Both men and women have a pelvic floor, but it is often overlooked as a source of pain, particularly outside of pregnancy and childbirth. The pelvic floor supports abdominal organs and plays a crucial role in functions like urination, defecation, sexual activity, and sexual pleasure. This group of muscles forms the base of our “abdominal core” and must be both strong and flexible in order to handle activities like lifting, running, jumping, coughing, sneezing, laughing – basically, all the things that make life enjoyable!
Symptoms such as chronic pelvic pain, a heavy, dragging sensation in the lower abdomen, changes in bowel or bladder control, painful intercourse, or sexual dysfunction could point to pelvic floor dysfunction. Pelvic floor specialists have received advanced training to conduct internal examinations via the anus or vagina, but general physiotherapists can still be a huge help by assessing the pelvic floor externally. They can determine if there’s dysfunctional pressure regulation within the abdominal cavity, which could be contributing to your pain.
A significant factor in pelvic pain is often overactivation of the pelvic floor muscles, rather than weakness. Chronic overactivity can limit the pelvic floor’s ability to expand and contract as needed for various tasks. Breathing techniques can help stretch and reduce unnecessary tightness in the pelvic floor muscles.
Try lying on your back and practicing deep belly breathing for 3-5 minutes (relaxed, without forcing your belly to push out). This helps expand the pelvic floor along with the belly. Your physiotherapist will also recommend functional exercises, stretches, and relaxation techniques to improve pelvic floor function.
The pelvis has three major joints aside from the hips: the pubic symphysis at the front, and the left and right sacroiliac joints (SIJ) at the back. Many important muscles influence the pelvic region, including the gluteal muscles, pelvic floor, hip flexors, stabilizers, rotators, and muscles in the lower back. Pelvic pain often compensates for issues in other areas like the hip, knee, or foot, and vice versa.
Physiotherapists assess your pelvis, spine, hips, and legs to determine how movement patterns may be contributing to your symptoms. They also look at how well your pelvic muscles control movement, helping to pinpoint the root cause of your pain. Based on this assessment, your physiotherapist will develop a personalized treatment plan involving manual therapy, stretches, and strengthening exercises to balance and stabilize the pelvic girdle.
Pelvic girdle pain (PGP) is common during pregnancy, affecting 56-72% of pregnant women. Hormonal changes, weight shifts, and changes in posture during pregnancy put added stress on pelvic joints and muscles, leading to pain. Physiotherapy can help by releasing tight muscles and providing targeted exercises to improve stability and manage pain.
Lateral hip pain is commonly caused by weakness or dysfunction in the gluteal muscles. This type of pain often occurs when starting or increasing physical activity. Every time you take a step, the muscles around your hip and pelvis must be strong and coordinated to absorb force and propel you forward.
Ageing and hormonal changes (especially in women) can also make the tissues around the lateral hip more prone to inflammation and pain, often making it uncomfortable to sleep, particularly on your side.
Physiotherapists perform functional tests to assess which muscles or joints are contributing to your pain. From there, they’ll design an exercise program to address the issue. A gradual return to exercise is essential to avoid aggravating the pain.
Proper hydration, rest, sleep, and nutrition can help reduce inflammation. If you sleep on your side, try placing a pillow between your knees to keep your legs aligned. Single-leg functional training and glute strengthening exercises can help your hip muscles handle more load, but it’s best to do this under the guidance of your physiotherapist to ensure proper technique.
As you can see, the pelvic region is both fascinating and complex, with a wide variety of diagnoses that may not always neatly fit into one category – or may overlap with others. That’s why your physiotherapist will focus on a detailed intake to develop the best treatment plan tailored to your specific needs.
