Low Back Pain and Your Pelvic Floor


The muscles that form the pelvic floor are just one group of muscles that play a role in stabilizing the spine.


What is spine stabilization and why does it matter?


If you look up the definition of stabilize it will say: ‘to hold steady, or to make stable or firm.’


If you consider any joint in the body, ideally you want that specific joint to be able to move through a functional range of motion (i.e. if you want to be able to reach into a high cabinet you would want your shoulder joint to have that available range of motion). While that same joint is performing its job of reaching into the cabinet, it also needs a certain amount of stability, so that when you reach up into the cabinet the ball, or head of the humerus, will not pop out of the socket. The bony structure of the joint as well as the muscles, ligaments and tendons that surround the joint provide its stability.

Stability in the spine is no different. Muscles around the vertebrae, as well as ligaments and tendons, work together under the direction of the nervous system to protect the spine and to enable the spine to move in different planes. Ideally the muscles work together effectively so that you can safely reach into the back seat while driving your car, efficiently swing a golf club or stretch far enough to reach up into that high cabinet.


There are 4 deep core stabilizers that respond in an anticipatory fashion to stabilize the spine before the extremities move. They are the pelvic floor, the diaphragm, the multifidus (back) and the transversus abdominus (front).


Other muscles play a role in stabilization, as well as moving the spine through different planes of motion including rotation, flexion, extension and sidebending. Some of these muscles are the rectus abdominis, the internal and external obliques and the psoas just to name a few.


If one of these muscles is not functioning properly, another muscle has to pick up the slack.

Controlling and moving the spine is a complicated process. There are many moving parts. When one part of the spine is not functioning properly, it can negatively affect the bigger picture.


The multifidus is a muscle located along the entire length of the spine, from the pelvis and lumbar spine all the way up to the cervical spine. Its job is to extend the spine, laterally flex the spine and rotate the spine. However, let’s say you lifted something heavy and now the multifidus is injured and you are experiencing back pain. If the multifidus is no longer able to stabilize the spine, someone else needs to pick up the slack. This could lead to overuse in other muscles that also stabilize the spine, as they try to pick up the slack from the injured multifidus.


Now let’s look at the pelvic floor muscles. The pelvic floor muscles have a few roles to play: 1- they stabilize the SI Joint, pelvis and spine 2- they control urination and defecation 3- they support the contents of the pelvic cavity 4-They play a role in sexual function


As a stabilizer of the spine and pelvis, the pelvic floor musculature might be one of the muscles that comes in to pick up the slack. If the pelvic floor is functioning optimally then there might not be any issues. But over time, in situations of chronic low back pain, the smaller muscles of the pelvic floor could become overworked. They may become overactive and have a difficult time shutting down. An overactive pelvic floor can lead to pelvic pain and other issues such as frequent UTI’s or painful sex.


For clients who are experiencing chronic low back pain, the pelvic floor could be the missing piece to alleviating their back pain for good. Getting all of the muscles working properly to stabilize the spine is the end goal. The pelvic floor is a key part of that puzzle, and could be the missing piece in solving someone’s chronic low back pain.


There is a strong correlation between low back pain and pelvic floor dysfunction. If you are experiencing symptoms of pelvic floor dysfunction, such as urinary incontinence, and have a history of low back pain, a pelvic floor physical therapist can help you address all of these symptoms.


Use the link below to schedule a Free 15 minute consultation today to discuss how physical therapy can help. If you had physical therapy before with little success or no real long term results, it might be because the root cause of your pain was not addressed. The R3finery specializes in one-to-one sessions with highly skilled physical therapists specializing in manual therapy who will help you discover and address the root cause of your pain, and help you get back to doing the things you love.


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