I had the opportunity to spend sometime with Alana Devlin, who is a Physiotherapist and Consultant in Pelvic Floor Health. We sat down and had a real talk about the pelvic floor and how we need to shine more light on pelvic floor dysfunction.
Pelvic floor dysfunction can present itself as urinary incontinence, fecal incontinence, pelvic organ prolapse (of the bladder, uterus, and/or rectum), sensory and emptying abnormalities of the bladder or rectum, sexual dysfunction, and chronic pain.
It is more common amongst women that have birthed children. I ask every single one of my pre and postnatal clients if they have had theirs checked and am still surprised how many have not. The truth is, we do not have to have carried a child in order to get our pelvic floor looked at. We want to be proactive with our fitness, so we seek out a personal trainer to ensure we are squatting, deadlifting, and running correctly. Therefore we also should be proactive and seek out help to ensure our pelvic floor muscles are functioning correctly.
Keep on reading to find out more about the pelvic floor and Alana.
R2R: How long have you been a Physiotherapy Consultant in Pelvic Floor Health?
AD: I have been a physiotherapist for 23 years and have been focused on women's health/pelvic floor for 15 years.
R2R: Why did you choose this specialty?
AD: I have always wanted to be involved in women health care. In the beginning, I was told that there wasn’t a market for it, which I disagreed with entirely. Peeing our pants is not normal, we should not have to go through life wearing incontinence pads and I wanted to help find solutions. Fortunately, the research has significantly increased and the current generation of women do not accept that peeing in our pants is normal, so more women are being vocal about pelvic floor issues.
R2R: Other than the obvious reason that men do not carry children or give birth, why are pelvic floor issues less common in men?
AD: Pelvic floor issues in men can happen after prostate surgery or some type of pelvic trauma. Their symptoms are pain during peeing or ejaculation. The other reason is that our anatomy is different. We both have a urethra and an anus, and these two canals have sphincters on them. Females have a 3rd canal, the vagina, and this does not have a sphincter. So we lack the extra musculature in that canal that provides control and support.
R2R: What are the main functions of our pelvic floor?
AD: It has 4 functions.
Supports Urinary Sphincter (controls flow of urine)
Supports Rectal sphincter (controls gas and bowel movements)
R2R:What are the signs/symptoms that indicate you should get your pelvic floor checked?
AD: I always refer to them as the 4 P’s.
Pain: Any pelvic or lower back pain, bony pelvic pain, pain during intercourse, pain after childbirth or hip pain that cannot be explained or relieved.
Pressure: Pressure in your pelvis that feels like as if your insides are falling out. This can be a result of a prolapse or muscle dysfunction.
Peeing: Peeing when you don’t want to be peeing or not peeing when you want to pee.
Poo: Are you constipated? Can you not control your poops or gas?
R2R: Would you recommend women to have their pelvic floor looked at either prior to becoming pregnant or at the beginning of their pregnancy?
AD: 100%. Prenatally I will start seeing someone after their first trimester and can continue up to about 34 weeks. Focusing on strengthening until 34 weeks, after that I focus on down training, elongating, and relaxing the pelvic floor.
R2R: What does a typical pelvic floor appointment with you consist of?
AD: In the initial appointment I take a detailed history of the individual and then a complete orthopaedic assessment. After that I complete an internal exam if it is required. The first treatment always includes education regarding the appropriate issues and any required exercise prescription.
R2R: In addition to seeing a physiotherapist for treatment for their pelvic floor, what else should women do to help with recovery? Especially after having a baby?
AD: Get some body that understands postpartum recovery, like a trainer. Do your research and make sure they are certified and experienced. But remember it takes time. After having a baby we still have changed hormones that may affect ligamentous, muscular function and balance. Again, every women is different.
“But remember it takes times. Every women is different.”
The more you know the more proactive you can be and the better quality of life you will have, so lets keep this conversation about the pelvic floor mainstream! Keep asking questions, sharing your experiences, and book an appointment to have your pelvic floor checked. You can book an appointment with Alana at several locations: Dr. Magnus Murphy Pelvic Floor Clinic, The Glencoe Club Physiotherapy Clinic , and the Lifemark Physiotherapy Clinic located in Scenic Acres .