The pelvis is comprised of 2 pelvic halves (the ilium), the sacrum and the tailbone (coccyx). The ilium is shaped like a bowl and provides support for the pelvic organs: vagina, bladder, uterus, rectum and bowel. In the male pelvis, there is no vagina or uterus; instead there is a penis with a longer urethra and a prostate. The pelvis is connected to the spine via the sacrum and to the legs through the hip joint. In addition, muscles and ligaments are attached to the bones of the pelvis, and nerves in the pelvis transmit impulses to muscle and organs (viscera). Connective tissue and fascia interconnect all of the tissue structures together for support, circulation, and function. The pelvis has many autonomic functions and relies on the brain to communicate information for function.
When medical professionals talk about pelvic dysfunction, they are referring to any of the above anatomy and physiology that is not working as it should. For example, if the pelvic floor muscles, sphincters, or ligaments become weak, it can cause urinary or fecal leakage, or the pelvic organs can fall down and out of the vagina. Medical conditions or injuries such as diabetes, Parkinson’s disease, stroke, surgeries, back problems, hysterectomy, or childbirth trauma can weaken the function of the nerves, causing weakness of the pelvic floor muscles. In other cases, the muscles become too tight or nerves can become overactive, causing pain inside the pelvis and pelvic organs, as well as constipation.
The pelvic floor muscles and support system helps these organs to function properly and the brain controls these muscles through the nervous system.
Physical therapists who specialize in women’s health work with physicians to improve dysfunction and assist the body to repair itself. A physician specializing in urology, gynecology, and obstetrics can diagnose the problem and will recommend medication, surgery and/or refer you to a women’s clinical health specialist to further evaluate your dysfunction and improve, or ideally restore, full function in all of the above areas.