"Are You Watertight?"
An odd question, I know, but when addressing pelvic floor strength this is just what I ask!
We are all aware that ladies get problems after having children or in advancing years with slight leakage of urine with sneezing or coughing. What is less commonly discussed is a gentleman's pelvic floor integrity. The pelvic floor muscles are located around the bottom of the pelvis and quite literally form a sling to keep our abdominal contents in, allowing waste removal as required.
Ladies are not surprised about being questioned about their pelvic floor strength but men are. "I'm not a woman, love!" is a response I have had on more than one occasion.
As an osteopath, I look at the body as an incredible machine. I assess how the spine is curved and how the muscles locally are affecting them curves. I also take into consideration other factors that may have an influence on the spine such as prostate cancer or bowel pathologies. Although these conditions can give rise to low back pain, they can also force the patient to recruit other muscles to aid the pelvic floor in retaining waste - to prevent leakage.
At the bottom of the spine the coccyx sits, within the pelvic floor. The coccyx, although a very small bone, can affect the curves in our spine if it is being pulled with sideways or forwards by the pelvic floor muscles. If there is poor strength in the pelvic floor muscles it may also allow the lumbar spine to increase in its curvature as it can not hold the coccyx in a neutral position.
When I give pelvic floor exercises to patients, sometimes it is to improve the strength of the muscles but sometimes it is with view to locate the muscles to sense the relaxation of the muscles.
The spine is stabilised by the pelvic floor muscles and deep core muscles and often when patients have had low back pain for a long time, addressing these muscles has very positive results.