Pelvic Floor Dysfunction

by Michelle Wright (post natal exercise specialist – Mishfit)


Pelvic floor dysfunction can vary greatly from woman to woman, with sometimes the symptoms being surprising similar.

It is absolutely essential that women are given the correct diagnosis of their pelvic floor dysfunction by a professional – such as a Women’s Health Physiotherapist or gynecologist, before they undertake an exercise option.

Here are some of the most common pelvic floor dysfunction issues:

Urge incontinence:

When you need to go, you need to go! On a physical level your pelvic floor needs to train the long twitch muscle fibres (like an endurance runner). A great tip when suffering urge incontinence – give you pelvic floor a series of quick contractions. This can trick your brain and give you a good 5 to 10 minutes to calmly find a toilet.

Stress incontinence:

Leaking a little wee when you laugh, cough, move quickly etc. This requires training the short twitch, or sprint function of your pelvic floor. Learning to contract quickly and practice timing is important. To retrain the body, break down the functions and re-coordinate the body, consciously at first. For example, contract pelvic floor, force a cough and then release pelvic floor. With time and practice, your body will learn better timing and will catch before it needs it, rather than after as an unconscious function.

Prolapse:

Prolapse means “fall out” and happens when the uterus, bladder or bowel falls out of place and into and sometimes through the vaginal passage. Currently prolapse affects around 50% of postnatal women. There are many factors that influence prolapse – hormonal changes (like that of child bearing and menopause), hereditary factors (prolapse runs in families), a history of heavy lifting, childbirth, lax ligament makeup and high impact exercise.

Prolapse may be a physical condition. But prolapse also effects mental and emotional well-being. To deal with prolapse effectively, it needs to be dealt with holistically. This includes addressing toileting behaviour and how women go about their functional day and how they exercise. Addressing incontinence and prescribing pelvic floor safe exercises is essential.

Hypertonic pelvic floor:

Hypertonic pelvic floor is when the pelvic floor does not switch off. For a pelvic floor muscle to be effective it needs to turn on and turn off when needed. Having a hypertonic pelvic floor that does not switch off can lead to incontinence, painful sex and re-occurring urine infections.

For women who have a hypertonic pelvic floor they need to learn to down train their pelvic floor. This includes relaxation techniques and making sure that they are not bracing their pelvic floor continually during exercise.

Vulvadynia:

Can be described as the pain, often unexplained in the vulva (around the entrance to the vagina). There is often no singular cause and often sufferers also are diagnosed with depression. Which is not surprising, as I would feel pretty depressed if my vulva felt pain constantly.

Vulvadynia can be explained as the body confusing signals with pain in the mind.

Vaginismuses:

This can often be confused with vulvadynia, but this is more a muscle spasm on anything penetrating the vagina (penis, tampons or undergoing a pap smear). For some women even the mere thought of penetration can bring on the painful muscular spasms. It is involuntary and the severity can vary greatly from woman to woman. Unfortunately the pain from sexual penetration is likely to remain until the vaginismus is addressed.

There can be many reasons for both Vaginismus and vulvadynia – sexual assault, ongoing yeast infections, stress, anxiety, and may need “down training” (i.e.: similar to a hypertonic pelvic floor)

Any pelvic floor pain:

For whatever reason, if there is any ongoing pelvic pain – I recommend you address it. Just like ignoring incontinence can possibly leading to prolapse – pelvic pain can possibly lead to vulvadynia and / or vaginismus.

Remember prevention with a daily pelvic floor routine is much easier than cure.

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