Hi friends! One of the missing links of treating pelvic floor disorders is perineal support. Ever heard of it? Many people haven’t, so this week let’s talk about what perineal support is, and how it could help you.
While we are physical therapists, we are not your physical therapist. This blog is intended to be educational but does not replace evaluation and treatment by a licensed healthcare provider.
Let’s start first by talking about why we need perineal support. The pelvic floor muscles, along with many ligaments and bones, help to support the pelvic organs. The pelvic floor muscles play act like a hammock starting at the pubic bone in the front and the tailbone in the back. If these muscles can’t do their job well, we can have leakage of pee or poop, one or more of the organs can start to fall into the vagina (called prolapse), or we can have pelvic pain.
Day-to-day we have forces from above the pelvic floor that push down on the pelvic organs. Our pelvic floor muscles create the force from below to help counteract the pressure from above. The forces from below must equal or exceed the forces from above or the organs will fall.
Perineal supports are things that we can wear that lift from the outside to help increase the forces from below. This can be tight clothing like spandex or garments, like the myPelvic Bra, designed specifically to support the pelvic floor. For many people, supports are the missing link for heaviness, pressure, and leaks when they are active.
Perineal support can help these muscles do their job. Here are 5 reasons why external supports may help you:
#1 Improves Pelvic Floor Connective Tissue Support
The pelvic floor consists of muscles and connective tissue. Things like chronic straining can place excess pressure on the muscles and connective tissue making it harder for them to support our pelvic organs.
#2 Improves Pelvic Floor Muscle Positioning
Perineal support can help to improve the position of the pelvic floor muscles. Often when the muscles are weak or have decreased resting tone, they sit lower or sag. This is called perineal descent. The pelvic floor muscles work more efficiently when they are in the proper position. Using perineal support to prevent this sagging means better support and less leakage.
#3 Improves Peeing and Bladder Emptying
While perineal supports need to be removed to go to the bathroom just like underwear, it can help us to pee more efficiently. When the bladder and urethra aren’t well supported by the pelvic floor, there can be descent especially as the day goes on making it harder to empty our bladders completely and with a good urine stream. Perineal support helps to minimize this descent throughout the day allowing us to pee better.
#4 Less Leakage with Urethra Hypermobility
When the pelvic floor and/or organs sit in a lower position, our urethra (where pee comes out) has less support. This lack of support can cause extra movement with things like sneezing or jumping and this extra motion can contribute to urinary leakage. Perineal support helps to support the pelvic floor and urethra so that you don’t have to worry about stress urinary incontinence.
#5 Prolapse Symptom Support
Pressure, heaviness, or bulging from prolapse from movement, or simply living our day-to-day lives can be draining. Perineal support helps to prevent or minimize the heaviness, dragging, and pressure you feel while you live a happy life doing all the things you want to do!
Perineal supports are typically one piece of the puzzle when managing prolapse symptoms. Pelvic floor muscle training, pelvic floor therapy, estrogen creams, lifestyle modifications, and more can all be helpful. See a pelvic floor physical therapist or occupational therapist near you or join our Power Over Prolapse E-Course to start enjoying the things you love again!
Ready to learn more about pelvic health? Here are some helpful resources:
Find a pelvic floor PT or OT near you at www.mypfm.com/find-a-pt
Order you myPelvic Bra perineal support
Watch Netflix for Your Pelvic Floor at Pelvic Flicks
Watch our YouTube playlist on Prolapse and the PFM
Learn more about the pelvic floor muscles with our book: My Pelvic Floor Muscles The Basics
Sign up for our email newsletter!
Visit our Instagram page for more on pelvic health.
For providers, check out myPFM Academy to learn more so you can better help your clients. With two membership options, you have access to courses, a growing library of patient handouts, hundreds of custom sharable images and infographics, and multilingual resources. At myPFM Academy you’ll find courses like:
External Support: The Missing Link with Jeanice Mitchell PT, MPT, WCS, BCB-PMD
Special Considerations for Hysterectomy and Prolapse Repair with Melissa Stendahl, PT, DPT
Pessaries: What Pelvic Floor Therapists Need to Know with Dr. Amanda Olson, PT, DPT, PRPC
Written by Emily Reul, PT, DPT