Pelvic Health Flashcards
What are the bony landmarks of the pelvic region? (6)
- Ilium
- Sacrum
- Coccyx
- Pubic symphysis
- Ischial tuberosity
- Ischial spine
What are the ligamentous support structures of the pelvis? (3)
- Sacrotuberous ligament
- Sacrospinous ligament
- Numerous visceroskeletal ligaments
What are the fascial supporters of the pelvis?
- Urogenital diaphragm
- Obturator fascia
- ATLA
- ATFP
The coccyx is a small triangular bone with 3-5 rudimentary vertebrae. What is the normal position of the coccyx in standing?
Normal Position = 20-45 degrees of flexion at sacrococcygeus joint
Available Movement at Sacrococcygeus Joint:
- Flexion/Extension = ___ degrees
- Sidebending = ___cm
- Rotation = ___-___ degrees
- Flexion/Extension = 30 degrees
- Sidebending = 1 cm
- Rotation = 20-30 degrees
When does movement of the Sacrococcyx joint occur? (4)
- Defecation
- Labor/Delivery
- Breathing
- Positional Changes
What are the (3) layers of the pelvic floor muscles?
- 1st Layer = Superficial Perineal Muscles
- 2nd Later = Deep Urogenital Diaphragm
- 3rd Layer = Pelvic Diaphragm
What are the muscles of the first layer (Superficial Perineal Muscles)? (4)
- Bulbocavernous
- Ischiocavernous
- Superficial Transverse Perineals
- External Anal Sphincter
What are the muscles of the second layer (Deep Urogenital Diaphragm)? (2)
- Compressor Urethrae
- Sphincter Urethrae
What are the muscles of the third layer (Pelvic Diaphragm)? (3)
- Levator Ani (pubococcygeus, iliococcygeus, coccygeus)
- Piriformis
- Obturator Internus
What are the risk factors for urinary incontinence? (9)
- Childbirth
- Obesity (abdominal girth)
- Smoking
- Caffeine and alcohol
- High impact physical activity
- Menopause
- Neurological conditions
- Pelvic surgery
- Pelvic floor muscle weakness/prolapse
What is Pudendal Neuralgia?
Pain along the distribution of the pudendal nerve; pan is of severe throbbing or stabbing character in the course or distribution of the nerve.
What are the (4) etiologies of Pudendal Neuralgia and some activities associated with each?
Tension
- Straining from constipation
- Strenuous squatting
- Childbirth
Compression
- Cycling
- Horseback riding
- Prolonged sitting
Surgical Insult
- pelvic reconstruction
- hysterectomy
Visceral-somatic Interaction
- chronic UTI
- yeast infections
- chronic bacterial prostatitis
What are some common symptoms of Pudendal Neuralgia? (8)
- Pain with sitting (decreases with standing)
- Urinary dysfunction (urgency/frequency, hesitancy, pain)
- Bowel dysfunction
- Sexual dysfunction
- Genital and/or anal pain
- Feeling of fullness in the rectum/vagina
- Burning, shooting, stabbing pain
- Decreased pain when sitting on the toilet
What is Coccydynia?
Pain in or around the bony structure at the bottom of the spine (coccyx, or tailbone).
What is the presentation of Coccydynia? (4)
- Pain with sitting directly over the coccyx.
- Pain moving from sit to stand.
- Pain with bowel movements.
- Tenderness on internal and external palpation.
What are some treatment methods for Coccydynia? (5)
- External/Internal coccyx mobilization.
- Glute max strengthening to self-mobilize the flexed coccyx.
- EMG biofeedback for hypertonus of the coccygeus.
- Seating support.
- Posture education.
What treatment methods are contraindicated during pregnancy? (5)
- E-stim in pelvic region.
- Therapeutic US in the area of pelvis.
- High-impact activities.
- Aggressive manipulating or stretching.
- Heat over abdomen during 1st trimester.
Exercise During Pregnancy:
- Is exercise recommended during pregnancy?
- Moderate intensity of exercise ___-___ minutes/day.
- Exercises during pregnancy should be focused on improving what? (6)
- What is the goal of exercise during pregnancy?
- Yes, provided there are no medical/OB complications.
- 20-30 min/day
- balance, stability, strength, LB, pelvis, PF, and TA
- Goal is to MAINTAIN fitness
Benefits of Exercise During Pregnancy:
- Reduces _______, _______, and ______________.
- Improves _________ capacity and _____.
- Helps counteract increased IAP, hormonally mediated reduction in urethral closure.
- Counteracts _______.
- Reduced risk of ________ ______ in obese women.
- 35-43% reduction in risk of __________ in first 20 weeks.
- Lower incidence of _________ symptoms.
- fatigue, varicosities, and peripheral edema
- aerobic capacity and BP
- counteracts laxity
- gestational diabetes
- preeclampsia
- depressive symptoms
What is Diastasis Recti Abdominis?
Separation of the linea abla at the midline of the rectus abdominis.
How is Diastasis Recti Abdominis measured?
- Finger width above and below the umbilicus.
- 3 fingers considered clinically significant.
- Check for separation during abdominal contractions
What is an exercise consideration for Diastasis Recti Abdominis?
Bracing with a towel or sheet and use taping or an abdominal binder during exercise.
SIJ Dysfunction:
- Use the concepts of _________ to treat the SIJ.
- Utilize specific SIJ examination methods.
- Treatment of SIJ Dysfunction includes _______ techniques and ______ _______ retraining.
- motor control
- manual techniques and motor control retraining
