By: Dr. Gretchen Brooker
When someone has pelvic floor dysfunction – it can cause a variety of symptoms that can be very confusing, which can lead to a trial of other treatment methods before someone even realizes they have a pelvic floor. For example, the primary issue might be constipation or constipation-dependent IBS. When the symptoms are related to pooping, we tend to go to our primary care or are referred to a gastroenterologist. Typically, this may end with a trial of Linzess, maybe a colonoscopy or instructions for Miralax or other medical management. This same person may also be struggling with bladder frequency & urgency, which leads them to a urologist or thinking they have a UTI. They may be placed on medications for overactive bladder or unnecessary antibiotics because their symptoms seem to mimic an infection. This same person may also be struggling with lower back pain and have been seeing a chiropractor or maybe just generalized PT.
All of these things may be helpful and necessary – however, as a pelvic floor therapist we put all these pieces together that boil down to one common culprit – the pelvic floor muscles.
No matter your gender or your age, we all have pelvic floor muscles, technically called the levator ani muscle. It sits inside the pelvis to support the pelvic bowl and surrounds the urethra and anus, as well as the vagina in women. Because the same muscle surrounds the urethra and the anus, it can cause symptoms affecting our pee and poop. The levator ani (pelvic floor) attaches to the front of the pelvis at the pubic bone to the back of the pelvis at the tailbone. Because of its attachment points, tightness or abnormal pulls on the pelvic floor can commonly cause lower back, sacral and tailbone pain.
So let’s go back to our example of our person struggling with constipation, bladder frequency & urgency and lower back pain. All of these symptoms are symptoms of pelvic floor dysfunction. Research shows that up to half of cases of chronic constipation are due to pelvic floor dysfunction, called puborectalis syndrome or pelvic floor dyssynergia, where the muscles contract instead of relax upon your attempt to poop. Symptoms of a UTI such as burning with urination, bladder frequency and urgency can be the same as pelvic floor dysfunction, except the urine culture is negative for bacteria with pelvic floor dysfunction. Lower back pain in women has been shown in research to be highly correlated with pelvic floor dysfunction, up to 98%. This means that almost every woman (not correlated with pregnancy) that has lower back pain has either a tightness or weakness in the pelvic floor muscles. And most of these women had tightness rather than weakness! (Meaning kegels are not the answer here).
This means that we need to be paying attention to symptoms as a whole and recognizing when issues that seem to be separate from each other (constipation, overactive bladder & lower back pain like in our example above) can actually be correlated to one common problem – pelvic floor dysfunction. Evidence & research has proven that pelvic floor rehabilitation is the first line of recommended treatment for leaking, constipation and pelvic pain; however we see patients finding us as a last resort or after their own research desperate for a solution. It’s time to be knowledgeable in our own bodies regarding our pelvic health, but it is also time for our providers to follow the research and prioritize pelvic floor therapy as the first line of treatment to prevent years of frustration and unnecessary testing and medications.
Does this sound like you or someone you know? Take the Cozean pelvic floor dysfunction screening here and contact us to learn how we can help. Are you a provider that wants to know more about how to screen and test your patients for pelvic floor muscle dysfunction? Contact us here and we would love to teach and meet with you.
