The Pelvic Floor: Also Known As “The Great Deceiver!”

What is the pelvic floor? Why do we call it "The Great Deceiver?"

By Julie Sarton, PT, DPT, WCS

Ahhhh, the elusive pelvic floor musculature.

In our practice at Sarton Physical Therapy, we have referred to this amazing set of muscles as “The Great Deceiver” for years!

Why, you might ask?

Well, first off, it is routine for most of our patients to see anywhere from 5-8 specialists before finding us or a solution to their pelvic floor dysfunction (this is a common theme experienced by other pelvic floor practices out there too)! Next, these powerful but commonly overlooked muscles can actually send pain signals elsewhere in the body through various referral patterns.

So what exactly is a referral pattern?

A referral pattern simply means that the source of the pain comes from one region of the body (i.e. a pelvic floor muscle like your pubococcygeus muscle), but the pain signal/sensation is felt elsewhere in the body (i.e. your tailbone hurts or your bladder has severe urgency).

In other words, your low back pain, hip pain, lower quadrant pain, bladder urgency/frequency, vulvar pain or coccyx pain may actually not be coming from these sources. Rather, it may be rooted in pelvic floor muscular dysfunction.

The brain only perceives where the pain is felt and not the actual source of the pain. Fascinating, isn’t it?

So, be a detective and go to work with your practitioner to figure out any referral patterns that exist and are rooted in your pelvic floor musculature. You can then eradicate any underlying sources and causes of your pelvic pain, sexual pain and even orthopedic pain!

So, what type of referral patterns do we frequently see that stem from the pelvic floor?

Abdominal pain
Low back pain, coccyx pain
Hip pain
Bladder pain, urinary urgency/frequency
GI symptoms including outlet constipation and pain..”the train arrives but it can’t move”
Non-bacterial “prostatitis”
Uterine pain “menstrual cramping sensation”
Clitoral/vaginal pain

Brief Patient Examples We Have Seen:

Low back pain from coccygeus
Hip pain mis-dx trochanteric bursitis from obturator internus
Lower quadrant pain from pelvic floor
Uterine pain from dysmenorrhea

Know that if you or a friend have experienced any of the above mentioned symptoms—or have been struggling relentlessly for answers—help is available. We would love to see you at Sarton Physical Therapy and if you are from out of the area, we are happy to help connect with you other practitioners across the globe or help you through one of our online sessions!

References

Pastore, E. A., & Katzman, W. B. (2012). Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain. Journal of obstetric, gynecologic, and neonatal nursing : JOGNN, 41(5), 680–691. doi:10.1111/j.1552-6909.2012.01404.x

Sarton, J. (2007) Physical Therapy for Pelvic Pain: Understanding the Musculoskeletal Connection. The Female Patient, 32(5).

We want to encourage you to get evaluated by one of our outstanding physical therapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain—you name it—these conditions do not have to control your life. There is hope. Call us today to book an appointment for 1 of our 3 Southern California locations, or inquire about a virtual, online treatment session.

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