Pelvic Health
What Is Pelivc Health?
Pelvic health focuses on the muscles of the pelvic floor. The pelvic floor is a complex group of muscles that quite literally form the floor of the pelvis, completing the cylinder that holds the pelvis and abdominal muscles.
The main functions of the pelvic floor are pelvic and abdominal organ support, maintenance of urinary and faecal continence and sexual function.
Types of Pelvic Dysfunction
Osteitis Pubis
Osteitis Pubis is the name given to the inflammation around the symphysis pubis. The symphysis pubis is the joint at the front of the pelvis where two of the pelvis bones meet. It is made of cartilage and surrounded by ligaments and muscles.
Osteitis Pubis can cause pelvic, groin and lower abdominal pain. It is commonly associated with repetitive stress on the joint in sport, post gynaecological surgery or pregnancy and childbirth. it may also be the result of trauma.
Physiotherapy can assess the causes of pain, and it is an important part of the recovery plan.
Incontinence
Up to 45% of all ladies suffer with urinary incontinence and 34% of older men. This most common types of urinary incontinence are stress incontinence, urge incontinence, or a mixture of the two.
Stress incontinence causes leakage of urine with exertion and is most common in ladies. Urge incontinence occurs when there is a sudden need to urinate, causing urine loss. It often affects ladies and older men.
A physiotherapy assessment is indicated for all types of incontinence and involves and internal examination to establish the cause of the incontinence.
Physiotherapy assessment is recommended as the first line of treatment in the NICE guidelines (2019).
Groin Pain
Groin pain occurs in the inner thigh between the abdomen and the leg. It commonly occurs when too much strain is placed on the muscles, particularly in sports involving running, jumping and sudden changes of direction leading to muscle tearing.
Gilmores Groin or Sportsman Hernia is a cuase of groin pain. It involves the lower abdominal muscles and the muscle tendons in the groin. Physio can identify the cause of the groin pain and will lead to a tailored treatment programme.
Prolapse
Pelvic organ prolapse occurs when the supporting structures of the pelvic organs become weakened, allowing one or more of the pelvic organs to bulge into, or protrude from the vagina or rectum.
A physiotherapy assessment of the pelvic organ prolapse enables a targeted approach to pelvic floor exercise and lifestyle modifications.
This treatment is recommended as a first line treatment in the NICE guidelines (2019).
Pelvic Pain
Pelvic pain ocurs in the lower abdomen or pelvis. It can be acute or chronic, sharp or dull, constant or intermittent.
There are many causes of pelvic pain, often requiring investigation by doctors. However, the muscles of the lower abdomen and pelvic floor are often overlooked, also, they may become injured or overworked, like any other muscle.
People with pelvic pain from another source, may hold the muscles of the pelvic floor tight, leading to muscle shortening and dysfunction and problems such as constipation, painful intercourse and stress incontinence.
Physiotherapy can address the involvement of the pelvic floor and abdominal muscles in pelvic pain.