Announcement

Collapse
No announcement yet.

Pelvic physio

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Pelvic physio

    This article is mostly aimed at women but some might find it of interest.


    What is Pelvic Floor Muscle Tightness?

    Many people with pelvic pain have pelvic floor dysfunction, but specifically hypertonic muscles, or muscles that are too tight. The pelvic floor muscles are a group of muscles that attach to the front, back and sides of the bottom of the pelvis and sacrum. They are like a hammock or a sling, and they support the bladder, uterus, prostate and rectum. They also wrap around your urethra, rectum, and vagina (in women).
    These muscles must be able to contract to maintain continence, and to relax allowing for urination and bowel movements, and in women, sexual intercourse.
    When these muscles have too much tension (hypertonic) they will often cause pelvic pain, or urgency and frequency of the bladder and bowels. When they are low-tone (hypotonic) they will contribute to stress incontinence and pelvic organ prolapse. You can also have a combination of muscles that are too tense and too relaxed.
    Hypertonic muscles can cause the following symptoms:
    • Urinary frequency, urgency, hesitancy, stopping and starting of the urine stream, painful urination, or incomplete emptying
    • Constipation, straining, pain during or after bowel movements
    • Unexplained pain in your low back, pelvic region, hips, genital area, or rectum
    • Pain during or after intercourse, orgasm, or sexual stimulation
    • Uncoordinated muscle contractions causing the pelvic floor muscles to spasm

    Pelvic floor muscle problems are diagnosed by specially trained doctors and physiotherapists using internal and external “hands-on” or manual techniques to evaluate the function of these muscles. They will assess your ability to contract and relax these muscles, and feel for tight bands or Trigger Points in the muscles. The bones and muscles of your lower back, hips and sacro-iliac joints will need to be assessed as well since these joints can stress your pelvic floor muscles. When your pelvic floor muscles are tight or weak they can also stress the joints of your back and hips, leading to persistent low back and hip pain. It is important for people who have unresolved low back and hip problems who also have pelvic floor problems (Incontinence, Prolapse, urinary or bowel urgency and frequency, Constipation or Painful Intercourse), to seek out a pelvic floor assessment since their pelvic floor problems may well be the reason that their low back and hip pain is not getting better.
    If an internal examination of the muscles is too painful, the connective tissue of your abdomen, thighs, groins and low back are often very tight. The connective tissue forms the container of the muscles, and these often need to be relaxed before any internal work can be done. The connective tissue dysfunction becomes the priority before the trigger points, or tight muscles can be effectively treated.
    When your pelvic floor muscles are tight and weak, the tension is treated before the weakness. Once the muscles have reached a normal resting tone, and are able to relax fully, their strength is reassessed and pelvic floor strengthening exercises are prescribed if appropriate.
    Self-care is an important part of treatment. Avoid pushing or straining when urinating and ask your health care provider about how to treat constipation. Relaxing the muscles in the pelvic floor area is important, and doing reverse kegels may be one way to help lengthen and relax these muscles. Regular deep breathing is an important part of learning to relax tension in all of your muslces, but particularly the pelvic floor. Using methods such as warm baths twice daily can also be helpful.
    Medication such as compounded vaginal or rectal diazepam can be quite helpful and may be prescribed by your doctor. These medications can be used as local muscles relaxants in the vagina or rectum. Good posture to keep pressure off your bladder and pelvic organs, and other stretching techniques such as yoga, can be helpful to avoid tightening and spasms in the pelvic floor muscles as well.
    Persistent pain education is an important part of treating pelvic floor muscle problems since the pelvic area is an area that we often hold our stress. Anxiety, stress and our thoughts, attitudes and beliefs can perpetuate the pain in our pelvis; understanding how our pain system works has shown to be an effective way of reducing the threat of ongoing pelvic floor problems.

  • #2
    I have a weaker lower back compared to my abs and rest of the body...
    "Girth over length :D "

    Comment


    • #3
      It strikes me that lower back issues are often implicated in stubborn pre e cases.

      Comment


      • #4
        Quote

        Men’s Pelvic Health

        http://pelvichealthsolutions.ca/wp-c...ll-200x300.jpgPelvic Health concerns are coming to the forefront. Pelvic floor physiotherapy can be extremely helpful to address some of the challenges that men may have when their pelvic floors are not working properly including:
        • Post-Prostatectomy Incontinence
        • Erectile dysfunction
        • Pelvic Pain including Chronic Prostatitis, Testicular and Penile pain syndromes
        • Nocturia (frequent urination at night)
        • Symptoms of retention which can often be associated with Benign Prostate Hyperplasia and/or a tight pelvic floor
        • Tight Pelvic Floor
        • Chronic Constipation

        Mens pelvic health has fallen behind in research, and recognition of pelvic floor muscle problems as they relate to overall health, specifically urogenital health. Pelvic health problems have received more attention from the medical community in general for women, leaving men confused, isolated and searching for answers. Please click on the links on this page to get more information on each of these pelvic health problems and follow the links throughout this website to get some real answers and potential solutions
        Unquote

        Comment


        • #5
          http://www.google.com.au/url?sa=t&rc...yvpXJxofCq20QA

          Comment


          • #6
            This is relevant to several current threads, there is a lot of info here . Physio has been moving forward rapidly in this area , you will note similarities to established Pegym practise .

