muscles, learn to use these muscles better and combine the activation into daily living and sport training to make sure you have the correct techniques to prevent pelvic floor dysfunction.

Physiotherapist Sanna Weurlander will provide you with more information.