Pelvic Floor Rehabilition 2017-12-13T06:12:33+00:00

Pelvic Floor Rehabilitation

The pelvic floor muscles mediate bowel, bladder and sexual activity. The role of the pelvic floor muscles is to help to preserve these mentioned activities. Biofeedback of the pelvic floor has been proven to assist in improving these activities and / or assisting in correcting if there is any pelvic floor disorders.

It is important to mention that biofeedback needs to be used in conjunction with prescribed medical treatment and behavior modifications.

Constipation & Other Elimination Disorders

The normal range for bowel movement frequency is from three times per day to three times per week. Generally, chronic constipation is having fewer than three bowel movements per week on a regular basis. Excessive straining, incomplete evacuation, and hard stools usually accompany the infrequent bowel movements. Many people experience constipation from time to time, but chronic (ongoing, unrelenting) constipation, disease, trauma, post-surgery, or age-related changes in the body may interrupt our ability to command this crucial body function and affects up to 34% of the population. (Rome III diagnostic criteria & Bristol stool scale).

Overview & Efficacy

Several comparative and controlled studies and numerous clinical studies have shown that muscle tension and pneumatic biofeedback can be highly effective for the treatment of most types of fecal incontinence (as long as the nerve paths are intact), and constipation due to malfunctioning anal muscles (as opposed to dehydration).

Why biofeedback would help this problem

The muscles of the pelvic floor (including those controlling the anus) can become weakened due to overall loss of conditioning with age, stretching during delivery, etc. These muscles may be in good shape but they may have to resist more pressure than they can handle during a cough or jump. Many people do not have a good sense of when they actually need to defecate and are either fooled by sensations that are just warnings or miss the warnings entirely.
Most people tense or relax the wrong muscles when they are trying to avoid leaking.

Biofeedback is a neuromuscular re-education tool used by therapists that can be used to tell if certain processes in our bodies are working correctly. Biofeedback therapy may be used to treat several bowel disorders such as constipation, elimination, and painful anal spasms of the pelvic floor muscles.

Overview & Efficacy

Several comparative and controlled studies and numerous clinical studies have shown that muscle tension and pneumatic biofeedback can be highly effective for the treatment of most types of fecal incontinence (as long as the nerve paths are intact), and constipation due to malfunctioning anal muscles (as opposed to dehydration).

Irritable Bowel Syndrome

What is irritable bowel syndrome (IBS)?

Irritable bowel syndrome (IBS) causes abdominal pain, bloating and alternating constipation and / or diarrhoea. The cause is often unknown, but factors such as dysfunctional pelvic floor muscles, emotional stress, infection and some foods can aggravate the condition. Treatment options include dietary modifications and stress management. A mixture of a few small controlled studies, a moderate number of small clinical studies, and many clinical case studies provide reasonably convincing evidence that biofeedback can effectively reduce or cure this problem.

Why biofeedback would help this problem

The underlying causes of irritable bowel syndrome are unknown for over 2/3 of the people suffering from this disorder. There are two main reasons biofeedback is thought to help IBS. First, stress responses which are expressed as abnormally great gastric reactions (compromised absorption, abnormal muscle contractions related to transport of materials through the gut, etc.) are a key part of the problem for between 1/3 and ½ of the people with IBS. Biofeedback has been shown to be very helpful in teaching people to recognize and control these overreactions. Second, biofeedback recordings can help almost everybody with IBS to recognize when their intestinal tract is about to react abnormally – before they would normally notice symptoms. This knowledge can be used to learn to be aware of when the system is just beginning to get out of hand and to prevent potential problems.

Incontinence

Incontinence is a term that describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence). Incontinence is a widespread condition that ranges in severity from just a small leak to complete loss of bladder or bowel control.

Urinary incontinence or under active or overactive bladder control is a common condition that is commonly associated with pregnancy, childbirth, menopause or a range of chronic conditions such as asthma, diabetes and arthritis.

Poor bladder control can range from the occasional leak when you laugh, cough or exercise to the complete inability to control your bladder, which may cause you to wet yourself. Other symptoms you may experience include the constant need to urgently or frequently visit the toilet, associated with ‘accidents’.

There are different types of incontinence with a number of possible causes. The following are the most common:

  • Stress incontinence
  • Urge incontinence
  • incontinence associated with chronic retention and
  • functional incontinence

Urinary incontinence can be caused by many factors, but can be treated, better managed and in many cases cured.  For this reason, it is important to talk to your doctor or a continence advisor about your symptoms, in order to get on top of the actual problem.

People with poor bowel control or faecal incontinence have difficulty controlling their bowels. This may mean you pass faeces or stools at the wrong time or in the wrong place. You may also find you pass wind when you don’t mean to or experience staining of your underwear.

About one in 20 people experience poor bowel control. It is more common as you get older, but a lot of young people also have poor bowel control. Many people with poor bowel control also have poor bladder control (wetting or soiling themselves). Faecal incontinence can have a number of possible causes.

