If you ever pee when you sneeze, struggle with lower back pain or feel pain during sex, you may be experiencing problems with your pelvic floor. And it’s not uncommon. One study in Australia based on 858 participants showed that 90 percent of women one year postpartum had developed pelvic floor dysfunction (PFD), according to an article in Herman & Wallace,

But pelvic floor problems aren’t limited to prenatal and postpartum conditions and they affect both men and women. Here, Zarina Vitebsky, a pelvic floor physical therapist at ProTouch Physical Therapy in Cranford, explains why this group of muscles is so important and what we all should know about treating pelvic floor problems.

We’re always hearing about how critical our pelvic floor is to our health. What exactly is it and why is it so important?
Your pelvic floor (PF) is a sling of three layered muscles that support your back, pelvis, hips, and organs.  It starts at the front of your pelvis and attaches to the back of your pelvis to your sacrum (the base of your spine) and your tailbone.  Both men and women have a pelvic floor, and it plays an important role in an individual’s urinary function, bowel movements, sexual dysfunction, support for hips, abdominal wall, lower back, and during the birthing process.  PF also houses nerves, arteries, and veins that supply nutrients to the legs and rest of the pelvis.  Your pelvic floor is a very complex and involved part of your anatomy that can be responsible for a wide array of symptoms.

What is pelvic floor dysfunction and what are the symptoms?
Pelvic floor dysfunction is the inability to correctly tighten, relax, or bulge the pelvic floor muscles in order to provide proper bodily functions.  The patient may experience leakage, uncontrollable gas, constipation, or diarrhea.  Sometimes, the patient will have achy, dull, or sharp pains that accompany bowel movements, intimacy, sitting, standing, and/or sleeping.  If the patient is experiencing organ prolapse, he or she may experience pressure with standing, sitting, or lifting and carrying an object.  Pelvic floor dysfunction is also commonly responsible for a variety of sexual conditions in both men and women.

How can a Pelvic Floor Physical Therapist (PFPT) help?
There is so much that can be done by a PFPT that can help a patient both prevent pelvic floor dysfunction and/or restore the pelvic floor after dysfunction has already developed.

A Pelvic Floor Physical Therapist (PFPT) will assess the patient to make sure that the hips, pelvis, and spine are aligned (including after pregnancy and childbirth for women).  The PFPT will also evaluate the spine for proper movement which ultimately affects proper bodily functions along with the tightness and trigger points of the connective tissue and muscles.  These assessments test for motor control to see how the muscles react to different functional positions.  An advanced Pelvic Floor Physical Therapist will also offer an internal exam to further test for organ prolapse and ensure the muscles are firing at a proper rate.  Once evaluated, a PFPT can truly help a patient recover by creating a customized protocol to address the patient’s specific dysfunction.  A Pelvic Floor Physical Therapist will also teach the patient how to further address their dysfunction at home with proper breathing techniques, pelvic tilts, posture, and visual & tactile cueing.

In the case of diastatis recti (DRA), the patient will be evaluated to see if the joints of the symph pubis and sacrum are closed (these joints tend to open during pregnancy and delivery).  If a protocol is created, a PFPT may also suggest a belly binder and other useful tips on how to restore the body.

Some PFPTs may also combine additional techniques such as Visceral Mobilization (also known as VM or Visceral Manipulation).  VM is a gentle massage that softens scar tissue and allows therapists to reposition organs within the body after they have moved out of their original location.  VM is not only useful to postpartum women but also to individuals suffering from endometriosis or post-operative scar tissue.

What should every woman know about preventative Pelvic Floor Physical Therapy (PFPT)?
For women, the pelvic floor is greatly impacted by pregnancy.  More than 60 percent of pregnant women will develop diastatis recti (DRA) during the third trimester, and with each pregnancy the abdominal wall will get weaker if not corrected.  While pelvic floor therapy can treat DRA, preventative Pelvic Floor Physical Therapy will decrease the chance of developing potential conditions such as DRA, organ prolapse, pain, incontinence, constipation, digestive dysfunctions, and low back & pelvic pain during and after pregnancy.  By addressing the stability of the pelvis and spine before issues arise, a PFPT is able to construct a customized protocol for the patient that can strengthen their pelvis, return the patient to their original and natural state of function, and decrease the potential for pelvic floor dysfunction during and after pregnancy.  The main goal here is to make the patient’s pelvic floor even stronger and more stable than prior to pregnancy.

What do you think everyone needs to know about pelvic floor dysfunction?
Pelvic floor dysfunction does not discriminate and is not limited to prenatal and postpartum conditions; it affects both men and women.  Since it is a very intricate part of the anatomy that affects bodily function, sexual function, nerves, organs, and muscles, there are so many difficult-to-diagnose and difficult-to-treat conditions that can arise from the pelvic floor often leaving individuals with a feeling of hopelessness.  But patients should not feel alone.  Many people are affected by pelvic floor dysfunction, and you can find a percentage of them on social media groups for support.  The first step in regaining your quality of life is to seek a Pelvic Floor Physical Therapist for an evaluation followed by a customized protocol that can restore your body to its original function.

ProTouch Physical Therapy
570 South Avenue East
Building G, Suite C
Cranford, NJ 07016
908-325-6556
protouchpt.com

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Zarina Vitebsky received her Master’s in Physical Therapy from Old Dominion University. Her clinical studies included training at St. Augustine University as an Orthopedic Spine Specialist.  Outside of her clinical studies, Zarina completed Visceral Mobilization (VM) training and CranioSacral Therapy (CST) training from The Barral Institute, along with extensive training in Arvigo Abdominal Massage Therapy. A strong advocate of both female and male pelvic floor dysfunction, she is also one of only two physical therapists in the US who have been trained by Dr. David Wise, author of Headache in the Pelvis, to carry out his specific pelvic floor pain protocol.

With a passion in Pelvic Floor Therapy and a desire to perpetually broaden her skills, Zarina has developed extensive and invaluable knowledge in pelvic floor anatomy, physiology, and pelvic floor dysfunctions. Her skills have been so well recognized and requested that she is now offering an Out of Town Patient Program for pelvic related conditions and created her own Facebook support group, New Jersey Pelvic Healing Institute.