2. VAGINISMUS, VULVODYNIA AND PELVIC FLOOR MUSCLE ACTIVITY

The pelvic floor muscles form the base of the abdominal cylinder and work in synergy with other muscles around the cylinder - the abdominal muscles and the diaphragm. Activity in each muscle group affects the others. Coordinated recruitment of these muscle groups is necessary for generation and maintenance of intra-abdominal pressure, postural support of the trunk, and during functional tasks such as lifting, coughing and nose blowing. Coordinated release of these groups is required for micturition, while defaecation may need activity in some muscles and release in others. Vaginismus and vulvodynia both have a component of over activity of the pelvic floor muscles which impairs normal function, though this over activity may only occur at the time of attempted penetration. Some of the physiological factors that contribute to this overactivity come from outside the pelvic floor muscle complex itself and can be ameliorated by understanding and management of these muscle synergies. An EMG study of muscle activity of the abdominal and pelvic floor muscles during a simulated body posturing for female sexual arousal will help to explain how the pelvic floor muscle over activity in vaginismus arises. Treatment programmes that have been used to successfully address these problems will be explained.

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Synergism between abdominal and pelvic floor muscles in healthy women: a systematic review of observational studies

Fisioterapia em Movimento ◽

10.1590/0103-5150.029.002.ao19 ◽

2016 ◽

Vol 29 (2) ◽

pp. 399-410 ◽

Cited By ~ 5

Author(s):

Lia Ferla ◽

Caroline Darski ◽

Luciana Laureano Paiva ◽

Graciele Sbruzzi ◽

Adriane Vieira

Keyword(s):

Systematic Review ◽

Pelvic Floor ◽

Observational Studies ◽

Pelvic Floor Dysfunction ◽

Cochrane Collaboration ◽

Pelvic Floor Muscles ◽

Abdominal Muscles ◽

Healthy Women ◽

Muscle Groups ◽

Starting Date

Abstract Introduction: The training of the pelvic floor muscles is widely used for treating pelvic floor dysfunctions, like urinary incontinence. During the training, abdominal contractions are avoided; however several studies support the use of the synergy between these muscle groups. Objective: Carrying out a systematic review of studies that seek to identify the presence of synergy between the muscles of the abdomen and the pelvic floor and its functionality in women without pelvic floor dysfunction. Methodology: To conduct the review, we have followed the recommendations proposed by the Cochrane Collaboration for systematic reviews. The literature search included the databases SCIELO, PEDro, MEDLINE, Cochrane CENTRAL and EMBASE, and manual research, the starting date of the databases until August 2013. We included cross observational studies with healthy women who were assessed to find the presence of synergy between the abdominal muscles and the pelvic floor. Results: We included 10 articles and they all showed the existence of synergy between the abdominal and pelvic floor muscles in healthy women in the supine, sitting and standing positions. Conclusion: Thus, we can conclude that there is synergy between the muscles of the abdomen and the pelvic floor in healthy women. Better understanding the behavior of these muscles and synergy may favor the development of strategies for the prevention and treatment of disorders of the female pelvic floor muscles.

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Impact of wearing high heels shoes on pelvic floor muscle activity and incontinence

Aesthetic Cosmetology and Medicine ◽

10.52336/acm.2021.10.3.08 ◽

2021 ◽

Vol 10 (3) ◽

pp. 153-156

Author(s):

Mateusz Leroch ◽

◽

Jakub Łaszcz ◽

Marcin Malon ◽

Sławomir Jarząb ◽

...

Keyword(s):

Urinary Incontinence ◽

Pelvic Floor ◽

Ankle Joint ◽

Muscle Activity ◽

Pelvic Floor Muscle ◽

Plantar Flexion ◽

Pelvic Floor Muscles ◽

Negative Effects ◽

High Heels

High-heeled shoes (so-called stilettos) are an important element of women’s wardrobe. Unfortunately, wearing high heels forces the ankle joint into plantar flexion. The daily positioning of the foot in plantar flexion can lead to many abnormalities in the human body. This position is unnatural for the organism from the point of biomechanics. The aim of the study was to present the effect of wearing high-heeled shoes (plantar position of the foot) on the activity of the pelvic floor muscles and the associated negative effects, such as urinary incontinence. The authors on the basis of the research showed that the activity of the pelvic floor muscles is the lowest in the dorsiflexion position of the ankle joint. A weakening of the pelvic floor can be associated with urinary incontinence and thus a deterioration of the quality of life.

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Physical therapy in the treatment of stress urinary incontinence

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1110638p ◽

2011 ◽

Vol 139 (9-10) ◽

pp. 638-644

Author(s):

Katarina Parezanovic-Ilic ◽

Branislav Jeremic ◽

Ljiljana Mladenovic-Segedi ◽

Slobodan Arsenijevic ◽

Milorad Jevtic

Keyword(s):

Urinary Incontinence ◽

Stress Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Exercise Program ◽

Pelvic Floor Muscles ◽

Repeated Measurements ◽

Abdominal Pressure ◽

Dynamic Technique ◽

Significant Difference

Introduction. Stress urinary incontinence (SUI) is an involuntary release of urine through the urethra during the increase of abdominal pressure in the absence of m. detrusor contraction. The exercise of pelvic floor muscles is recommended as the first line of cure. It is the least invasive and the only method without any undesirable side effects, which leads to either improvement or complete cure of SUI in 80-85% of cases. Objective. The aim of this study was to establish whether the strengthening of pelvic floor muscles using proprioceptive neural facilitation (PNF) spiral dynamic technique was more efficient in comparison to classical Kegel exercise. Methods. The research was carried out at the Centre for Physical Medicine and Rehabilitation, Clinical Centre Kragujevac. Sixty-six female patients with the symptoms of SUI were monitored in the period of two years. Thirty-four patients did pelvic floor muscle exercises twice a day, in the morning and in the evening, with 15-20 contractions. Thirty-two patients used PNF spiral dynamic technique for strengthening pelvic floor muscles. The patients who used the spiral dynamic technique also did some exercises from the program; they exercised twice a day, in the morning and in the evening, following the prescribed schedule. Treatment outcome was assessed by measuring the pelvic floor muscles by a vaginal dynamometer. Results. The values of the pelvic floor muscle force that were measured using the vaginal dynamometer in both examined groups (PNF spiral dynamic technique or Kegel exercise) were statistically significantly higher after the implemented exercise program (t-test; p=0.000). No statistically significant difference in pelvic floor muscle values was found between the patients who applied PNF spiral dynamic technique and those who did Kegel exercise either before or after the exercise (two-factor analysis of variance with repeated measurements, factor of exercise type; p=0.899). Conclusion. Strengthening of pelvic floor muscles by exercises results in a significant increase of pelvic floor muscle strength and reduction of SUI symptoms, regardless of the used exercise program, PNF spiral dynamic technique or Kegel exercise program.

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