FEATURE TECHNIQUE LENDING VOICE TO WHISPERED DISEASE Keeping quiet about pelvic floor disorder need not be your patient’s only option I BY SCOTT LEVINE frequent urination, a prolapsed uterus among women, which is when the pelvic organs may bulge out of the vagina. Aside from the physical effects, these conditions can have serious psychoso-cial consequences for people as activities are withdrawn and relationships can be affected. Worst of all, these symptoms are often just coped with and dismissed as a normal sign of aging. There are a number of options for managing pelvic floor disorder, includ-ing medications like anticholinergic drugs that block the action of a chem-ical messenger acetylcholine. The most common option for many, unfortu-nately, is withdrawal – simply refraining from many activities and wearing a protective garment. It is important to help patients real-ize it is not necessary to live with this discomfort, and to consider chiroprac-tic as their best non-surgical option. Nearly 200,000 women undergo pelvic organ prolapse reconstructive surgery annually, with a third of the surgeries representing repeated procedures. As chiropractors, we are perfectly positioned to identify early signs of pelvic floor dysfunction, even before symptoms of incontinence have started, and correct it through better nerve function, biomechanics and muscle strength. It is important to ask questions to learn if your patients have any symp-toms. Symptoms would indicate they have had the condition for some time. Multiple vaginal births and C-sections are risk factors for women. Other risk factors – for both men and women – include past fall on the hips, car acci-dent, disuse atrophy, even as mild as poor gait can lead to pelvic floor weak-ness. Other causes include pelvic insta-bility, nerve entrapment and poor motor control. Because pelvic instability will precede incontinence, testing for it can help with early diagnosis and prevent the whispered disease from ever occur-ring. Instability is caused by weakness in the ligaments and/or muscles that stabilize the pelvic joints. t is estimated 40 per cent of men and women will experience pelvic floor disorder at some point in their lives. Despite this fact, most people will suffer through it in silence – thus the term, whispered disease. Pelvic floor disorders occur when ligaments and pelvic structures no longer support organs like the uterus, vagina, bladder and prostate. This condition is more common as people age, mainly because of decreased movement and improper breathing (chest and shallow breathing, as op-posed to abdominal deep breathing). One early cause of pelvic floor weak-ness (many patients will show no signs of incontinence) is pelvic instability. Understanding what questions to ask, how to test and diagnose for pelvic instability and pelvic weakness, and then treat it is key to helping patients become active again. Patients with pelvic floor disorder typically have a history of pelvic or low back pain. Later symptoms will include urinary incontinence, urinary leakage, MYTH ABOUT KEGEL EXERCISE DR. SCOTT LEVINE , DC, is the founder of MyRxX.com, a cloud-based video prescription exercise software. He runs the Vita Health Clinic located in downtown Toronto. His practice is focused on functional exams and treatments with background in applied kinesiology. Contact him at [email protected]. 34 Canadian Chiropractor May 2014 Look at the function of the pelvic floor. Have you ever noticed that bladder control in children occurs concurrently and coincidentally when they begin www.canadianchiropractor.ca
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