            Comment


            • #7
              It's a very good read; give it a try.
              The world's still a toy if you just stay a boy!

              Comment


              • #8
                Pelvic Floor Muscle Relaxation for Men - Pelvic Pain Foundation

                Comment


                • #9
                  What Causes Pelvic Floor Muscle Spasm?

                  Possible causes include the following:
                      • Overloading the pelvic floor muscles with too much pelvic floor exercise and insufficient relaxation. Women who regularly perform pelvic floor exercises or kegel exercises need to take the time to relax their pelvic floor muscles too.
                      • Overloading the pelvic floor with potentially unsafe intense abdominal core exercises
                      • Pelvic surgery including prolapse surgery and hysterectomy
                      • Pelvic infection or inflammation
                      • Recurrent infection such as cystitis
                      • Pelvic trauma
                      • Postural problems
                      • Mental/emotional factors.

                  It currently remains unclear whether pelvic pain causes pelvic floor muscle spasm, or whether the pelvic floor muscle spasm causes the pain – it’s a bit of a chicken or the egg story. What is known is they are both very much interrelated.
                  Problems Caused by Overactive Pelvic Floor Muscles

                  Overactive pelvic floor muscles can cause a range of bladder, bowel and sexual problems in addition to pain, emotional issues and progressive pelvic floor muscle weakness. These problems include:
                      • Bladder problems; slow urine flow, difficulty commencing urination, inability to completely empty the bladder, interrupted urine flow and even urinary urgency. These can result from the lack of pelvic floor muscle relaxation.
                      • Bowel problems; constipation, incomplete emptying of the stool, difficulty commencing bowel movement and straining throughout emptying. The straining associated with constipation can then cause increased pelvic floor muscle pain and increased tension. Furthermore additional problems may develop such as rectal prolapse, hemorrhoids and anal fissures.
                      • Sexual problems associated with intercourse and penetration. Vaginismus is the term used to describe the condition where the pelvic floor muscles spasm involuntarily with the threat of vaginal penetration which can prevent sexual intercourse, insertion of tampons and gynaecological examination. Sexual problems that result from overactive pelvic floor muscles can cause considerable emotional difficulty with stress, anxiety and relationship difficulties.
                      • Ongoing pain floor pain and discomfort caused by pelvic floor muscle over activity or pelvic floor muscle spasm can be very stressful and anxiety provoking which often makes the condition worse. The physical discomfort associated with pelvic floor muscle tension presents differently in different women; it may present as pain, ache or discomfort in the low abdominal, low back and/or in and around the vagina and anus.
                      • Pelvic floor muscle weakness results from the pelvic floor muscles contracting too much and tiring out. As a result when they are required to work they are not able to, contributing to problems such as stress incontinence (involuntary leakage of urine with exercise or activity). The supportive function of the pelvic floor muscles may also be compromised, increasing the vulnerability to other pelvic floor problems such as vaginal prolapse.

                  If you suffer from pelvic floor muscle tension and/or pelvic pain, you can access professional treatment by speaking with your doctor or a qualified Pelvic Floor Physiotherapist.

                  Comment


                  • #10
                    Long time reader first time posting


                    The recommended exercise as described by the article is reminiscent of the isolation/training of the IC that you and Minuteman have discussed in previous posts; followed by a relaxation of the pelvic floor. I can't remember your final analysis in those posts but I seem to remember you being unconvinced of any benefit from IC isolation.

                    Do you think that this article suggests benefit from a routine as simple as IC isolation/strengthening combined with relaxation/reverse kegeling ?

                    Comment


                    • #11
                      I will have to reread the article . The ic kegel is unproven in that few guys can actually do it . A simple front kegel seems to hold the same benefit . Then again there is confusion as to what is being done often people say ic kegel when it is actually front kegel.

                      Comment


                      • #12
                        Several guys in current threads can benefit from reading this thread.

                        Comment


                        • #13
                          Another quote.

