Why We Assess Outside the Pelvis – What’s Really Causing Your Pelvic Problems

October 22, 2019

Most clients coming to us expect that we do a pelvic exam, work on some kegels, and that’s pretty much it. There’s a general social (and medical) assumption that pelvic issues such as prolapse or incontinence are a result of muscle weakness, and unfortunately, there are even still some pelvic health physio’s operating on this assumption. When women receiving treatment based on this principle don’t improve, it can leave them feeling like they are to blame, because as i’ve often heard on initial assessment, “I just haven’t done enough kegels”.

So let’s bust some myths here:

  1. Most pelvic issues are associated with pelvic floor muscles that are too tight, not too weak.
  2. Tight doesn’t mean strong, and weak doesn’t mean loose. Often weak muscles are tight because they’re having to work extra hard.
  3. Pelvic issues are a lot to do with the pressure system in your abdomen. i.e. Excess pressure pushing organs down for prolapse, or excess pressure pushing urine out in incontinence.
  4. If the pelvic floor muscles aren’t working well, this can be a result of a posture or alignment issue undermining them, so fixing the pelvic floor without fixing the global issue is a waste of time.
  5. The pelvic floor muscles are by far the most ’emotional’ muscles in the body. They respond to stress states to a greater extent than any other muscle. So treating the pelvic floor like they’re robotic muscles and not connected to your mental health can also miss the mark.

Pelvic floor rehabilitation has come a LONG way over the last 10 years, with fabulous clinical leasers like Diane Lee and Julie Wiebe expanding our thinking. We don’t put any other body part in a box. It would be like giving every patient with a shoulder injury generic push ups to do.

So when you see a progressive pelvic health physio, they should be assessing the whole body and ensuring they’re really finding the cause of the problem, and not just assuming it’s in the pelvis.

Often, the pelvic floor is actually the victim and not the culprit, and when you treat the culprit (commonly in your head, neck or back but can be anywhere top to toe), the pelvic floor issue naturally resolves itself.

Of course for some the issue is in the pelvis, but it’s important to ensure this is the case so time and treatment is optimized, and we’re not putting you through multiple unnecessary pelvic exams.

At The Cheerful Pelvis we use a repeated testing approach to ensure we have figured out where the root cause is coming from before we jump into treatment or anything pelvic specific. Sometimes that means a pelvic exam isn’t even necessary. Although for those who wan’t one for your own piece of mind we will always make that a priority.

As this can be a departure from your expectations, we ensure to talk you through everything so it makes sense in the moment, and if we find the root cause it can be immediately apparent to you an us as it can change symptoms in real time.

If you have any questions please contact us, or book now for a thorough assessment of your pelvic issue.