We have written before about how the pelvic floor is often overlooked by orthopaedic physical therapists, but there is still a lack of awareness of the specialty. People forget that pelvic floor dysfunction can present as low back, groin, hip, LE pain and more. It is more than just "B&B problem." Even though there is a movement in the physical therapy world that is shooting down the importance of core stability training, it is a concept that should not be ignored. When people think of the various components of the core, the two that are often forgotten include the diaphragm and pelvic floor. There is probably more awareness regarding diaphragmatic breathing compared to proper pelvic floor function, but it definitely is still lacking. There are classes about various assessment and treatment techniques for breathing in the orthopaedic world that are accepted due to the ease of application. With the sensitivity around the pelvic floor (no pun intended), we are often hesitant to even subjectively assess the area.
Julie Wiebe, PT recently wrote a post about pelvic floor activity with squats. With squats being a higher level exercise, people are often aware of the necessity of core activation, but again let the pelvic floor fall to the wayside. Due to the lack of public education regarding the area, there is a significant amount of inappropriate advice for pelvic floor training. There is an excessive amount of information on the web that advocates for kegels as the solution to any pelvic floor dysfunction. This is often the opposite of what is desired as over-recruitment of the pelvic floor can lock up hip mobility and encourage excessive lumbar mobility. The pelvic floor has an intricate relationship with some of the hip stabilizer muscles and is important for serving as a stable base. Check out Julie's article for further understanding of how the pelvic floor acts throughout the squat and other functional activities. As orthopaedic physical therapists, we need to increase our knowledge of the impact this can have on our clientele.
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