And what can I do about it?
The human body is an amazing work of art. We are still discovering complex mysteries regarding how it functions, why certain things occur, and how to handle the aging process. As most of us have experienced, the aging process certainly comes with as many unpleasant as enjoyable side effects. We may experience painful joints, creaky knees, bladder leakage, loose skin, vaginal dryness, frequent bathroom urges, groin pain, painful intercourse, or low back pain. Many of these nuisances are seen as “unavoidable aspects of aging”. But there is hope! Many of these issues are neither unavoidable nor “normal” parts of the aging process!
Pelvic problems come in many forms for both men and women. For both sexes, it can include bladder urgency and/or frequency, low back pain, hemorrhoids, fecal incontinence, and groin pain. For men it can include genital pain, erectile dysfunction or enlarged prostate. Sometimes for women the effects of childbirth may exacerbate pelvic concerns. Female pelvic issues can include vaginal prolapse, vaginismus (painful spasms of the vagina), painful intercourse, interstitial cystitis (painful spasms of the bladder), or rectocele / cystocele (compression of surrounding tissue onto the vagina).
If there is hope…what can I do?
Pelvic floor therapy and rehabilitation is widely used but not well known. There is a growing field of practitioners who focus solely on the pelvic region. They handle common concerns like urinary incontinence, as well as structural abnormalities, post surgical care, post partum care, and preventive treatments such as preparing the pelvic region for an uneventful and “easy” birth.
Pelvic floor therapy focuses on the following four major causes to pelvic issues:
Structural: the muscles may be too tight, which can pull on the bones and slightly move them out of alignment.
Muscular: trauma to the area may overstretch or tighten muscles, which can create a weakness in the musculature.
Neurological: the nerves may be overstimulated, which can cause the muscles to tighten or loosen too much.
Fascial: fascia is like saran-wrap, connecting various tissues throughout the body. It commonly gets crinkled and clumped together, creating tender points within the pelvic region (this can occur in fascia all over the body).
The goal of pelvic therapy is to smooth out the fascia, release the tender points, tighten or relax the muscles, realign the bony structures and retrain the brain to eliminate overstimulated or under stimulated nerve signals to the muscles. The work is performed both internally and externally around the pelvic region. Not only are patients treated in office, they are usually given exercises to perform at home in order to maintain the work that has been completed in office. As the body learns the proper alignment, the exercises reinforce this new pattern.
A common misconception is that pelvic floor therapy is simply glorified kegels. Kegels can be performed at any time and are designed to strengthen the pelvic floor muscles. Unfortunately, most people perform kegels incorrectly, using their buttocks, their lower back, or inner thigh muscles. Additionally, there are many intricate muscles within the pelvic region that are not addressed with this exercise. Simply performing a kegel does not address the specific nature of one’s medical condition. Pelvic floor therapy considers the individual components contributing to the problem.
Where can I find help?
Many practitioners, such as naturopathic doctors, medical doctors, nurse practitioners, physical therapists, and chiropractors, are focusing on pelvic floor therapy and rehabilitation. It is important to ask your practitioner what kind of training he or she has received specific to pelvic floor therapy, how extensive that training was, and how comfortable she or he is working with your particular medical concerns. Check out the Women In Balance provider tool to locate a pelvic floor specialist in your area.
By Jamie Fields, ND