Low back pain? Your pelvic floor could be an important piece of the puzzle

Do you experience low back pain that isn’t getting better with traditional PT or other treatments? Maybe you find some temporary relief but it always comes back. Pelvic floor dysfunction might be the key to your healing.

In fact, a 2018 study found that 95% of women with low back pain also have pelvic floor dysfunction(1). That is a huge percentage and we want to harness that information! I’ve been a specialist in pelvic floor conditions for 10 years and have found that once we start addressing pelvic floor dysfunction patients that have dealt with chronic back pain for years start to notice significant improvement.

The pelvic floor muscles are a part of a group of muscles which make up our “deep core” also known as our abdominal canister because of its shape. The pelvic floor lives at the bottom of the canister while the diaphragm lives at the top. The deepest layer of the abdominal muscles (the transverse abdominals) wrap around the canister and the lumbar mutifidi muscles form the back. Together, these muscles play a HUGE role in overall stability and function of our lumbar spine, hips, pelvis, and more! If they aren’t well coordinated, mobile, and strong the low back won’t function as well and that can lead to pain.

A common finding I see with patients is pelvic floor tightness with an inability to coordinate lengthening and relaxation of these muscles. The tightness can be a result of many different factors including scar tissue, myofascial tightness, a tension holding pattern, impaired movement patterns, and a heightened nervous system. When this muscle group is unable to relax, lengthen and coordinate with its neighboring muscles in the deep core the entire stability and function of the canister is compromised, leading to increased stress on the lumbar spine and pelvic girdle.

On the other hand, when the pelvic floor muscles are generally weak or lacking tension then they are unable to provide support and stability to the lumbopelvic region. There is literature to support pelvic floor muscle strengthening in the treatment of chronic low back pain. (2)

When treating the lumbar spine, the pelvis (or any other part of the body, for that matter) we need to address more than just the spine or the pelvis itself, we must look at the bigger picture. This helps us achieve both symptom relief and the promotion of long lasting healthy functional movement so we can keep doing all of the things we love for years to come!
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If you are dealing with low back pain that isn’t getting better, it’s time to get help!

Next steps:

1. Have an evaluation with an orthopedic pelvic PT!
   1. Interested in learning more about working with me?  Sign up for your FREE 30 minute PT consultation
2. Work toward better posture which could be contributing to a tension holding pattern. 
   1. Evaluate your ergonomic set up for desk work
   2. Pursue exercise that supports postural alignment like yoga
      1. Join me Saturday mornings at 9:30 AM for Yoga for Healthy Aging 
      2. Try my On-demand Patreon yoga classes
3. Support relaxation of your central nervous system
   1. Check out my diaphragmatic breathing video to coordinate your pelvic floor and diaphragm with breath.

Footnotes

1. Musculoskeletal Sci Pract. 2018 Apr;34-47-53. doi:10.1016/j.msksp.2017.12.001 Epub 2017 Dec 9
2. Bhatnagar1, et al. Indian Journal of Physiotherapy and Occupational Therapy, July-September 2017, Vol. 11, No. 3