                          Many evidence based studies prove that pelvic floor physical therapy is an effective treatment approach for men and women suffering from pelvic pain caused by tight muscles and restricted tissues. The pelvic floor muscles, namely the levator ani, coccygeus and obturator internus can develop adhesions, tension or trigger points which restrict movement and cause pain. Trigger points are palpable spasms/knots within muscle tissue and can occur in pelvic floor muscles. Trigger points can lead to adhesions of fascia/connective tissue of the abdomen, groin, pelvic floor and even restrict the viscera (colon, uterus, bladder, prostate gland) within the pelvic bowl.
                          The pudendal nerves and its branches, traveling from the sacrum (back of the pelvis) and running all through the pelvic floor region innervates the vaginal/penile and rectal areas. The nerves can become squeezed as it travels through tight muscles and fascia, which then decreases optimum pelvic floor function and increases pain.
                          The pelvic floor muscles are located INSIDE our bodies, in women the muscles are approximately 1-2 inches up from the vaginal/rectal region and in men, the muscles are approximately 1-2 inches up from the base of the penis/rectal region.
                          The pelvic floor muscles are key for four functions of the body:
                          1) lower back/core stabilization; 2) normal urinary function; 3) good bowel function; 4) satisfying sexual function.
                          As a core stabilizer, the pelvic floor works with 3 other core muscles, the Transversus Abdominus (deepest stomach muscle), Multifidus- (deep low back extensor muscle), and deep fibers of the Iliopsoas (hip flexor muscle). These 4 muscles work together to keep our core strong, flexible and prevents lower back pain. If one of the 4 core stabilizer muscles becomes weak or injured, then the other 3 muscles have to work harder to compensate. Over time this puts great strain on the whole core, which leads to back pain/stiffness/weakness.
                          The pelvic floor muscles are directly involved with three bodily functions, urinary, bowel and sexual.
                          For functional urination, the pelvic floor muscles surround the urethral opening and should relax when you are voiding and maintain closure or tension when you are not voiding. If the muscles are in spasm, urinary symptoms such as leaking, or feeling a strong urge to void, or having to go to the bathroom multiple times a day (called urinary frequency) and/or being awoken at night to void more than once (called nocturia), can occur. Women using public restrooms should not “hover” over the toilet, as this sustained half squat creates tension in the pelvis and does not allow full relaxation of the sphincters around the urethra to allow full urination. Best to use the protective toilet seat covers and sit comfortably.
                          For normal bowel movements, the pelvic floor muscles should be able to open and widen to allow the full passage of stool. When not having a BM, the pelvic floor maintains tension at the rectal opening to prevent leakage. If the pelvic floor is weak, leakage can occur. If the pelvic floor is tight, constipation resulting in sitting too long at the toilet, straining to defecate can occur. Toileting should take no longer than 5 minutes following the urge to void. Even though you may not feel completely empty, it’s better to stand and leave the bathroom versus continue to sit and strain. Constant straining can result in hemorrhoids and/or the development of a rectocele, which further impedes good function.
                          For satisfying sexual function, the toned and flexible pelvic floor allows for more intense orgasms in men and women. A fully relaxed pelvic floor helps women experience pain free intercourse with their male partners. Many patients who are experiencing sexual pain may experience difficulty with partner relationships or even avoid them due feeling of shame or inadequacy.
                          Pelvic pain due to restricted muscles can be released and return to normal function, no matter how long a person has been experiencing symptoms.
                          Physical therapists trained and mentored in pelvic floor work can:
                          • apply targeted manual therapies to rid muscles of trigger points
                          • utilize biofeedback therapy to help patients learn how to either downtrain (relax) their pelvic floor or to uptrain (strengthen) the pelvic floor
                          • perform visceral mobilization to improve the mobility of organs lying within the pelvic bowl
                          • mobilize and teach a patient self-connective tissue (skin rolling) techniques to abolish tight skin and fascia of the inner thighs and abdomen
                          • teach patients gentle stretching techniques with foam rollers, tennis balls, knobbles, Theracane, S –wands and dilators
                          • educate in exercises for a strong core
                          • teach diaphragmatic breathing and visualization to help lower tension of the pelvis and to increase oxygenation to the body and decreased stress
                          • guidance in cardiovascular exercise to pump more oxygen and nutrients to the tissues
                          • teach proper bladder and bowel techniques and habits

                          Most people start to feel better after 2 months of consistent, twice a week therapy which incorporates many of the above techniques. Some reach goals sooner; others may take up to 3 months. By attending regular pelvic floor physical therapy and performing all the home exercises, faulty pattern are reversed and many people are pain free within 2-3 months.

                          Comment


                          • #14
                            That last post was a quote from a New York physio spruiking for business.

                            One will notice the similarity to established pe gym practise.

                            Comment


                            • #15
                              Thanks for the information.

                              Comment

                              Working...
                              X