Stress and the Pelvic Floor published | 06 March Your palms begin to sweat, your stomach feels uneasy, you are tired but you cannot sleep. There is a pounding in your head, you have chest pain, your sex drive is negative. There is pain and tightness in your muscles. These are all COMMON EFFECTS OF STRESS ON THE BODY. You cannot sit still, you are overwhelmed and irritable. You feel anxious, with a lack of motivation and focus. You feel alone even in a room full of people. You are sad, and possibly depressed. These are all COMMON EFFECTS OF STRESS ON MOOD. You are socially withdrawn, no longer exercising, and cannot eat or are overeating. You become angry and short tempered, and may have outbursts. You rely on crutches like smoking, drinking or drugs to help you cope. These are all COMMON EFFECTS OF STRESS ON YOUR BEHAVIOR. The human body is designed to experience stress, and to react to it. Stress can be a very important protective mechanism whereby the body becomes alert and ready to avoid danger. This positive stress is referred to as “eustress”. The opposite occurs when stress becomes negative and an individual faces continuous challenge without relief. This type of stress is called “distress”, and it is this stress that impacts the body in the ways outlined above. So what does all of this have to do with the pelvic floor you ask? Wait…WHAT IS the pelvic floor you ask? Believe me when I say you are not the first to ask, and you will definitely not be the last. You should have a better understanding when we are through. The pelvis is the “bony container” that surrounds the bowel, the bladder, and the reproductive organs. The pelvic floor muscles present like a hammock and span the bottom of the pelvis, holding the pelvic organs in place and playing a vital role in bowel, bladder and sexual function. What you may not know is STRESS CAN DIRECTLY AFFECT YOUR PELVIC FLOOR!!! Remember, we talked about the body’s response to stress? When we experience stress, particularly that of a prolonged nature, we hold our muscles very tightly – all muscles, even our pelvic floor muscles. Stress plays a major role in pelvic floor disorders, and many of my clients experienced their first pelvic floor symptom during or following a particularly stressful time in their lives. We have all encountered cyclical situations situations at some point, and a chronic state of stress is no different. Stress and the tightening of the pelvic floor muscles (consciously or subconsciously) can lead to conditions such as: Urinary or fecal incontinence (leakage) Urinary urgency Urinary frequency Sexual pain, difficulty with sexual arousal and orgasm Constipation Pelvic pain including vulvodynia and vaginismus Bladder pain including painful bladder syndrome And many others These conditions then lead to stress and anxiety – possibly because people are afraid to discuss them – and so the cyclical pattern continues. The only way to initiate the healing process is to break the cycle! The most important message I can convey is that we need to talk about pelvic pain. NO. MORE. WHISPERING. How will people ever understand the relationship between stress and pelvic pain if we do not talk about it? Each day, I challenge every one of my clients to discuss their pelvis with one other human. This might be their partner, their best friend, or a random stranger in line at the grocery store (you may never see them again, so go for it). It might seem like unconventional advice, but people should NOT have to suffer in silence or go through life with the belief that peeing your pants when you age is normal. Or that the inability to hold a bowel movement after giving birth is normal. Or that the stress associated with a traumatic event will forever define your ability to have pain-free intercourse. Common, yes! Normal…NO! There is help out there, and people who want to help! As mentioned above, sometimes it does take a village, and as a pelvic health physiotherapist I am fortunate to have established a wonderful reference team that I confidently refer to when needed. You have to start your journey somewhere – start by talking! Keri Martin Vrbanac Registered Physiotherapist, Pelvic Health Physiotherapist & Owner of a Body in Motion Keri has been a Registered Physiotherapist since 1997 when she graduated with distinction from the University of Toronto. Prior to beginning her physiotherapy studies, Keri completed a Bachelor of Physical and Health Education and a Bachelor of Arts, with distinction, from Queen’s University. Keri’s clinical expertise has included orthopedics, pediatrics, neurological specialties and sports therapy. Keri discovered her passion for Pelvic Physiotherapy in 2013 and has continued to further her education in the areas of sexual pain, incontinence, special topics in women’s health including endometriosus, infertility and post hysterectomy treatment. Keri enjoys her work with her children with pediatric incontinence, her pre-natal and post-natal clientele, as well as men and women suffering with pelvic pain as a result of bladder or bowel difficulties, interstitial cystitis and prostatitis, just to name a few. http://www.abodyinmotion.ca