Pelvic Floor Muscle Function and Strength

Definition[edit | edit source]

Pelvic floor muscle function can be defined as the proper squeeze or contraction of the pelvic muscle.

Pelvic floor muscle strength can be defined as maximum voluntary contraction a person attempts to recruit as many fibers in a muscle as possible.

Importance of proper evaluation of pelvic floor muscle and function[edit | edit source]

·        Pelvic muscles are deep and are very difficult to contract isolately despite of the instructions given.

·        Pelvic floor evaluation post and pretreatment help to know the efficacy of the treatment

Assessment methods[edit | edit source]

Methods for evaluating PFM function and strength can be categorized as:

1. Methods to measure ability to contract (clinical observation, vaginal palpation, ultrasound, MRI, electromyography [EMG]).

2. Measures to quantify strength (manual muscle test by vaginal palpation, manometry, dynamometry, cones).

Pelvic Floor Muscles.jpg

External Observation[edit | edit source]

External visual observation of the perineum may be utilized to visualize what the patient does when asked to contract the pelvic floor and is usually the initial step is assessing pelvic floor muscle function.  Caution against using observation as the only assessment as the inward movement of the skin may be created by contraction of the superficial perineal muscles and have no influence on urethral closure mechanism.  In women who are obese, a correct lift can be difficult to observe externally.

[1]

Digital Palpation[edit | edit source]

Digital palpation of the vagina PFM is the standard when assessing the ability to contract the PFM by most physical therapists.  The quality of contraction and upward movement can be assessed digitally.[2]

Presentations[edit | edit source]

http://www.youtube.com/watch?v=w08iCzxnQBUKegel or not.png
Pelvic Physiotherapy - to Kegel or Not?

This presentation was created by Carolyn Vandyken, a physiotherapist who specializes in the treatment of male and female pelvic dysfunction. She also provides education and mentorship to physiotherapists who are similarly interested in treating these dysfunctions. In the presentation, Carolyn reviews pelvic anatomy, the history of Kegel exercises and what the evidence tells us about when Kegels are and aren't appropriate for our patients.

View the presentation

References[edit | edit source]

  1. Tom Ockler, PT. Trigger point assessment and treatment for Pelvic Floor triggers M 3 Seminar. Available from: http://www.youtube.com/watch?v=cWJwGvFDGLg [last accessed 30/04/14]
  2. Bo K, Sherburn M. Evaluation of female pelvic-floor muscle function and strength. Phys Ther 2005;85:269-282.