Pelvic floor dysfunction (PFD) refers to a wide range of diagnoses which occur when the muscles of the pelvic floor are not functioning appropriately. Normal muscles can contract and relax fully. PFD can result from muscles that are over-active or under-active and may not be able to contract or relax fully.
Muscles that are over-active may feel tight and weak. You may experience painful penetration, urine leakage, urgency/frequency with urination, painful sitting, painful exercise or constipation. You may have a history of other orthopaedic issues including low back or Sacroiliac (SI) pain, hip pain or post FAI surgery as well as coccyx (tailbone) pain. Kegels or pelvic floor muscle contractions are NOT the first line of treatment with overactive pelvic floor muscles. In fact, the opposite action, relaxing these muscles and learning to coordinate relaxation and contraction are the initial focus of treatment. With improved coordination, you can learn to contract efficiently again and re-integrate activities including core exercises, high impact activity including running and CrossFit as well as Pilates and yoga. You will learn guided progressions to return to intercourse and sitting without pain.
Muscles that are under-active may feel weak and saggy. You may experience leakage of urine or fecal matter, loss of control of vaginal or rectal gas during inversion exercises, heaviness in the pelvic floor or related issues involving low back, pelvic girdle or hip pain. First line treatment can include learning to find and activate pelvic floor muscles in isolation and slowly re-integrate movement, build strength and endurance through specific targeted exercise tailored just for you.