Pelvic floor dysfunction and back pain.

Pelvic floor dysfunction and back pain.

Both women and men can develop back pain resulting from pelvic floor dysfunction.

While it is common to find exercises based on Pilates and other methods for the pelvic floor, identifying the cause of the dysfunction may be the only way to improve the condition.

Common causes of pelvic floor dysfunction include

  • Childbearing
  • asymmetrical gait
  • Previous lower back injuries
  • C section or other abdominal scars

There are a growing number of therapists who have been trained in pelvic floor therapy and nonsurgical myofascial release to improve pelvic floor function. Many will also include pelvic floor exercises that can include Bridges, lunges and clams shells to improve the strength of the lower core muscles. 

Women who have had children are most likely to develop problems such as urinary incontinence and in some cases, a prolapsed uterus. Typically, Kegel exercises are recommended.  In Australia, there is a phone app for pelvic floor exercises that you can download for free.

While the myofascial release of the pelvic floor is growing in popularity as our understanding of how the myofascia (the connective tissue surrounding the organs and muscles) affects how we function and move has continued to expand. The idea that pressure on the region is constantly stretching these tissues is popular, but may not actually be the reason behind so many people having problems with their pelvic floor muscles.  Perhaps, this is why so many people who engage in pelvic floor therapies and classes must continue to do them for years without a resolution of the problem.

Active Scars

C sections, hernia repairs as well as other abdominal surgeries may have left scars that attach to organs or other structures responsible for standing and walking. These are known as active scars and can affect the way you stand, walk and move months or years later.  The neck and back pain you experienced after your c section or hernia repair is often a symptom of an active scar forming.  Evaluation within the first 6-8 weeks after surgery for the development of an active scar may help you avoid chronic problems many years later.  Scars, as they are forming, are much easier to treat and resolve than scars that are more mature months or years later. It is my experience that most surgeons are unaware of these types of scars, as they are not considered life-threating.

Post-surgical infections in my experience of treating hundreds of these scars will often result in more chronic active scar problems.   Treatment that includes fascial release in the abdomen and surrounding the scar can markedly improve an active scar.

The spine, pelvis and the way you have adapted to walking is also a contributing factor that is not regularly addressed by these methods.

From a chiropractor’s perspective, most back, gait and pelvic floor issues should include management of the person and not just the pelvic floor.   The current approach of a specialist for everything is expensive, inefficient and often ineffective. Unfortunately, this approach is what most patients are accustomed to.

A primary care approach of the musculoskeletal system is more practical since pelvic floor problems can include the feet, how you move, the joints of the spine and pelvis as well as the muscles and the fascia of the pelvic floor.  One practitioner addressing your problem using an integrated approach can draw from many methods as needed during an office visit saves the patient time, money and travel while offering a one-stop approach to resolving an often multi-faceted problem.   This type of patient-centered approach is ideal since treatment may include manipulation of the pelvis, foot orthotics to balance the pelvis, myofascial release to the core muscles, leg muscles and other involved tissues and corrective exercises, usually in one practice setting.   This holistic type of approach is most common in chiropractic offices.

Problems that involve an active scar are most likely to improve with a treat – test – treat protocol.   When a patient is having difficulty with a particular exercise due to pain during an exercise, the practitioner can actively treat the mechanism of the dysfunction while the patient performs the exercise.   Patients often notice an immediate improvement of their symptoms after performing myofascial release this way, after other approaches failed to resolve their symptoms.   Exercises may then help restore normal functional movement patterns after mechanical restrictions in the core and pelvis are eliminated.

Some women who have a prolapse of the uterus may actually have problems that are worsened by an active scar and biomechanical concerns that distort the core, preventing the pelvic floor muscles from functioning properly.   A holistic chiropractic approach is more likely to lead to better diagnosis and resulting treatment that looks toward resolving the problem rather than just treating it. In other words, there are likely more to a prolapsed uterus when an active scar is involved.

What should you expect on a first visit to the chiropractor

  • A complete history
  • Thorough exam
  • An explanation of your problem and perhaps why it exists
  • A treatment plan that is comprehensive which may include exercises, manipulation of the spine and extremities, foot orthotics and myofascial release treatment to the involved tissues.

Our goals are your goals; feeling better and improving the quality of your life.