A Dysfunctional Pelvic Floor (a real pain in the HOO HAA).

The muscles of the pelvic floor play an important role in woman’s health. (Nothing new here 😉 but please, read on). They serve as the floor to your core while influencing peeing, pleasure, breathing & of course the birth process.  When the pelvic floor is dysfunctional it is a real pain in the hoo haa. 

Pelvic Floor dysfunction (PFD) refers to a range of symptoms including back pain or pelvic pain, an overactive bladder, organ prolapse, sexual disorders & all things incontinence.  Peeing, pooping, etc. etc.  The physical & emotional impacts of these struggles can be immense! (Hello PND). 

Pregnancy, childbirth & even aging can put these muscles through their paces.  Trust me, I’ve truly tested the integrity of my pelvic floor over the last little while with having 3 children in as many years.  Many women go from a time when they didn’t give the integrity of their pelvic floor a single thought to worrying about pain, prolapse & peeing when they cough or sneeze for years after.  Around 25% of all women suffer from pelvic floor related conditions at some time in their life, contributing to massive emotional, physical & social stress.

I’m talking here mostly about PFD that is experienced during perinatally.  Because honestly, I’m kind of familiar with that.  It IS common. There are several factors about your birth experience that can increase the risk of dysfunction including the mode of delivery, vaginal birth interventions, the size of your baby & BMI prior to & during pregnancy.  There is always some stress & healing involved for the pelvic floor following pregnancy & delivery but that does not mean that there is supposed to be lasting dysfunction.  Remember the old saying, just because something is common it doesn’t make it normal.  Just because your friend Polly pees a little bit when she runs, skips & jumps on the trampoline it does not make it ok.  What normal should look like is FUNCTIONAL, with functionality comes strength, which then gives us confidence to push forward & reach the goals of performance, aesthetics or lead strong, fit & healthy lifestyles. If that’s what we want.  Not the other way around. 

So Chiropractic what? The evidence shows that the structure & musculature of the pelvic floor also play an important role in stabilizing the spine & pelvis.  Therefore, any imbalance in the pelvis, too tight or too weak for example, can contribute to symptoms of dysfunction like low back pain both during pregnancy & postnatally.  It is worth considering the relationship between the pelvic bones & the function of the associated muscles.  Mechanically speaking, when there is ideal positioning, mobility & symmetry, the ‘pullies & leavers’ work better.  The influence of chiropractic care on core & pelvic floor function may be one of the reasons why we see such a positive influence on low back & pelvic girdle pain during pregnancy, as well as improved outcomes during labour. 

Other studies have demonstrated that pregnant women who received chiropractic care had a greater ability to relax their pelvic floor muscles at rest.  This relaxation of the pelvic floor muscles illustrates that chiropractic care can be of benefit to pregnant women, supporting them to have a natural vaginal delivery which is good news for both mother & baby. 

As you can see, the evidence has great implications for supporting mums as they prepare for birth.  Supporting biomechanical & neurological function in the core & pelvis helps the mother feel more comfortable & confident as she enters into labour & may actually facilitate the capacity to relax the pelvic floor in a way conducive to a smooth delivery.  Chiropractic care can also be beneficial in clearing any interference from the nervous system which may be affecting the function of your pelvic floor.  We can work with you & your pelvic floor physiotherapist to help you achieve the results you deserve.

My own pelvic floor experiences included seeing a Chiropractor for regular care throughout each of my pregnancies.  This was particularly helpful in my first pregnancy for managing symphysis pubis disfunction (pregnancy induced pain in the pubic symphysis region) & in my final pregnancy for balancing & relaxing my pelvis in order for my baby who was found to be breech at 37 weeks to position himself into an optimal position for a natural vaginal birth.  I also attended pregnancy & postnatal Pilates classes when I was able to, which helped keep my core strong & balanced. And finally, following relatively easy, quick & smooth births that resulted in some tearing, I saw a pelvic floor physiotherapist who helped me with the rehabilitation of my pelvic floor musculature.  Today, I am confident that my pelvic floor is functional, but that doesn’t mean that I stop taking care of it 😉. 

So with Chiropractic care, we can have an impact on your pelvic floor, along with your specialist physiotherapist of course.  We want more woman to feel functional, comfortable and confident in their beautiful bodies. 

References

Lisi AJ. Chiropractic spinal manipulation for low back pain of pregnancy: a retrospective case series. J Midwifery Womens Health 2006;51(1):e7-e10.

Diakow PR, Gadsby TA, Gadsby JB, Gleddie JG, Leprich DJ, Scales AM. Back pain during pregnancy and labor. J Manipulative Physiol Ther 1991;14(2):116-8.

Pelvic floor functional changes with spinal manipulation in pregnant and non-pregnant women: A pilot study.  JMPT 2016.