I am so excited to welcome my first guest to the blog today. Dr. Ivy Colbert from Empower Physical Therapy in San Diego is on Steph’s Fitculture to talk about the pelvic floor and the importance of strengthening, lengthening, and relaxing the pelvic floor muscles.
Most people don’t realize the significance of the pelvic floor and that lower back, tail bone and nagging hip flexor pain is likely the result of pelvic floor dysfunction. Many women chalk up their symptoms to childbirth and aging and find it “taboo” to talk about.
As an entrepreneur in the fitness industry, I have met countless women that have pelvic floor issues accompanied by lower back, tailbone, and hip flexor pain. Inevitably I talk about my experience with pelvic floor therapy; come to find out, very few realize the correlation between a weak pelvic floor and their pain and symptoms.
While some of the material covered here might feel awkward discussing, I felt compelled to share what I have learned to build awareness around the fact that there is a solution. This is relevant information for all ages because taking care of your pelvic floor at an early age sets you up for an easier pregnancy, childbirth, postpartum and life beyond your child-bearing years. Pelvic floor health isn’t exclusive to women either; men suffering from weak pelvic muscles also experience lower back and hip pain, as well as sexual dysfunction.
The pelvic floor muscles are an integral part of your daily function. They support all the organs in your pelvis…bladder, urethra, rectum, anus, prostate, uterus, cervix, vagina, and your intestines. These muscles hold up a lot of things and help to stabilize your hips and torso; especially when you are walking, running, sitting, or standing. Pelvic floor muscles also help support your sexual health including sensation, arousal, and orgasm. Having pain during intercourse can also be a sign of pelvic floor dysfunction.
While most people assume that pelvic floor issues arise from pregnancy and childbirth, it might be surprising to learn that there are other things that can wreak havoc on your pelvic floor like abdominal surgery, repeated heavy lifting and daily habits surrounding elimination. Endometriosis and irritable bowel syndrome can also play a role in pelvic floor dysfunction.
While having four vaginal deliveries certainly played a role in my pelvic floor issues, the fact that I had multiple hernia surgeries and a diastasis recti repair compounded my weaknesses. I personally got to the point where the pain in my lower back and hips were limiting my activities and affecting my daily life. Despite my fitness routine and healthy lifestyle, I felt so weak and fatigued due to the stiffness and heaviness I felt in my lower back and pelvis. After countless trips to the chiropractor, acupuncturist, and massage therapist, I thought maybe I had cancer or some sort of tumor and was dying. I know this is dramatic, but I went there..if I take such good care of myself and feel this shitty it must be something BAD. Thankfully it was just my pelvic floor muscles.
Over the past six weeks, Dr. Ivy has worked on decreasing the tension in my abdomen (due to scar tissue from abdominal surgeries) and pelvic floor so that I can engage and activate those muscles better. Also, we’re working on diaphragmatic mobility through hands on work and breathing. Since the diaphragm, pelvic floor, and abdomen are all connected, they need to be able to work together to be coordinated and strong when you need them to be.. like when you walk, jump, run, laugh, sneeze, lift etc. I’ll let Dr. Ivy take it from here! If you are in the San Diego area, I highly recommend checking her out Empower Physical Therapy. Life changing.
Introducing Dr. Ivy
Thank you so much, Steph! It’s a pleasure to be featured on your blog to talk about Pelvic Floor Physical Therapy.
Steph did an amazing job of introducing the topic of pelvic floor physical therapy and her own experience with it. As she mentioned, these issues can be a bit embarrassing to talk about, but it’s important to bring awareness to that fact that pelvic floor physical therapy can help! As a pelvic floor therapist, it isn’t uncommon for me to hear that pelvic floor therapy was someone’s “last resort”. Often times my clients have been to countless specialists before coming to pelvic floor physical therapy and discovering it was exactly what they needed.
What is the Pelvic Floor?
The pelvic floor is a network of muscles that sit at the base of our pelvis. Everyone has a pelvic floor. Sadly, it is often something that is overlooked or ignored even though it’s such an important part of our daily function. We need our pelvic floor to be able to hold pee, poop, and gas in and to be able to let it out voluntarily. We need these muscles to support important organs like our bladder, uterus, and rectum. We need these muscles to be able to work with our core and diaphragm to support the healthy function of our spine and hips. We also need these muscles for sexual function and to be able to orgasm.
What is Pelvic Floor Therapy?
The biggest misconception about pelvic floor therapy is that all we do is teach you how to Kegel. This could not be further from the truth. In fact, in some cases Kegels could do more harm than good! As pelvic floor therapists, we look at someone’s body as a whole and how the pelvic floor interacts and functions with the rest of the body. Instead of just looking at the pelvic floor or another part of the body in isolation, we must treat “each gear in the system” to truly address the issue at hand. Thus, not only are we looking at the pelvic floor– we are assessing and treating your posture, your alignment, your foot and ankle mobility, your hip and core strength, your breathing and diaphragm function etc. We also ask about your eating and sleeping habits, stress level, activity level and lifestyle habits. Pelvic floor therapy is very holistic by nature.
What Do You Do During a Pelvic Floor Exam?
Now that you know more about pelvic floor physical therapy, let’s get into the nitty gritty of exactly what we do during a pelvic floor evaluation. First, we’ll take an in-depth history and talk about any of the concerns you are currently having. Next, we’ll assess the way you walk, the way you squat, your posture and your balance. We may look at your lumbar and hip range of motion, so we might ask you to do a few movements. Then we’ll have you lay on the table and look at your alignment, flexibility, range of motion and test your strength. We’ll look at your abdomen to assess any scar tissue if you’ve had any previous abdominal surgeries. We’ll look at your ribs and your diaphragm/breathing function. Finally, we’ll do an internal pelvic exam.
