Due to recent events, Phoenix Physical Therapy has had to temporarily suspend treatments to ensure the safety of our patients, staff and community. However, despite this “pause” in care Phoenix Physical Therapy is still thinking about our patients and how COVID-19 can negatively impact their pelvic floor muscle. That may seem like a bold statement, but there is a strong connection between stress and pelvic floor muscle dysfunction. Stress and anxiety can create new symptoms or even make present symptoms worse. Before discussing further on that mind and body connection, it is important to have a general understanding of how the pelvic floor functions, what issues can occur and why they can occur. It is also important to note that all humans have a pelvic floor, so pelvic floor issues are not gender specific and can occur in anyone.
The pelvic floor (PF) muscle’s function includes storing and the evacuation of our feces and urine, supporting our pelvic organs, sexual function, stability of the pelvis and hips, pumping blood and the lymphatic fluid back towards our hearts. A few examples of what PF dysfunction can look like is urinary or fecal loss, frequent urination, difficulty emptying the bladder, or pelvic pain. Many times, these symptoms are attributed to a weak pelvic floor and the term “kegels” usually is the said “remedy.” A kegel is part of an exercise regimen that involves contracting your pelvic floor to improve strength. If “kegels” have worked for you then that is great and we at Phoenix Physical Therapy are very happy for you. However, pelvic floor therapy involves much more than “kegels” and I put “kegels” in quotations because the term has had a history of being misconstrued and implemented incorrectly. A very common pelvic floor dysfunction, but not as readily discussed, is hypertonic pelvic floor muscles, which translates to tense muscles that do NOT relax appropriately.
Imagine if your elbow was always completely bent. What would happen over time is loss of function and weakness from the inability of that muscle to relax or contract correctly. Also, that bent elbow position could get uncomfortable and even painful. That bent elbow analogy is the same concept for hypertonic or tense pelvic floor musculature. It is just much harder to connect with the pelvic floor muscles than those muscles around the elbow, especially because you can’t visualize them as easily. A hypertonic PF muscle can be weak, painful and dysfunctional.
Our autonomic nervous system, which is composed of the sympathetic nervous system and parasympathetic nervous system, is our physical response to stress. There are many ways that stress can impact our bodies and nervous system, but this focus will be more on a muscular level. The sympathetic nervous system is our “flight or fight” response to a stressor and what occurs to our muscles is guarding and tension. Our parasympathetic nervous system should be activated once that stressor is over, also known as the “rest and digest” response. An example would be if you were walking casually in the woods and all of a sudden a bear starts chasing you, so you run. The stress of being in danger signals your nervous system to respond by “flight or fight” so that you can recruit your muscles and get away safely. After you get away from the bear and are secure at home, the fight or flight response is no longer needed and the “rest and digest” response starts so that you can recover and relax from that intense activity.
In times of chronic stress and anxiety, muscles can be in that constant state of contraction due to being in the sympathetic state. This constant state of contraction can cause muscles to be tense and painful. Some individuals will experience stress headaches due to tense neck and upper trapezius muscles, and some individuals will experience pelvic pain or PF dysfunction due to chronically tense pelvic floor muscles. Stress can be a major factor in WHY you are having pelvic floor dysfunction. So please take the time to focus on activities that help ease your mind and body in a healthy and positive way. Also, rest assured knowing that Phoenix Physical Therapy is still here and we look forward to helping you the best that we can until we can safely open our doors again.
If you need more information, please contact Phoenix Physical Therapy through emailing our website or if you want to talk to someone in the Phoenix Physical Therapy office please call us at 802-863-6662. During these times of suspended treatments due to COVID-19 someone from the office will always check the phone and email messages daily, getting back to you as needed. Telemedicine appointments are always a great option for those in immediate need. Please let Phoenix Physical Therapy know, as we are here to help!