Pelvic Floor 101 and PT
WHAT IS THE MYSTERIOUS PELVIC FLOOR?
Its a group of muscles around your lady bits (or manly parts for those gents reading this). Maybe you have heard about it, maybe you haven't. Either way, it is a part of your body and therefore, you have a right to know why the hell its important and how it works. I am going to give you the low down of the mysterious body parts down below.
Let start with a few pics. I am a visual person, so here you have it, the pelvis. The picture to the right is a view from the front.
In this image you can see bones (the white parts), some pelvic floor muscles and a glimpse of the pelvic organs that are housed inside the pelvic bowl.
Women, you have 3 very important holes through the pelvic floor, men, you have 2 because your sexual organs are hanging out. In order from top down in image below. Ladies and gents, the yellow dot in the picture is the tip of the clitoris ice burg!! It is not just a dot in real life, it has a neck and arm that extends on either side of the vagina. It is shaped more like a lovely wishbone (no it's not a bone), which hugs the vaginal opening during arousal.
Hole number one: urethra, where the pee flows through.
Hole number 2: (sorry men, this one you are missing): vagina.
Hole number 3 anus, where you poo from.
Wow! Can you imagine a life without those openings? Pee, poo and sex are all vital functions. Where would be today if we couldn't evacuate toxins (unneeded liquid/solids) and procreate! Our abdomens would be full of shit and we would become extinct. Maybe that is a little far fetched, but you catch my drift.
If you don't find those 3 functions important, here are a few more functions the pelvic floor has: its part of our core for balance, strength and movement (so if you are an athlete or any human that doesn't lay in bed 24 hours a day, you better have a good functioning pelvic floor) and it help pumps blood and lymph through our body (blood flow keeps us alive, people).
Hopefully you find one of these functions snazzy enough to learn more about your pelvic floor or even get yours checked out to make sure all is good down below! If not, wait until one isn't working properly and that will get your attention.
And that is where Pelvic PT comes in..to help get all those muscles and systems working in synergy. The main goal is to give you control back of your body and systems in a time when it may seem as though your body has taken control of your life. For example, if you are having urinary urgency, you may have stopped going out with friends to certain places that don't have easy access to a bathroom. If you are experiencing pain with intercourse, your relationship with intimacy may have changed or come to halt. If you are constipated and other pooping problems, you may be stressed and unsure about your body. You don't have to feel stuck. These issues don't have to be permanent, but you may need some guidance to get over the hump.
If you are embarrassed to tell your friends, partner, family member or even doctor all your pee, poo or sexual health stories, come see a Pelvic PT. We will listen without judgement and you can tell us all about the size and shape of your poo, positions during sex that do or don't feel good, how many pads you may be wearing to wick away the leaky urine! It is important information and we are open to hearing all you have to say. We accept all stories and listen with a curious ear. It may seem scary to tell someone about your special parts and how they are or are not functioning optimally, but your story guides the treatment.
So, what actually happens during an evaluation and session with a pelvic PT? Well, that can vary drastically from one day to the next and depends on the specific issue you are having. Here is what it is NOT: a gynecological exam. The evaluation and sessions are flooded with communication and education aimed at empowering you to feel in control of your body again.
The evaluation begins with a thorough conversation about your daily routine, past medical history, nutrition, toileting habits, work life, bowel, bladder and sexual health. Next, there is a physical assessment which may include assessing static and dynamic postures in various positions, range of motion of the spine, hips and other parts of the body related to your issue, breathing patterns, muscular strength, coordination or motor control and finally the pelvic floor!
How do I assess the pelvic floor? First off, I do not use a speculum or stirrups. I step out of the room as you undress and lay on a warm, comfortable table and cover yourself with a towel or sheet. I will take a look and examine the vulva or undercarriage for tissue quality and see what happens when you cough, kegel or bear down. I will map out the external pelvic floor muscles looking for any tender spots, check reflexes and sensation. If you are comfortable, I will then check your inner pelvic floor muscles for strength, function and sensation. Remember these deeper muscles are inside the pelvis, so to best access them, I place a well lubricated and gloved finger inside the vagina or rectum. I will assess muscle tone, tenderness, the quality of a kegel, ability to release the kegel and for pelvic organ prolapse. This part of the evaluation is usually pretty quick, only about 10-15 min. I then leave the space again for you to clean up and get dressed.
With a bunch of information gathered from the evaluation, we sit back down, go over the findings and begin a plan to regain your confidence with your body and get you back to doing things you enjoy again.