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Pelvic Floor Dysfunction

Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

The specific aim of this chapter is to introduce the role of the pelvic floor and pelvic floor dysfunction for arthroscopic and open hip joint preservation surgery patients presenting with pain and functional impairments. Painful pelvic floor muscles may occur as a result of inherent musculoskeletal causes or may be the result of somatic dysfunction occurring in the hip. An overview of the muscles, bones, and nerves of the pelvis and pelvic floor will be presented. Visceral and somatic referral patterns and biomechanical links between the hip, pelvis, pelvic floor, and lumbar spine will be pointed out, in particular in the context of the patient with chronic symptoms and/or increased tone and muscle dysfunction. The reader will be exposed to the epidemiology, pathophysiology, and presentation of pelvic floor dysfunction in order to raise awareness of the pelvic floor as a symptom generator in “hip” pain patients. Patient evaluation, including the pelvic floor examination, will be presented to increase understanding of how to utilize the physical examination to identify dysfunctions and guide in comprehensive treatment planning. Although some clinicians may prefer to refer pelvic floor patients to expert providers, this chapter will provide knowledge regarding the evaluation such providers will perform; collaborative care with physicians and physical therapists treating pelvic floor patients is invaluable in this patient population. Ultimately, knowledge of pelvic floor function and dysfunction will broaden the differential diagnosis for patients presenting with hip- and pelvic-related pain increasing the accuracy of diagnosis and help dictate the most appropriate treatment for these patients.

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References

  1. Maglinte DDT, Kelvin FM, Fitzgerald K, Hale DS, Benson JT. Association of compartments defects in pelvic floor dysfunction. Am J Roentgenol. 1999;172:439–44.

    Article  CAS  Google Scholar 

  2. Prather H, Dugan S, Fitzgerald C, Hunt D. Review of anatomy, evaluation and treatment of musculoskeletal pelvic floor pain in women. Phys Med Rehab. 2009;1:346–58.

    Google Scholar 

  3. Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am. 1998;25:723–46.

    Article  CAS  PubMed  Google Scholar 

  4. Thomas TM, Plymat KR, Blannin J, Meade TW. Prevalence of urinary incontinence. Br Med J. 1980;281:1243–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Nygaard I, Barber MD, Burgio KL, Kenton K, Meikle S, Schaffer J, Spino C, Whitehead WE, Wu J, Brody DJ. Pelvic floor disorders network. Prevalence of symptomatic pelvic floor disorders in US women. JAMA. 2008;300(11):1311–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Butrick CW. Pelvic floor hypertonic disorders: identification and management. Obstet Gynecol Clin North Am. 2009;39(3):707–22.

    Google Scholar 

  7. Hunt D, Clohisy J, Prather H. Acetabular labral tears of the hip in women. Phys Med Rehab Clin North Am. 2007;18:497–520.

    Article  Google Scholar 

  8. Arendt-Nielsen L, Svensson P. Referred muscle pain: basic and clinical findings. Clin J Pain. 2001;17:11–9.

    Article  CAS  PubMed  Google Scholar 

  9. Wallace K. Female pelvic floor functions, dysfunctions, and behavioral approaches to treatment. Clin Sports Med. 1994;13(2):459–81.

    CAS  PubMed  Google Scholar 

  10. Barber MD, Bremer RE, Thor KB, Dolber PC, Kuehl TJ, Coates KW. Innervation of the female levator ani muscles. http://www.ncbi.nlm.nih.gov/pubmed/12114890 Am J Obstet Gynecol. 2002 Jul;187(1):64–71.

    Google Scholar 

  11. Ashton-Miller JA, DeLancey JO. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007;1101:266–96.

    Article  PubMed  Google Scholar 

  12. Bump RC, Mattiasson A, Bo K, Brubaker LP, DeLancey JO, Klarskov P, Shull BL, Smith AR. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol. 1996;175:10–77.

    Article  CAS  PubMed  Google Scholar 

  13. Galletti R, Obletter M, Giamberardino MA, Formica LM, Cicchitti G, Vicchiet L. Pain from osteoarthritis of the knee. Adv Pain Res Ther. 1990;3:183–91.

    Google Scholar 

  14. Isherwood PJ, Rane A. Comparative assessment of pelvic floor strength using a perineometer and digital examination. BJOG. 2000;107(8):1007–11.

