Pelvic Health & Orthopedic Physical Therapy
Addressing your questions about pelvic, women's, and musculoskeletal health. Health is a journey. Movement is healing!
The abdominal cavity is made up of four distinct borders. The top is the diaphragm, the back is the muscles of the back, the front is the abdominal muscles, and the bottom is compromised of the pelvic floor musculature. The abdomen contains a pressure system in this cavity which is influenced by our breathing and the activities we do throughout the day. This pressure is called "intra-abdominal pressure".
Intra-abdominal pressure can increase when you lift something, cough, sneeze, step down the stairs, and go from sitting to standing. Additionally, this pressure can change when you use the toilet if you strain. I mean think about it, have you ever tried to lift something heavy like a piece of furniture? Instinctively if something is really heavy we hold our breath to try to make the abdominal cavity stronger to lift the item. When we implement this technique we utilize pressure to press out against all borders of the abdominal cavity. Here's the catch it's can have some not so positive outcomes on our body. This increase in pressure presses right on your uterus, bladder and intestines (if you are a woman). These organs respond by going to areas of least resistance, the vaginal vault or rectal opening. This can contribute to pelvic organ prolapse. Additionally, it can cause the bladder to feel an increase in urinary urgency or may cause some accidental leakage of urine. It may also make an existing diastasis recti more challenging to deal with as you cannot appropriately generate force through your abdominal muscles. The number one thing to remember, DON'T HOLD YOUR BREATH. Don't hold your breath with lifting, don't hold your breath during exercise, don't hold your breath on the toilet. The next step is appropriately coordinating your breath, but never forget the number one rule. It is important to brace your pelvic floor and abdomen appropriately with more strenuous activity. If you feel that managing intra-abdominal pressure is something you find challenging you should see a pelvic health physical therapist.
Always a day late and a dollar short. In honor of International Women's Day yesterday, I'd like to take a moment to discuss something that has weighing on my mind lately. I have had the wonderful opportunity to work with many independent and intelligent women in my field. My patient population consists of women of all ages from a variety of backgrounds. One commonality I find among many is the lack of knowledge these women have regarding their own anatomy and the negative body image as well as perceptions they have related to sexual identity. There seems to be this common thread in our society that females just don't understand their anatomy and how it functions completely. I think this lack of understanding coupled with current societal teachings promotes poor body image.
For instance, many women feel that their anatomy is not correct. They don't understand that vuvlas can vary in appearance and that is normal. They don't really take ownership of the vuvlar region. As such they dissociate. When we start treatment of pelvic floor musculature they can really struggle with how to access that part of their body. Additionally, they don't fully understand they pleasure centers associated with their anatomy. The clitoris is located at the top of the vuvlar area where the labia meet (and this is only the exposed part of the clitoris, there's much more to this organ under the surface of the skin). It has 8,000 nerve endings, that is double what the head of the penis contains. The density of nerve endings makes this organ more sensitive to stimulation and pleasure. Then there is the oh so elusive g spot. This is supposedly on the front wall of the vagina. There is mixed evidence regarding the presentation of this area in all women. Some women experience this sensitivity, some women do not. All in all for International Women's Day let's take a moment to appreciate female anatomy and promote positive body image!
Endowarriors is the sisterhood of women who share the symptoms and diagnosis of endometriosis. One in ten women is estimated to have endometriosis (1). Endometriosis is when the endometrial lining of the uterus begins to grow on other organs and tissue outside of the uterus. It can cause pain with periods, pain with intercourse, infertility, pain with urination and bowel movements during menstruation, GI upset, fatigue, and chronic pelvic pain (1). Oftentimes women with this diagnosis are delayed in getting treatment because it takes so long to identify what is going on. True identification involves laparoscopic surgery to identify endometrial growth . Women with endometriosis are at a higher risk for developing ovarian cancer, breast cancer, and autoimmune diseases.
The treatment available for endometriosis targets the symptoms and effects of the diagnosis, but not the cause. It slows the progression. With so many individuals with endometriosis we can do better. March is endometriosis awareness month. If you have been diagnosed with endometriosis make sure to surround yourself with a support network. There are lots of options through twitter and facebook as well as online forums if you would rather not find a local group. http://endometriosis.org/support/online-support/ https://www.facebook.com/endowarriorssupport/ https://www.facebook.com/endometriosis.support.diet.tips/ If you feel you may have symptoms consistent with endometriosis talk with your physician. It is important to be open about the symptoms you are experiencing.
References:
1. https://www.acog.org/ |
AuthorHello! I am Caitlyn, Doctor of Physical Therapy and Board Certified Women's Health Physical Therapist working in St Louis, Missouri. Faculty in developing residency program. Endowarrior Categories
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