Visceral Manipulation and Your Pelvic Floor – Why Organ Mobility is Key for Pelvic Health

Your pelvic floor has many important jobs, including roles in bladder and bowel function, sexual function, and force translation. One of the other important roles, and what I’m going to be discussing more in depth in this blog post, is organ support. Your pelvic floor supports your bladder, uterus or prostate, and rectum. That means pelvic floor dysfunction can affect how your organs are supported, but also that organ mobility and motility dysfunction can affect your pelvic floor.

First, let’s talk about what organ mobility and motility is

We often don’t think about the way our organs move or function unless we have a significant organ specific problem. However, if our organs are restricted in our thorax, abdomen, or pelvis, they can affect the way our body moves and can cause pain, tightness, and other problems.

Organ mobility is the ability for an organ to move and slide against other tissues and structures in the area. For example, if you bend over to the side, your organs and their surrounding tissues (fascia, ligaments, etc) are able to slide, compress, or stretch to accommodate this movement. Your organs are also able to expand and contract to perform functions as needed. For example, your bladder can expand as it fills with urine, then contracts to release urine, then is able to expand again.

Organ motility is the organs own intrinsic motion. Motility is a rhythmic motion that allows fluids to move through the organs, nutrients to be carried to tissues, and waste products to be removed from tissues.

If organ mobility or motility are reduced, patients may experience symptoms such as fatigue, digestive issues, constipation, musculoskeletal pain or tightness, anxiety, and more. Check out this resource from the Barral Institute to learn more.

The pelvic organs and pelvic floor – how they work together

One of the major roles of the pelvic floor is to support your pelvic organs. Your pelvic floor is like a trampoline at the bottom of your pelvis. For optimal function, your pelvic floor should have a nice baseline tension.

If your pelvic floor muscles are weak and disconnected, it’s like cutting a couple springs off of your trampoline. Your organs will not be very well supported. If your pelvic floor muscles are tense and guarded, it’s like tightening your springs and pulling the trampoline taut. In this case, your pelvic floor muscles can’t support your organs well during movement, breathing, or anything that requires the pelvic floor to absorb or translate forces.

Your pelvic floor muscles also work inversely with your bladder and bowels. As your bladder fills with urine, your pelvic floor muscles maintain baseline tension to avoid leaking. When you sit down to pee, your pelvic floor muscles relax and your bladder contracts to release urine. When you have a bowel movement, your pelvic floor muscles need to lengthen as you gently create pressure in your abdomen to push stool out (you also have internal and external anal sphincters that play a role here – but this is really a whole other discussion outside of the scope of this blog!).

During pregnancy and childbirth, optimal pelvic floor function is also important. As your uterus (and baby!) grow, your pelvic floor muscles need to be able to support the increase in pressure. During a vaginal delivery, your pelvic floor muscles need to be able to lengthen as your uterus contracts to push baby out. It is important to learn about your core and pelvic floor so you can best support your body during pregnancy and prepare for labor and delivery! I teach all about this in my online course Birth Ready, and I also work with expecting moms in my offices in the Memphis, TN area and virtually wherever you are!

Why organ mobility and motility matter for pelvic health

I treat a lot of patients in my office for pelvic health conditions including pelvic organ prolapse, urinary or fecal incontinence, pelvic pain, endometriosis, constipation, and more. Regardless of what symptoms you are experiencing, assessing organ mobility and motility is important.

I still assess my patients as a physical therapist as well. This means that I assess their breathing, strength, mobility, and range of motion. If it is appropriate and the patient is comfortable with it, we may also do an internal pelvic floor muscle assessment. An internal pelvic floor muscle assessment can provide valuable information about how you are managing pressure and how your pelvic floor muscles are functioning. However, if you are not comfortable with an internal pelvic floor assessment, please be sure to let your therapist know and don’t be discouraged from seeing a pelvic floor therapist! We can still help you without doing an internal assessment.

During the evaluation, I also do a listening to assess any areas of restriction in the organs throughout your thorax and abdomen. Listening is a gentle technique that helps us determine where tension is being held in your body. Assessing and treating these areas can improve organ mobility and motility, releasing restrictions that may be affecting how your pelvic organs are functioning.

Imagine if your bladder or uterus has restrictions from a previous pregnancy, inflammation from interstitial cystitis, or restrictions from chronic pelvic pain. Your pelvic floor muscles may guard to protect the area of inflammation or restriction. This can cause chronic pelvic floor muscle tension, which can lead to back pain, hip pain, pain with intimacy, and bowel and bladder dysfunction. A pelvic floor therapist may release the pelvic floor muscles, but if the restriction is in the organ, the muscles will likely return to their guarded position.

In my experience, it’s important to release both organ restrictions and muscle restrictions. We then want to add movement, good pressure management strategies, and strengthening for long term results.

If you’re interested in learning more about visceral manipulation, check out my organ mobilization masterclass. If you want to schedule a virtual appointment or in-person at my offices in Collierville or East Memphis, TN, you can do so here.

Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS, PCES