The following are the most common:

  • weak back passage muscles due to childbirth, age, some types of surgery or radiation therapy
  • constipation
  • severe diarrhoea.

Overview & Efficacy

Several comparative and controlled studies and numerous clinical studies have shown that muscle tension and pneumatic biofeedback can be highly effective for the treatment of the two most common types of urinary incontinence (physical stress and urge) as long as the muscle attachments are intact, most types of faecal incontinence (as long as the nerve paths are intact), and constipation due to malfunctioning anal muscles.

Why biofeedback would help this problem

The muscles of the pelvic floor (including those controlling the anus and urinary sphincters) can become weakened due to overall loss of conditioning with age, stretching during delivery, bladder or prostate surgery etc. These muscles may be in good shape but they may have to resist more pressure than they can handle during a cough or jump. Many people do not have a good sense of when the actually have to urinate or defecate and are either fooled by sensations which are just warnings or miss the warnings entirely. Most people tense the wrong muscles when they are trying to avoid leaking. Biofeedback used in combination with pelvic floor rehabilitation methodology can be used to help patients recognize when they need to have a bowel movement and to relax the appropriate muscles in the appropriate sequence when ready or to contracting the correct muscles to reduce the possibility of any type of leaking.

Vulvar vestibulitis

Vulvar vestibulitis syndrome (VVS), vestibulodynia, or simply vulvar vestibulitis, is vulvodynia localized to the vulvar region. It tends to be associated with a highly localized “burning” or “cutting” type of pain. Until recently, “vulvar vestibulitis” was the term used for localized vulvar pain: the suffix “-itis” would normally imply inflammation, but in fact there is little evidence to support an inflammatory process in the condition. “Vestibulodynia” is the term now recognized by the International Society for the Study of Vulvovaginal Disease.

Overview & Efficacy

Several small controlled studies have shown that muscle tension biofeedback from the pelvic floor is at least as effective as surgery and cognitive restructuring for improvements in sexual functioning and significantly reduced pain during intercourse (but not quite as much as surgery) among people with vulvar vestibulitis.

Why biofeedback would help this problem

The pelvic floor muscles do not behave normally when vulvar vestibulitis is present. There are more spasms and abnormal levels of tension. Psychophysiological recording techniques can record these patterns of muscle tension. Muscle tension biofeedback is used to show these patterns to the patient so she can learn to recognize when patterns become abnormal and to normalize them. When the patterns of muscle activity become normal, symptoms are significantly reduced or eliminated.

Pelvic Pain & Chronic Pelvic Pain

Pelvic pain is pain in the lowest part of your abdomen and pelvis. In women, pelvic pain might refer to symptoms arising from the reproductive, urinary or digestive systems, or from musculoskeletal sources.

Depending on its source, pelvic pain can be dull or sharp; it might be constant or off and on (intermittent); and it might be mild, moderate or severe. Pelvic pain can sometimes radiate to your lower back, buttocks or thighs. Sometimes, you might notice pelvic pain only at certain times, such as when you urinate or during sexual activity.

Pelvic pain can occur suddenly, sharply and briefly (acute) or over the long term (chronic). Chronic pelvic pain refers to any constant or intermittent pelvic pain that has been present for six months or more.

Chronic pelvic pain (CPP) is a common problem and presents a major challenge to health care providers because of its unclear etiology, complex natural history, and poor response to therapy.

Chronic pelvic pain is poorly understood and, consequently, poorly managed. This condition is best managed using a multidisciplinary approach. Management requires good integration and knowledge of all pelvic organ systems and other systems including musculoskeletal, neurologic, and psychiatric systems.

Overview & Efficacy

A significant number of these patients may have various associated problems, including bladder or bowel dysfunction, sexual dysfunction, and other systemic or constitutional symptoms. Other associated problems, such as depression, anxiety, and drug addiction, may also co-exist. Hundreds of controlled and clinical studies of various sizes, some with multiyear follow-ups, show that biofeedback can help and / or eliminate chronic pain either by rectifying the underlying problem causing the pain or by reducing stress magnifying it.

Why biofeedback would help this problem

There are many different causes of chronic pain. In many instances, there is a specific problem which can be identified. In others, the body has become oversensitive to stimulation. Anxiety can also magnify pain tremendously. Psychophysiological assessments can frequently identify causes of chronic pain not diagnosable through other techniques. For example, in lower back pain, they can detect abnormal patterns with which low back muscles interact with each other as well as abnormal amounts of muscle tension – the combination of which frequently causes low back pain. Biofeedback treatments aimed at rectifying specific problems such as abnormal muscle tension in pelvic floor muscles causing pelvic floor dysfunctional problems that can cause bladder, bowel or sexual dysfunction problems can be very successfully treated. Biofeedback to help people control their anxiety and, thus, reduce the overall amount of pain felt, can also be very helpful.