    Article  CAS  PubMed  Google Scholar 

  15. Thompson JA, O'Sullivan PB, Briffa NK, Neumann P. Assessment of voluntary pelvic floor muscle contraction in continent and incontinent women using transperineal ultrasound, manual muscle testing and vaginal squeeze pressure measurements. Int Urogyneco J Pelvic Floor Dysfunct. 2006;17(6):624–30. Epub 2006 Mar 11.

    Article  Google Scholar 

  16. Frawley H. Pelvic floor muscle strength testing. Aust J Physiother. 2006;52(4):307.

    Article  PubMed  Google Scholar 

  17. Rogalski MJ, Kellogg-Spadt S, Hoffmann AR, Fariello JY, Whitmore KE. Retrospective chart review of vaginal diazepam suppository use in high-tone pelvic floor dysfunction. Int Urogynecol J. 2010;21(7):895–9.

    Article  PubMed  Google Scholar 

  18. Crisp CC, Vaccaro CM, Estanol MV, Oakley SH, Kleeman SD, Fellner AN, Pauls RN. Intra-vaginal diazepam for high-tone pelvic floor dysfunction: a randomized placebo-controlled trial. Int Urogynecol J. 2013 May 17. [Epub ahead of print]

    Google Scholar 

  19. Markwell SJ. Physical therapy management of pelvi/perineal and perianal pain syndromes. World J Urol. 2001;19(3):194–9.

    Article  CAS  PubMed  Google Scholar 

  20. Sinaki M, Merritt JL, Stillwell GK. Tension myalgia of the pelvic floor. Mayo Clin Proc. 1977;52(11):717–22.

    CAS  PubMed  Google Scholar 

  21. Slocumb JC. Neurological factors in chronic pelvic pain: trigger points and the abdominal pelvic pain syndrome. Am J Obstet Gynecol. 1984;149(5):536–43.

    Article  CAS  PubMed  Google Scholar 

  22. Prather H, Spitznagle TM, Dugan SA. Recognizing and treating pelvic pain and pelvic floor dysfunction. Phys Med Rehabil Clin N Am. 2007;18(3):477–96. ix.

    Article  PubMed  Google Scholar 

  23. Giambernardino M. Muscle pain, referred pain. In: Schmidt R, Gebhart G editors. Encyclopedia of pain: SpringerReference (www.springerreference.com). Springer-Verlag Berlin Heidelberg, 2013. DOI:10.1007/SpringerReference_334843 2012-07-16 14:05:41 UTC.

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Authors and Affiliations

  1. Rush Medical College, Departments of PM&R and Preventive Medicine, Rush University Medical Center, 1725 West Harrison Street, Suite 855, Chicago, IL, 60612, USA

    Sheila A. Dugan

  2. Clinica de Medicina Fisica y Electrodiagnostico (CMFE), Highway #2 Km 133.5 Center Plex Building suite 103, Aguada, PR, 00602, USA

    Sol M. Abreu-Sosa

  3. Buen Samaritano Hospital, Aguadilla, PR, 00605, USA

    Sol M. Abreu-Sosa

Authors
  1. Sheila A. Dugan
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  2. Sol M. Abreu-Sosa
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Corresponding author

Correspondence to Sheila A. Dugan .

Editor information

Editors and Affiliations

  1. Dept. of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane Nho

  2. Dept. Orthopaedics, Hip Service, Schulthess Clinic, Zurich, Switzerland

    Michael Leunig

  3. Caspary Building, Ground Floor, Center for Hip Pain and Preservation, New York, New York, USA

    Bryan Kelly

  4. Department of Orthopaedics, University of Michigan Domino's Farms Lobby A, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher Larson

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Dugan, S.A., Abreu-Sosa, S.M. (2014). Pelvic Floor Dysfunction. In: Nho, S., Leunig, M., Kelly, B., Bedi, A., Larson, C. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_63-1

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  • DOI: https://doi.org/10.1007/978-1-4614-7321-3_63-1

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  • Publisher Name: Springer, New York, NY

  • Online ISBN: 978-1-4614-7321-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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Chapter history

  1. Latest

    Pelvic Floor Dysfunction
    Published:
    19 August 2021

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_63-2

  2. Original

    Dysfunction
    Published:
    24 April 2014

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_63-1

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