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Pelvic Pain and Incontinence

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The pelvic floor is a group of 26 muscles that extend from your genitals to your tailbone. It is designed to help with bladder and bowel control, hold your pelvic organs in place, and support your spine, pelvis and hips.

If the pelvic floor muscles become too loose or too tight, you may develop a pelvic floor disorder. This can include pain, frequent urination, incontinence, or constipation among other symptoms.

Cancer treatments, including surgery, chemotherapy and radiation, also can cause pelvic floor disorders.

Our experienced occupational and physical therapists can treat pelvic floor dysfunction to help you regain urinary or bowel control, ease pelvic pain, and have a better quality of life.

Incontinence is the involuntary loss of urine. People of all ages can struggle with bladder control but the issue is more common in women and as we age.

Incontinence types include:

  • Stress: When urine escapes due to the downward push on the bladder from a cough, laugh or sneeze.
  • Urge: Your bladder can't hold urine so you suddenly have to go. Outside variables such as running water may also cause urge incontinence.
  • Mixed: Stress and urge combination
  • Overflow: Bladder constantly dribbles
  • Functional: Physical impairment limits ability to get to bathroom quickly enough

Bowel incontinence, or fecal incontinence, is the involuntary loss of bowel control as a result of nerve or muscle damage from aging, diabetes, a spinal cord injury, stroke, or childbirth. It also can be caused by a neurologic condition or other reasons.

Bowel incontinence can be chronic or recurring and may accompany diarrhea, constipation, gas and bloating. With urge incontinence, the need to defecate comes on so suddenly that you may not make it to the toilet in time. With passive incontinence, you may not be aware you need to go.

If incontinence is affecting your life frequently, contact your doctor. While the condition can be embarrassing, treatments can help. This includes pelvic floor retraining and other exercises.

Constipation may be caused by digestive problems or too much tension in pelvic floor muscles.

This uncomfortable condition happens when the colon absorbs too much water and muscle contraction in the colon is slow and sluggish. This delays the transit time of waste through the colon so the stool becomes hard and dry.

Symptoms of constipation include straining during movements more than 25% of the time, having less than three bowel movements per week, feeling bowel movements are incomplete, and have bowel movements that result in "pebble-like" feces.

Pelvic floor therapy can assist patients who have constipation by addressing diet and exercise, and by teaching new toileting strategies.

Pelvic pain includes pain in the tailbone, rectum, low back, low abdomen, sacrum or vagina that can be made worse by weak or tight muscles. It may start gradually or suddenly at any stage of life, from young adult to post-menopausal.

Causes of pelvic pain are varied. They may include:

  • Endometriosis, where uterine tissue grows outside the uterus.
  • Chronic pelvic inflammatory disease, a long-term infection, often sexually transmitted, that can causes scarring in your pelvic organs.
  • Irritable bowel syndrome, which is often diet-related, can cause bloating, constipation or diarrhea, as well as pelvic pain and pressure.
  • Painful bladder syndrome, also known as interstitial cystitis, can cause recurring bladder pain and a frequent need to urinate.
  • Pelvic congestion syndrome, in which varicose-type veins around the uterus and ovaries are enlarged causing pelvic pain.
  • Musculoskeletal problems, including pelvic floor muscle tension, inflammation of the pubic joint and tailbone pain.
  • Other factors, including depression, chronic stress, or a history of sexual or physical abuse may increase your risk of chronic pelvic pain.

Pelvic Floor Health

Learn to treat pelvic pain and incontinence, and how a healthy pelvic floor can help aid digestion.

Watch: Listen to Your Gut

Watch: Pelvic Pain Explained

Watch: Stop the Leak

Treatments

Treatments for pelvic floor disorders, from bladder or bowel incontinence to pain, can help you regain control and confidence. While sometimes surgery and medications can help, rehabilitation therapy that includes exercises and behavioral changes offers the most effective, lasting way to improve your symptoms.

Our occupational and physical therapists are trained in pelvic floor dysfunction. They will carefully evaluate you to understand your issues and assess your pelvic floor. We'll also look for other issues such as scarring from a C-section or other abdominal surgeries.

Through rehabilitation therapy, we'll develop a personalized treatment plan for your specific needs. Treatment may include:

  • Biofeedback. Using a sensor, we measure muscle tension and strength; a computer screen nearby lets you see results immediately as you tighten and relax the pelvic floor muscles.
  • Strengthening exercises. Strengthening the pelvic floor and core stabilization muscles can help with symptoms.
  • Stretching. Stretching the muscles that cross the pelvis and go into the back, abdomen or legs can help relieve muscle tension and help them contract more effectively.
  • Relaxation training. Pelvic floor tension can come from other parts of the body; learning how to relax your pelvic floor muscles can decrease pain and leaking.
  • Scar tissue release. Using a hands-on technique, therapists can help tissue restrictions that cause pain and tightness to release and make the muscles work better.
  • Bowel and bladder retraining
  • Education. We’ll help you learn more about your condition and how your diet also plays a role in pelvic health.

Contact Us

Our pelvic floor and incontinence therapy services require a doctor’s referral. If you need help with a referral or would like more information, call 816.691.1795.