Written by:
DANI ANDERSON, PT, DPT, WCS
Doctor of Physical Therapy, Women’s Health Certified Specialist
Pelvic floor weakness can be present BOTH with hypertonic (increased activity) or hypotonic (decreased activity) pelvic floor muscles. Either the muscles aren’t working enough to provide stability, or they are trying to work ALL THE TIME and are no longer efficient. In each of these states, the pelvic floor is not able to properly support the pressures from above. This could lead to bladder and bowel dysfunction, pelvic pain, AND the sensation of pelvic heaviness.
One common example of this is pelvic organ prolapse (POP). Prevalence of POP has been found to be as high as 50% based on gynecological assessment, though prevalence drops significantly based on symptomology.[1] Pelvic organ prolapse occurs when there is a weakening of the fascia, connective tissues, and ligaments that support the pelvic organs (bladder, rectum, uterus). Symptoms may consist of urinary, bowel, and sexual difficulties, along with a common complaint of heaviness or pressure within the vagina. Prolapse can be graded into four different grades (1 to 4) based on the degree of organ descent within the vaginal cavity, though symptoms don’t always correlate with the severity of descent.
Congestion within the pelvis could come from digestive gases or stool due to GI upset or constipation. It could also stem from a venous insufficiency known as pelvic congestion syndrome (PCS). PCS is defined as the presence of pelvic or ovarian varicose veins associated with pelvic pain persisting for 6 months or longer. 30-40% of chronic pelvic pain cases are associated with pelvic congestion syndrome.[1] Low back pain and pelvic heaviness are common symptoms associated with PCS and the symptoms tend to be exacerbated by standing, intercourse, and menstruation.
It can sometimes be tough to determine the primary cause of a symptom such as “heaviness in the pelvis,” but one can get to the bottom of it with the help of medical professionals. Sometimes all it calls for is some retraining of your pelvic floor muscles and balancing of the tissues that make up your pelvic-abdominal canister.
If your tissues are in coordination and balance with each other, then internal pressures are neutralized and your “canister” is as strong and stable as a full, closed, non-shaken can of pop!
[1] https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0038-1636519
DANI ANDERSON, PT, DPT, WCS
Doctor of Physical Therapy, Women’s Health Certified Specialist
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