What are some signs and symptoms of pelvic floor dysfunction????  In part 1, I spoke about function of the pelvic floor and core and what may cause a weakness.  In this installment, I’ll go over the most common signs and symptoms that you may notice that could be potential indicators of pelvic floor dysfunction.

Urinary and/or Fecal Incontinence

Probably the most well known sign of pelvic floor dysfunction is urinary and/or fecal incontinence.  What this means is either a small or large of urine or stool escapes from the urethra or rectum when you don’t want it to.  There are 3 types of incontinence:

  1. Stress incontinence:  this is when leakage happens with a specific activity.  Common activities include sneezing, jumping, coughing, laughing, running, lifting, skipping and quick changes in direction.
  2. Urge incontinence:  this is when leakage occurs after the urge to go to the bathroom comes on quickly.  An example of this would be coming home and putting the key in the door and suddenly having incontinence.
  3. Mixed incontinence:  this is a combination of both stress and urge incontinence

The way in which a physiotherapist treats each of these symptoms is very different.

Pelvic pain

Another indication of possible pelvic floor dysfunction is pelvic pain.  This can include any of the following:

  1. Pain with intercourse (dyspaneuria)
  2. Pain with insertion of a tampon or touch (vaginismus)
  3. Pain at the pubic symphysis
  4. Pain at the sacroiliac joint
  5. Deep muscular pain

Pelvic organ prolapse

A pelvic organ prolapse is when either the bladder (cystocele), the uterus or the rectum (rectocele) push against the pelvic musculature and bulge into the vaginal canal.  There are 4 grades of prolapse ranging from slight to coming right out of the vagina.  This complaint causes quite a bit of anxiety when it’s diagnosed.  I really think it’s important to remember that although this sounds bad, it is the result of dysfunction of the core and can be addressed with a combination of posture, education on lifting, breathing strategies and household tasks as well as  exercise.  If the prolapse is within the vaginal canal, it is very appropriate for pelvic floor physiotherap

Urgency and frequency

This is the need to pee often and quickly.  This can happen with or without incontinence.

Rectus diastasis

A rectus diastasis (or diastasis recti) is a splitting of the connective tissue (linea alba) of the abdominal wall.  This happens in 100% of pregnancies.  Most women’s abdominal wall will come back together on it’s own within 3 months, but in some cases it doesn’t.  A core and pelvic floor that is not engaging properly can be a contributing factor.

So, there you have it.  This list is of the most common signs and symptoms I see in the clinic, but it’s not an all inclusive list.  In some instances, it’s the pelvic floor and core causing some issues.  In other instances it’s other structures such as the thoracic or lumbar spine joints, their associated nerves and discs, structures associated with the hip and even your autonomic nervous system.  If you are experiencing symptoms or you just don’t think things are right, be sure to get assessed by a qualified health professional so you can get the most appropriate and specific care possible.