The pelvic floor is an area that is not talked about much. Yet it can significantly affect the quality of life. When it is not working properly, the body will sooner or later show it, through pain, pressure, urine leakage or difficulties in intimate life.
Why is a pelvic floor examination performed at all?
It helps us to accurately assess:
- Whether the pelvic floor muscles are weakened (hypotonic)
- Or, on the contrary, excessively tense (hypertonic)
- What is their strenght
- Contraction endurance
- Ability to relax
- Sensitivity and soreness of individual structures
In women, we often find that the pelvic floor muscles are not only weakened, but also overloaded and under increased tension. In both cases, however, they do not function optimally.
How problems can manifest themselves.
With increased tension (hypertonia):
- Pain in the pelvic area, lower abdomen or hips
- Painful menstruation
- Pain during intercourse
- Difficulty with defecation
- Sometimes incontinence
When weakened (hypotonie):
- Incontinence
- Pelvic organ prolapse
- Postpartum difficulties
Very often we encounter a combination of both conditions.
When is it appropriate to undergo an examination?
We recommend an examination, for example, in the case of:
- Painful menstruation
- Painful sexual intercourse
- Incontinence
- Pelvic organ prolapse
- Coccyx pain
- Conditions after childbirth
- Postoperative conditions
- Inability to get pregnant (functional sterility)
- Vaginismus
What are the methods of examining the pelvic floor?
- aspect (visual examination) - we observe the overall posture, position of the pelvis, curvature of the spine, skin folds, possible swelling in the pelvic area
- palpation (examination by touch) – we palpate tension in the pelvic and hip area, sensitivity around the pubic symphysis or coccyx, tension of the abdominal muscles and muscles of the lower extremities
- joint mobility examination - we examine the mobility of the joints, mainly in the pelvic area (SI joints, hip joints, but also the overall mobility of the spine)
- ultrasound examination (UZ) - we observe the movement of the pelvic floor muscles through the abdominal wall
- per rectum / per vaginam examination – specific internal examinations of the pelvis
The pelvic floor can also affect distant areas of the body. For example, significant tension in the pelvic floor muscles can, in addition to pain during sex or pain in the coccyx area, also manifest as pain in the lumbar or thoracic spine, or even as neck or headache. The body is connected through muscle chains, and therefore problems can chain each other and travel far from the place of the real cause.
The pelvic floor plays a major role in women even before a planned conception. Ludmila Mojžíšová has already found that in certain cases, significant tension in the pelvic area can cause functional sterility (infertility). Furthermore during pregnancy, when the pelvic floor muscles are put under great strain in terms of pressure and stretching. And of course, in post partum period, when the body is slowly put back together.
Our practice confirms how important it is to take care of this area for women who are going through periods of change, not only physical but also psychological. And if our body works as we wish, everything is easier to tolerate.
At SPINEZIO physiotherapy we work with maximum respect, explaining every step and emphasizing your comfort.
Author of the article:
Mgr. Michaela Horká, physiotherapist SPINEZIO
