Pelvic Floor Dysfunction: More Common Than You Think

By: Lauri K. Friedman, MSPT

Do you experience leakage with running or jumping activities? If so, you are not alone. Urinary leakage affects millions of American women ages 18-55 and billions of dollars are spent on pads, laundry and caretaking annually. More and more we are realizing that pelvic floor dysfunction (PFD) affects female athletes, younger women, even high school-age girls, and we need to start talking more openly about it.


According to a Norwegian university study, a high prevalence of pelvic floor muscle dysfunction is seen in high-impact athletics such as gymnastics and track and field.  Running and jumping activities place an increased strain on the pelvic floor and can cause dysfunction and lead to pain, weakness and incontinence.


Do you ask your high school athlete about incontinence?  You should because kids can also have PFD. They can experience daytime and nighttime wetting as well as constipation. A combination of exercises targeted to improve the strength of the pelvic floor has been shown to decrease accidents and constipation in kids.


Ok, so let’s talk about the pelvic floor…what is it? The pelvic floor is composed of a group of muscles, fascia and ligaments that attach to the front, sides and back of the pelvis. These muscles form a hammock that supports the internal organs of your body. The pelvic floor also helps stabilize the pelvis, trunk, and hip joints. When these muscles do not work together the way they should, we see pelvic floor dysfunction. There could be accompanying hip, lumbar, sacro-iliac joint or coccyx (tailbone) pain. Pregnancy and childbirth are two acute events that can stretch the muscles of the pelvic floor. In fact, research shows that giving birth increases the risk of pelvic floor dysfunction by 18% after the first child and 32% by the third.


There are many types of PFD and incontinence is the most common.  Urinary incontinence is the involuntary loss of urine. There is stress incontinence–the loss of urine from activities such as sneezing, coughing, laughing, running or jumping.  Urge incontinence is when you have a  strong and sudden need to urinate, and the bladder squeezes or spasms and you lose urine.  Mixed incontinence–the most common in older women–is a little of both. Pelvic pain is another type of PFD. Pelvic pain is pain felt anywhere in the pelvic region.


PFD can be truly debilitating and can interfere with everyday activities. Imagine being at work and not knowing if you are going to have an accident. Suppose you had a fear of leakage every time you met your running group.  What about having so much pain that you can’t use a tampon or have normal sexual activity? Or imagine being a kid at school and worrying about wetting your pants.


Well now that you imagined it, let’s use energy and resources to fix it! Pelvic floor dysfunction is a growing field within women’s health practices.  Those who suffer with it are talking more openly about PFD and recognizing there are treatment options.


Hey, I get it. Who wants to be sitting around at the coffee shop talking about urinary incontinence or pelvic pain? But until we do, millions of American women are going to suffer.  A women’s health physical therapist (pelvic floor specialist) can discuss your history and symptoms with you and develop a treatment plan that may include manual therapy, home exercises, and behavior modification. Pelvic-floor physical therapists want to educate and empower women so they have the tools necessary to help themselves get stronger, reduce pain, improve leakage, and meet other health and fitness goals.


Lauri Friedman, MSPT is a physical therapist at FOUNDATIONperformance Sports Medicine in Pawtucket RI. She works with orthopedic and sports-related injuries with a special interest in women’s heath. Lauri lives on the East Side with her husband and three children. Lauri can be reached at [email protected]


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