Pelvic floor dysfunction for men (and women!)

Pelvic floor – the missing link in persistant pain!

The pelvic floor is a very important muscle group that plays an important role in our bodies. If it is not working as it should, it can cause big problems that ultimately lead to pain. In our clinics we find the pelvic floor to be very important, and often find this muscle group to be one of missing links for people with long term pain who have tried everything else to no avail. Now we are going to tell you why!
What is the pelvic floor and what does it do?
The pelvic floor is comprised of a group of muscles that span the area underneath our pelvis. As well as supporting the pelvic organs and maintaining continence, the muscle group also forms part of our intrinsic core stability system.This system includes the pelvic floor, the diaphragm, transverse abdominis and multifidi which all work together to increase intra-abdominal pressure, increase tension in our thoracoloumbar fascia and improve segmental alignment.This results in optimal stabilisation of the lumbo-pelvic-hip complex, which in turn makes the transfer of force between the lower and upper extremities more efficient. This then has the knock on effect of improving the function of all other muscle groups and kinetic chain subsystems. Powerful stuff for a group of small muscles!

In function, the pelvic floor must contract and relax, lengthen and shorten, and work in tandem with the other muscles of the intrinsic core if we are to move efficiently and pain free.

It is much easier to grasp this concept visually, so check out the video on the left where Dave talks through the pelvic floor and discusses its function as it relates to a step up.

Pelvic floor dysfunction – not just a woman thing!
As you can see the pelvic floor is a powerful muscle group. On the flip side, however, given the amount of functions the pelvic floor is involved in, even the slightest imbalance or dysfunction can wreak havoc on the entire body. If the pelvic floor takes on too much work or doesn’t pull it’s weight, the whole intrinsic stabilisation system becomes dysfunctional. This can lead to all sorts of problems, and will play a role in many cases of pain, including back pain, neck pain, nerve pain, even shin splints as Dave describes above!
When we discuss the pelvic floor with patients in the clinic, especially with men, the first reaction is often surprise. It is a common misconception that only pregnant, post-natal, or elderly women need to worry about their pelvic floor. The fact is that all of us need our pelvic floor to perform efficiently if we want to move without pain or restriction.And pelvic floor dysfunction is more common than you think. In fact, last year we ran a workshop on the pelvic floor for runners and Up and Running Huddersfield. Of the 12 of so attendees, 9 had some element of pelvic floor dysfunction contributing to their pain, and 3 of these were men. It is not just a woman thing!

Another common misconception is that pelvic floor dysfunction = a weak pelvic floor. This is only half true. In fact, more often than not we find that the pelvic floor is OVER-active – working too hard to compensate for something up or down the chain, or not lengthening fully and becoming tight. This causes as many problems as a weak muscle group.When you consider the fact that we spend most of the day sat down in cars, at computers, in front of the TV – it’s no surprise our pelvic floor often becomes tight and overactive. It never really gets fully stretched as would happen at the very bottom of a deep squat.
What are the symptoms?
So how do you know if you have a pelvic floor dysfunction? Some of the symptoms are more subtle then you think, as you can see by the examples below
  • Painful intercourse
  • Difficulty starting a urine stream
  • Urinating to what you think is completion only to find there was one last drop left
  • Constipation
  • Urgency to use the loo
  • Urinating like a jet stream
  • Incontinence
  • Impotence
  • Rectal and uterine prolapse
  • These are but a few examples..
In addition, the pelvic floor has an attachment to our obturator internus muscle on each side, and therefore when one becomes dysfunctional the other normally joins it. Obturator internus laterally rotates our hip when the hip is in extension, or abducts the hip when it is in flexion. Therefore, pelvic floor dysfunction can contribute to hip pain or hip impingement.

What can I do about it?
If you are already in pain and you believe your pelvic floor may be involved, there is no better alternative than getting assessed. This will let us find out to what level your pelvic floor is involved, whether it is over or under-active, and how it all happened in the first place – allowing us to guide your body to a permanent solution.If you are not already in pain, and would just like to keep your pelvic floor healthy the top 3 tips are:
  • Improve your overall body condition / strength
  • Squat deep – this will help keep your pelvic floor able and limber to lengthen and shorten as it should
  • Get good core sequencing and activation – this will prevent your pelvic floor having to overwork and compensate for other muscles

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