Misconceptions about Pelvic Health and Pelvic Physiotherapy
Some of the most common phrases I hear as a pelvic physiotherapist are “I had no idea physiotherapy could treat this” and “I wish someone had told me about this sooner!”. Which is why I wanted one of our first blogs to dispel some of the myths about the pelvic floor and emphasize how important pelvic physiotherapy can be! So here are some of the most common misconceptions about pelvic health that I have encountered as a Pelvic Physiotherapist.
1) Myth: Incontinence Is Normal After Giving Birth And I Can Expect It’s Just A Normal Part Of Getting Older.
FACT: INCONTINENCE IS COMMON BUT NOT “NORMAL”!
The risk of incontinence (the uncontrollable leakage of urine or stool) increases in postpartum and postmenopausal women – but in many cases can be controlled or minimized with pelvic floor retraining. The pelvic floor muscles work to compress the urethra (the small tube that drains urine from the bladder) and rectum to maintain control of your bowel and bladder. Changes to these muscles after pregnancy and childbirth or with hormonal changes during menopause can lead to weakness and poor coordination. Pelvic physiotherapy can help by assessing the muscles of your pelvic floor, testing strength and endurance and prescribing appropriate exercises.
2) Myth: Painful Intercourse Is Just Something I Have To Live With.
FACT: INTERCOURSE SHOULD NOT AND DOES NOT HAVE TO BE PAINFUL!
There are many reasons why intercourse may be painful – but working with a pelvic physiotherapist can help. Dyspareunia (painful intercourse), Vaginismus (the inability to achieve penetration during intercourse) and vulvar and vestibulodynia (unspecified pain around the vulva and vaginal opening) may be associated with tightness or tension in the pelvic floor muscles or muscles of the hips, low back and abdomen. Sensitized nerves around the vulva and vestibule may also contribute to painful intercourse. Pelvic physiotherapy can help to identify the cause of your pain and provide you with strategies to address it.
3) Myth: I’ve Been Having Low Back Pain For Years, But That Has Nothing To Do With My Pelvic Floor Health.
FACT: THERE IS EVIDENCE LINKING CHRONIC LOW BACK PAIN WITH PELVIC FLOOR DYSFUNCTION.
The pelvic floor plays a number of important roles in our body. Beyond maintaining continence, sexual function and supporting our organs – the pelvic floor is an important part of our core, helping to support and stabilize the pelvis and low back. In a recent study of women presenting with chronic low back and pelvic pain, 71% had pelvic floor muscle tenderness and 66% had pelvic floor muscle weakness (Dufour et al., 2017). The important connection between the core and the low back means that those who suffer from chronic low back pain may benefit from a pelvic floor physiotherapy assessment.
4) Myth: I Had A Caesarian Delivery (C-Section) Not Vaginal, So I Don’t Need Pelvic Physiotherapy Postpartum.
FACT: MANY WOMEN WHO DELIVERED BY CAESARIAN SECTION STILL SUFFER FROM INCONTINENCE AND PELVIC DYSFUNCTION (LIKE PELVIC PAIN OR PAINFUL INTERCOURSE) POSTPARTUM.
Pregnancy and delivery, whether it is vaginal or by c-section, can have a significant impact on muscles and joints of the pelvis and low back. A pelvic physiotherapy assessment postpartum can help with managing scar tissue (from either c-section or if there was trauma to the perineum) assess pelvic floor health and introduce safe exercise to help you return to your functional movements as quickly and pain free as possible.
5) Myth: Pelvic Physiotherapy Is Just For Women
FACT: MEN CAN BENEFIT FROM PELVIC PHYSIOTHERAPY TOO!
Men may also experience pelvic dysfunction such as pain with urination or ejaculation, pelvic pain in the perineum or lower abdomen associated with tension in the pelvic floor muscles. I most commonly see men for urinary incontinence post-prostatectomy surgeries for prostate cancer.
6) Myth: I Don’t Need Pelvic Physiotherapy, I Already Know How To Do Kegels!
FACT: 1) MANY PEOPLE AREN’T ACTUALLY DOING KEGELS CORRECTLY. 2) KEGELS AREN’T ALWAYS THE ANSWER!
To do a kegel correctly the muscles of the pelvic floor are contracting independently of other muscles in the body. The general rule is if someone can see that you’re doing a kegel, you’re probably not doing it right.
More importantly, kegels aren’t the end-all and be-all of Pelvic Physiotherapy. Muscles may be lengthened and weak in the pelvic floor, but in many instances they are also short/tight and weak! For many patients I focus on stretching and relaxing the pelvic floor before I start any sort of strengthening.
I hope this helps to shed some light on the pelvic floor and the role that Pelvic Physiotherapy has to play in optimizing your pelvic health. If you have any questions about whether pelvic physiotherapy is right for your, feel free to reach out to us at info@bluewaterpelvic.com
