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Is my back pain related to my pelvic symptoms?

This is a question that comes up often in clinic. People may assume that because we specialize in pelvic dysfunction, we don’t treat backs. Well, that could not be farther from the truth! As a Physical Therapist who specializes in Pelvic Floor, the spine is a very important part of our assessment and plan of care. Let’s talk about why.

The spine receives stability through the muscles of the diaphragm, abdominal wall, deep spinal muscles and the pelvic floor. These muscles coordinate to provide stability not only to the spine but also the pelvis and hip joints. When back pain develops, this system is inhibited (turned off). This can lead to a cycle of dysfunction that causes use to over use some muscles to compensate for the lack of stability.

Respiratory Diaphragm, deep abdominal muscle (transverse abdominus), deep spinal muscles (multifidus) and the Pelvic floor muscles.

When you get into a patterns of compensation, you tend to create more strain and pressure into the lower abdomen and pelvis. This can lead to conditions like pelvic organ prolapse, urinary or bowel incontinence and joint pain. Studies have shown that in women who have back pain 95% also have pelvic floor muscle dysfunction. Most commonly, muscle over activity, or too much tension.

Why is this important to understand? Too often women are sent to physical therapy for back pain and they see a PT who does not consider the pelvic floor, or even know much about the connection. Or, vice versa; they see a pelvic physical therapist for their pelvic symptoms who does not screen the rest of their body.

What can you do as a consumer? Ask your therapist what they know about both treating the spine and it’s relationship to the pelvic floor. Make sure you find a provider who recognizes that the whole body is ONE. We cannot possibly care for your spine if we aren’t considering your pelvis, hips, knees and feet. And, we have to also consider the trunk, shoulders, neck and head too!

Our Bodies are truly amazing. If you are struggling with back pain or pelvic issues you deserve a provider who will really look to create and restore balance to your whole being. An integrative approach.

–Sarah Dominguez, PT, MSPT, CLT, CMTPT, WCS, PYT-c

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