Pelvic Floor

Question 1

Pelvic floor dysfunctions can contribute to a number of conditions including: (7)

Answer 1

• Urinary stress incontinence
• Fecal incontinence
• Sexual dysfunction
• Pelvic relaxation
• Levator ani syndromes
• Chronic low back pain
• Chronic pelvis pain

Question 2

Kegel exercises

Answer 2

Developed in the 1950s to treat early stages of pelvic relaxation, rather than corrective surgery

Question 3

Chronic _____ can strain the pelvic floor

Answer 3

Coughing

Question 4

Assessment of the pelvic diaphragm

Answer 4

Flex the patient’s knee and hip on one side.
Introduce fingers medial to the ischial tuberosity, letting the pads of the fingers keep contact with the medial surface of the ischium.
Your fingers are now pressing into the ischiorectal fossa.
As the patient inhales, the pelvic diaphragm presses down on your fingertips. With exhalation, the pelvic diaphragm should move cephalad (superior)

Question 5

With inhalation, the pelvic diaphragm should move ___ and with exhalation move _____

Answer 5

Inferior (inhale)
Superior (exhale)

Question 6

If the pelvic diaphragm is unable to descend, it is an ___ dysfunction (so an ____ restriction

Answer 6

exhalation dysfunction
inhalation restriction

Question 7

If the pelvic diaphragm is unable to ascend, it is an ____ dysfunction (so an ____ restriction)

Answer 7

Inhalation dysfunction
Exhalation restriction

Question 8

Exhalation dysfunction (restriction in inhalation - does not descend) = indirect method

Answer 8

Patient position: supine with knee and hip flexed on side to be
treated
* Therapist position: seated by the table on the side of the pelvis to
be treated
* Procedure: With the hand closest to the patient, introduce the fingers into the ischiorectal fossa. Place the other hand just below the costal margin on the same side to monitor movement of the
respiratory diaphragm.
Ask the patient to take a deep inhalation, then exhale to the limit and hold the exhalation until forced to breathe. Repeat 2-3 times.
Recheck the pelvic diaphragm.

Question 9

Inhalation dysfunction (restriction in exhalation - does not ascend) = indirect method

Answer 9

Patient position: supine with knee and hip flexed on side to be
treated
* Therapist position: seated by the table on the side of the pelvis to
be treated
* Procedure: With the hand closest to the patient, introduce the fingers into the ischiorectal fossa. Place the other hand just below the costal margin on the same side to monitor movement of the
respiratory diaphragm.
Ask the patient to take a deep inhalation and hold breath to limit. The pelvic diaphragm begins to ascend a moment before
forced exhalation occurs. . Repeat 2-3 times.
Recheck the pelvic diaphragm.

Question 10

Direct method for inhalation dysfunction (exhalation restriction so pelvic does not ascend)

Answer 10

Patient position: supine with knee and hip flexed on side to be
treated
* Therapist position: seated by the table on the side of the pelvis to
be treated
* Procedure: With the hand closest to the patient, introduce the fingers into the ischiorectal fossa. Place the other hand just below the costal margin on the same side to monitor movement of the
respiratory diaphragm.
Ask the patient to take a deep inhalation and hold breath to limit. The pelvic diaphragm begins to ascend a moment before
forced exhalation occurs. . Repeat 2-3 times.
Recheck the pelvic diaphragm.