by guest blogger, Michelle Herbst, MPT, DPT

As a young lady, I loved the start of a new school year.  When I heard the late summer locusts calling, my eager anticipation began of meeting my teacher and, yes, learning new things.  My love for learning has continued into adulthood and has made it easy, as a clinician, to embrace the time commitment of delivering comprehensive and quality patient education.  I love the light bulb moment of seeing the patient’s face light up when they begin to have a working knowledge of their diagnosis.  The light bulb moment often allows the patient to become more accepting of their current limitations and have a renewed sense of commitment to and respect for the healing process.  In order words, expanding a patient’s knowledge base allows her to realize just how awesome the healing process can be and often spurs long-term positive changes. So, now that school is in session let’s turn our attention to what pelvic floor dysfunctions (PFD) is.  My hope is that the information presented may create a light bulb moment for you as you improve your working knowledge about PFD.

Before we go further, let’s define what a healthy pelvic floor is.  What are the characteristics of a healthy pelvic floor?  Per Wang et al, a healthy pelvic floor includes the normal placement of pelvic structures and normal functioning of the pelvic muscles, bladder, and bowel.  By contrast, those individuals with PFD have abnormal placement of pelvic organs or structures, and/or impaired functioning of the bladder or bowel.

What diagnosis or diagnoses are associated with PFD and what causes PFD?  PFD is a set of clinical disorders which generally includes urinary and fecal incontinence, pelvic organ prolapse, impaired emptying of the urinary tract and bowel, sexual dysfunctions, and pelvic pain.  PFD affects millions of women and, early research suggests, four percent of men.  The cause or etiology of PFD is not clear-cut, black or white.  Rather, it results in varying shades of gray and is typically related to injury to pelvic muscles, nerves and connective tissues.  Risk factors for PFD include being female, aging, pregnancy, interstitial cystitis,  obesity, and low back pain.

How is PFD diagnosed? Urologists and OB/Gyns are trained in examining and diagnosing PFD by observing and palpating pelvic structures and by collecting and evaluating objective data such as voiding data and diaries.  Additionally, nurse practitioners and women’s health physical therapists can collect additional quantitative data confirming the diagnosis of PFD by using electromyographics (EMG), which measure the activation and relaxation patterns of pelvic floor muscles.

PFD includes a range of diagnoses that relate to how your pelvic floor or basket works.  As clinicians, our goal is to improve the  patient’s working knowledge of something specific which includes simply knowing how to do something.  Specific to pelvic  rehabilitation, working knowledge is the ‘how to’ for improving the function of your pelvic basket.

OK – so here is your test:

  • What is your working knowledge for PFD diagnosis?
  • Have you been properly diagnosed by a qualified health care provider and what is your diagnosis?
  • Do you have risk factors that you could change, such as obesity and low back pain that you may be able to address to improve your pelvic floor health?
  • Do you have a treatment plan that is being administered by a qualified provider?  If not, what are your options?
  • Have you used Hab-It:  Pelvic Floor or thought about using the Hab-It program?

Our commitment at Hab-It is to provide you the tools and resources for successfully managing and rehabilitating PFD.  As your  knowledge base grows, so will your commitment to positively impact your pelvic floor function.  This may occur through the use of the guided Hab-It workouts, posting your questions to “Ask Tasha,” or working with your local women’s health physical therapist in conjunction with the Hab-It program.

Knowledge is power.  Now that you identified a way to improve your pelvic floor function, I challenge you to learn it, do it, live it. You will be grateful you did.

References:  Wang Y-C, Hart DL, Miodusk JE. Characteristics of Patients Seeking Outpatient Rehabilitation for Pelvic Floor dysfunctions. Physical Therapy. 2012; 92(9):  1160-1173.

Published by Tasha

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