Pelvic Floor Health Check
Confused about the state of your pelvic floor? Put it to the test with Real-Time Ultrasound.
Have you ever wondered about exactly what’s happening when you do a pelvic floor contraction? Due to the internal location of these muscles there is often a lot of confusion around what you should or shouldn’t be feeling when you attempt a contraction. Sometimes when people think they are doing a pelvic floor contraction they are in fact doing the opposite and ‘bearing down’ also called a valsalva contraction. This incorrect action increases intra-abdominal pressure and actually lengthens and stretches the pelvic floor making it weaker and reducing coordination.
Studies have shown that when verbal instruction is given to women with urinary incontinence to perform a pelvic floor contraction:
– 26-49% could produce an effective contraction
– 25-39% used a Valsalva action (incorrect contraction)
(Image courtesy of the Continence Foundation of Australia)
Why do we need the pelvic floor anyway?
The pelvic floor muscles:
- help to keep us continent
- support the pelvic organs such as the uterus, bladder and rectum stopping them from descending down to the perineum.
- help to provide stability to the lumbar spine, especially important in lower back pain.
improve sexual response
When they aren’t working properly several symptoms can develop over time including:
- difficulty emptying the bladder completely often resulting in straining
- increased frequency of urination
- lower back pain
Women’s health physiotherapists use digital examination and real-time ultrasound to assess the pelvic floor muscles by determining if the bladder neck elevates, depresses or doesn’t move. An elevated bladder neck indicates a correct pelvic floor contraction, whereas a depressing bladder neck indicates an incorrect contraction or a valsava contraction. A non-moving bladder neck indicates a very weak or non-existent contraction.
In a recent study of 104 women with incontinence and prolapse, the women were asked to draw in and lift their pelvic floor muscles. The results showed 38% elevating, 19% not changing, and 43% depressing the pelvic floor (Thompson and O’Sullivan ’03).
Those are not good odds if relying on verbal instruction alone. If you are suffering with incontinence or prolapse the last thing you want to do is make your condition worse. Real-time ultrasound has become a valuable tool for physiotherapists in both assessing and rehabilitating the pelvic floor. If you’re confused about the state of you’re pelvic floor and want to put it to the test, book an appointment with one of our highly trained women’s health physiotherapists.