STRAP? PELVIC FLOOR MUSCLES

syndrome (20). On palpation the pelvic floor is very uncomfortable, and increased resting tone can often be detected by surface electromyography. This type of myofascial pain is typically found in the posterior fibres of the levator ani and the coccygeus. It responds well to trigger point pressure release treatments. Once the overall increased tone is released, normal function can be restored by following a pelvic floor rehabilitation programme, but there must be a strong emphasis on the importance of relaxation of the muscles.

Many factors can contribute to the onset of pelvic pain. Among these are: n injury to the coccyx n lumbosacral joint dysfunction n stress n lifestyle issues n local surgery (such as haemorrhoidectomy). Some pelvic pain occurs in certain sporting and fitness

activities but it may also be the root cause of other pathologies. Hypertonicity of the pelvic floor muscles in men can produce pain in the perineum, the lower abdomen, testicles and penis and cause variable urinary tract symptoms such as urgency and frequency of urination. Unfortunately these symptoms are often misdiagnosed as “prostastitis” (20).

CONCLUSIONS

The pelvic floor muscles, by virtue of being deep inside the body, are frequently forgotten when considering overall fitness. Yet for everyone (and for women in particular) they can easily become dysfunctional. Such dysfunction impacts not only on bladder and bowel function but also on genitourinary support, with the potential for prolapse and pelvic pain syndrome. There is a need for integrated practice between sports therapists and practitioners in women’s health and continence care, and this will be of immense benefit to individuals taking part in sport and fitness at any level, from novice to expert.

n How fit is the average athlete’s pelvic floor muscle?

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n Should all training programmes include a pelvic floor muscle workout?

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n Bladder and Bowel Foundation www.bladderandbowelfoundation.org

n Association of Chartered Physiotherapists in Women’s Health www.acpwh.org. uk

www.sportEX.net References

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THE AUTHOR

Julia H Herbert Grad Dip Phys MSc MCSP is a specialist physiotherapist who has worked in continence and women’s health for over 25 years. She has completed various courses in

incontinence and bowel dysfunction and holds a masters degree in practice development. Currently she is involved in a multiprofessional continence team, with other roles in lecturing, product development, consultancy, and training. In her private practice she treats bladder, bowel and pelvic floor muscle dysfunction, and is particularly interested in bowel dysfunction, biofeedback training and neuromuscular electrical stimulation.

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