The term pelvic floor refers to a group of muscles that extend from the pubic bone to the tailbone and support the bladder, rectum, and uterus. Just as a floor, or foundation is important to the stability of any structure, so is the pelvic floor important to the stability of the organs. If there is weakening in these muscles, issues such as incontinence (urinary leakage), prolapse, and pain can occur.
The pelvic floor, similar to other muscles, will often weaken over time, with increased pressure, or any traumatic event. Just like any other muscle, if not regularly worked out, the pelvic floor muscles will lose strength and tone. Hormonal changes similar to those seen in pregnancy and menopause can also contribute to weakened muscles. Increased pressure on the pelvic floor can result from weight gain (including the weight gain of pregnancy), strain from constipation or childbirth, or even prolonged pressures from coughing or sneezing. Even some activities where repetitive jarring motions occur such as running or jumping (basketball, gymnastics, etc) can cause increased pressure on the pelvic floor, ultimately causing weakening.
One of the more common symptoms of a weak pelvic floor is urinary leakage or urinary incontinence. This can be further broken down into two subtypes, stress urinary incontinence and urge incontinence. Stress urinary incontinence occurs when there is added stress or pressure on the pelvic muscles, and they can no longer hold the opening to the bladder (urethra) closed.
Once an issue arising from the pelvic floor is identified, we can then move forward with treatment strategies. At Women’s and Maternity Care Specialists, we have the ability to manage pelvic floor dysfunction through the use of electromyography. This use of the computer assisted rehabilitation allows us to properly assess the pelvic floor baseline, function, and response to treatment.
Therapy sessions are typically divided into two parts, the work session and stimulation session. During the work session, a vaginal probe is inserted and sensor electrodes are placed on the abdomen. Both probe and sensors pick up any muscle activity and allow us to identify any initial concerns (such as pelvic floor laxity or tension). The probe and sensors will remain in place for the duration of the session. The provider will then guide the client through a series of Kegel exercises, and the client will receive feedback on the computer screen on how well she is contracting the pelvic floor muscles. This biofeedback part of the session is particularly useful in gaging strength, duration, and overall quality of pelvic floor contractions (Kegels). Many clients find this part of the therapy very enlightening and engaging, as it allows them to make adjustments to how they perform a Kegel and see real time results.
The second portion of the pelvic muscle rehabilitation is electrical stimulation. Similar to using a TENS unit on an external muscle group, the vaginal probe can emit different frequencies of stimulation to further engage the pelvic floor muscle group. The stimulation can be customized for each individual and her needs, allowing the user to increase or decrease the time and level of stimulation. This portion of the therapy further aids in strengthening the pelvic floor muscles and preventing undesired symptoms such as urinary leakage.