A pelvic floor exam by a pelvic floor therapist is entirely different from a pelvic exam by a gynecologist. As pelvic floor therapists, we evaluate the strength, relaxation, coordination, and tension of your pelvic floor muscles. This involves one gloved finger with lube inserted into the vaginal canal without the use of a speculum. In order to truly understand the muscular function of the pelvic floor, it is necessary to have this intravaginal exam. However, if someone is uncomfortable with having an exam, there are still other ways we can help them.
How Do I Know I Need to See a Pelvic Floor Therapist?
Pelvic floor therapy can benefit most women at any stage of life. If you’re pregnant, we can help you prepare your pelvic floor for an easier labor and delivery and set you up for a better postpartum recovery. If you’ve recently given birth, therapy can help you recover faster and return to sex and exercise. For clients entering menopause, there are inevitable hormonal changes that occur that can affect pelvic floor muscular function and we can help navigate any issues that may arise. Often times when clients come to us with persistent pelvic pain, low back pain, or hip pain; the pelvic floor muscles are the culprit. If you are having difficulty having an orgasm, have pain or urinary leakage during sex or difficulty with initial penetration– pelvic floor therapy can help resolve that as well. Pelvic floor therapy can also help if you experience urinary leakage when you lift, cough, sneeze or laugh; and can also help if you constantly feel the urgency to urinate. If you struggle with constipation and painful pooping, it’s likely that your pelvic floor muscles are a contributing factor, and we can help you experience easier bowel movements.
These are the main reasons that clients come to see us, but if you aren’t struggling with any of these issues and still want to learn how to take better care of your pelvic floor, here are some simple lifestyle tips to keep in mind:
Pelvic Floor Tips:
Most of us are dehydrated and constipated. We don’t drink enough water throughout the day and instead drink teas, coffees, sodas, and juices. Not only do some of these act like a diuretic and dehydrate us more, they can cause the pH of our bladder to be more acidic, irritate our bladder lining, and increase our urgency and frequency; causing us to make bathroom trips when it isn’t absolutely necessary. This doesn’t mean you have to give up your morning coffee; just increase water intake so it exceeds the amount of other beverages you are drinking.
2: Avoid the “JIC” Pee
“JIC” stands for Just In Case. This means, try not to go to the bathroom just in case you won’t be by another bathroom or just in case you’re afraid you might experience leakage with a “full” bladder. Every time you urinate without really needing to go or before the urge is present, you are creating a signal to your brain to empty your bladder before it reaches its capacity.
3: Sit Your Butt Down
And I mean, fully sit down. No hovering your bottom over the toilet or power peeing! When you hover over the toilet, your quads, glutes, and adductors activate– which makes it harder for your pelvic floor to RELAX.
We need our bladder and pelvic floor to work in harmony. When we pee, our bladder contracts and our pelvic floor needs to fully relax in order to relax the urethral sphincter to let the pee out. If you were to contract your pelvic floor during this process, it’s going to be much harder to fully empty your bladder and potentially lead to some urinary retention.
4: Avoid Power Peeing
I know many of us are in a hurry and will “power pee” to empty the bladder faster. But please, try not to push your pee out with force! When you push the pee out, you are straining; causing an excessive pressure downwards on your pelvic floor muscles and organs that may lead to a worsening of any prolapse or hemorrhoids. So, sit down, relax, and allow yourself to breathe. It’s called a REST-room for a reason.
5: The Magic Number of 8
When you count the seconds of your urine stream, how long did it last? 8-15 seconds? or 3-5 seconds? If your urine stream lasted less than 8 seconds, then your bladder probably didn’t really have to empty. Healthy bladders empty for a count of at least 8 seconds. Also, count the number of times you went to the bathroom in a day. Healthy bladders take less than 8 bathroom trips a day. If you consistently have a urine stream that only lasts for a couple seconds and make frequent bathroom trips every hour, this is a sign that you need to see a pelvic floor therapist.
6: Unclench Your Butt and Pelvic Floor
So many of us hold tension in our bodies due to underlying stress or trauma. We unknowingly clench our glutes and pelvic floor muscles throughout the day as a protective response or due to being in a state of fight or flight. This can cause tightness and tension in our pelvic floor muscles (imagine curling your bicep tight all day– that would definitely cause some soreness!). This tension in our pelvic floor can inhibit our strength– making our pelvic floor muscles tight, weak, and uncoordinated. We often equate tightness to strength…however, when a muscle is too tight and is unable to relax, it becomes dysfunctional!
By practicing these lifestyle habits, we can prevent certain pelvic floor issues from happening! Just small changes throughout your day can make a huge impact. Because the pelvic floor is such an integral part of our daily function, it’s important to understand how to take care of it and to reach out to a pelvic floor therapist when experiencing related issues. Spreading this awareness about the pelvic floor and its importance can potentially change someone’s life that might not have otherwise known about pelvic floor physical therapy!
It was an honor and a pleasure being able to share more about what we do as pelvic floor physical therapists. Thank you so much for having me on the blog! For anyone located in San Diego and in search of a pelvic floor therapist, please come by our clinic at Empower Physical Therapy! We’d love to have you.
Learn more about Dr. Ivy and Empower Physical Therapy – https://www.empowerphysicaltherapy.net/about