Why should you consider the pelvic floor in women with lumbopelvic and hip pain?
Dune et al (2022) published yet another paper that demonstrates the link between lumbopelvic-hip pain and pelvic floor muscle tenderness. In their retrospective study of 177 women, there was a 7:1 Odds Ratio of women with lumbopelvic and hip pain having vaginal pelvic floor myofascial pain. In 85% of the women the tenderness was bilateral.
Their conclusion?
"This finding suggests that a vaginal pelvic floor muscle exam should be part of the assessment of all women with lumbar, hip and or PGP."
Do you screen all of your women with lumbopelvic pain for vaginal myofascial sensitivity? What if it is NOT in your current scope of practice?
Vandyken et al (2020) demonstrated that the CSI can be used as a surrogate measure of tenderness on palpation of the pelvic floor muscles. The presence of OAB is also highly linked to overactivity of the pelvic floor muscles (Keizer et al 2019).
Are you using the CSI for all of your lumbopelvic-hip pain patients? Are you asking them about bladder frequency and urgency?
We need to consider the preponderance of research that supports overactivity in the core muscles (pelvic floor/TA/MF) vs. weakness in lumbopelvic-hip pain.
Is it time to challenge your current strategies for core strengthening and trade them in for strategies that reassure your patient that their back is “fit for purpose”?
Pelvic floor muscle tension and global guarding strategies are more prevalent in CLBP than weakness.
Interested in learning more? Join Carolyn Vandyken for a live, in-person PABC course in Vancouver on February 11-12, 2023 for a Fresh, Biopsychosocial Approach to Core Training.
Physio Finds is a monthly News Update in collaboration with PABC’s Knowledge Services Manager Terri McKellar.
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