Tom Myers Reviews New Research on Link between Female Urinary Incontinence and Myofascial Dysfunction in Pelvic Floor Muscles

Editor’s Note: Tom Myers is reviewing this abstract: Is there a Difference in Whole Body Standing Posture in Women with Urinary Incontinence Based on the Presence of Myofascial Dysfunction in the Pelvic Floor Muscles? published in Physical Therapy and Rehabilitation Journal, 06 July 2021.

This research points toward a resurgence of biomechanics in the sense of movement efficiency. Previous attempts to link posture to pain have been spotty at best. The problem with most Posture -> Pain studies is that the pain patterns are quite idiosyncratic and individual. Linking researchably similar symptoms with a particular postural measure – in this case, pelvic angle – leaves out so many other relevant factors that it is a wonder that they got the result they did. And more power to them.

Urinary incontinence has been mostly accepted as a muscle strength problem, and occasionally it is. Far more often it is a coordination problem, as Diane Lee has shown clearly. In these cases, teaching the abdominal balloon to respond reflexively, to close all sphincters as one. Efficient movement distributes strain more or less equally over the whole structure.

Postural studies will produce moire-revealing results, I predict, when we have the language and imaging expertise to weigh not only A-P pelvic angle but anterior and posterior shift relative to the feet, various tilts, and shifts in the rib cage and resultant lumbar strain. And finally the hidden cause of many an incontinence, pelvic torsion, where the twists put into the intra-pelvic joints and ligaments – sacrospinous and sacroiliac.

I understand that these long-term postural effects are secondary to the primary assault on women’s bodies – C-section and endometriosis scars, episiotomies, tears, just pregnancy, and so many over-controlled deliveries. Why some women self-repair, while others have lingering effects, is a vital question.

These and other similar topics and experiences will be front-and-center in our Maine summer course, Deeper Ground: Restoration and Vitality for the Female Pelvis, August 7-8. I’ll be teaching and would love to see you there. 

— Tom Myers, Clark’s Cove, Maine, July 8, 2021


To read a relevant post from Tom, check out this link to his article in Massage and Bodywork, Resolving the Wounds of Childhood.