Levator Ani Syndrome - Episode 18
Levator Ani Syndrome, a condition affecting the deepest pelvic floor muscles, is brought to light in this podcast episode. Get a comprehensive understanding of the pelvic anatomy and how dysregulation of the levator ani muscles can lead to various symptoms, from abdominal pain to urinary issues. Discover the causes behind this syndrome, such as muscle imbalances, poor toileting habits, and past injuries. Learn about the diagnostic process involving physicians and pelvic health physical therapists, and explore treatment options ranging from physical therapy exercises to medical interventions. Join the mission to normalize discussions about pelvic health and put an end to silent suffering.
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Dr. Kari: Welcome to the Marone Pelvic Health podcast. Hi, I'm your host, Doctor Kerry Roberts. On this show, we will be discussing a variety of things regarding your pelvic health. These conversations will be a mix of education, personal experiences, and a blend of tips you can apply to have a healthier pelvis. The goal of this show is to normalize conversations around pelvic health and help women stop suffering in silence. Welcome back. So today I want to jump right in and talk about something that I think more people have experienced and maybe didn't know what it was. I have a family member that has this and said, I just get this sharp pain around my anus, and I thought it was just, you know, something for my pregnancy, but I want to dig into it. Let's talk about it. Let's explain what it is and discuss some things that you can overcome it and help it feel better. Okay, so what is Levator Ani syndrome? Before we talk about what Levator Ani syndrome is, I think it's important to talk about what is the Levator ani. So when we think about the pelvic floor, the pelvic floor, or the pelvic muscle. The pelvic floor muscle group is actually comprised of over a dozen muscles. And they sit in the pelvis, in the base of the pelvis, and they are in three layers. So you've got a superficial which is closest to the skin, a second layer, and then the third layer, or the deepest layer, which is closest to your insides. Now, the superficial layer is usually the squeeze muscles they give us. They help us control our bowel function, our bladder function. They also help us with our sexual function. And then that third layer, the deepest layer inside, is known as the levator ani. So when those muscles contract, yes, they elevate the ani, or they elevate the anus. Yes, they do. But they also give a lot of support for those structures, and they contribute a lot with bladder control, excuse me, bowel control as well. So levator ani syndrome is when your levator ani muscles, or your deepest layer of your pelvic floor muscles have some sort of dysregulation, or they're just not proper functioning the way they should. Some muscles are kind of overactive, and they're turning on all the time. You can almost think of it as having a muscle cramp, like a Charley horse or. Yeah, a muscle cramp in those muscles. Now, what, what are some of the symptoms of levator ani? Well, it's the deepest layer of our pelvic floor muscles. So anything that's related to pelvic floor activity could be impacted. So you could experience abdominal pain, because abdominal growing pain works right there with the pelvic floor. You can have pain with intercourse, pain with your monthly cycle. You can have some sort of dysfunction or pain with sex after you've had a baby. It can present as si pain or back, back hip girdle pain or si joint dysfunction. You can have postpartum pain. You can have rectal pain, which is pain right at the rectum, testicular pain, vaginal pain, you can experience chronic constipation, you can have urinary issues. You can also have bladder pain. So pretty much anything that goes with the pelvic floor, you could potentially experience it. A lot of people experience a cramping or a sharp shooting, almost like a lightning pain deep around the anus. Some people experience this kind of like a constant ache throb, which is more chronic. And other people experience it where it's a sharp shooting pain for moments, and then it dissipates for who knows how long until it comes back again. Now, what causes it? There are a lot of things that could cause it. Think about a muscle. If you have a cramp in your calf after you've run a mile, what causes it? Maybe you didn't stretch properly. Maybe you weren't properly hydrated. Maybe you didn't warm up enough. Maybe you've had an old injury, so it's easy to be inflamed. Those same principles can occur with any muscle group, including the pelvic floor, including the levator ani. So if you're not getting that proper blood flow, maybe you're not. That blood flow is impaired for some reason. Maybe you've had another injury that's impacted the blood flow. Maybe you've got some inflammatory spot response going on. Maybe you've got some upregulation with your sympathetic nervous system. So you are carrying a lot of stress. Therefore your pelvic floor is carrying a lot of stress. Maybe those muscles are inherently shortened, they're in a shorter state, or they don't have the range of motion that we would like to see. We could also refer that as that to them being tight, or maybe they can't generate the power that they need to, which we would say is a weakness. You don't have the strength you need. Maybe it's got plenty flexibility. The range is good, maybe the strength is perfect, but maybe it's just not turning on and off properly, or it's not working. It's not playing with others well. And that is what I like to call when things are not. When they are. Shoot, the word just jumped out of my head when it lacks coordination. So muscles have to work together. So some will turn on, some will turn off this. One will help the other, the other will help the third, and they all kind of work together in harmony. Well, when that harmony is disrupted on the muscle level, that presents as disorder or as lack of coordination. So all of those things contribute to having this. Now, some things that can contribute to heaviness are, if you don't have proper habits when you're using the restroom, maybe you, your stool is constantly loose, so you're constantly kind of clenching for that bowel control, or maybe your stool is very hard, you have chronic constipation, so you're constantly bearing down on those muscles. Either one can kind of be leading cause for this or something that can be a risk factor for this. If you don't have proper toileting habits, usually those are things that are ingrained in us as children. If you have a history of hemorrhoids, again, that is with that mismanagement of the pressure bearing down when you're having a bowel movement, it could be something that runs in your family, or you could have some other sort of injury. Now, you usually will go to a physician, or you can go to a pelvic health physical therapist to be be diagnosed. I can't speak to exactly what physicians do, but what I can speak to with pelvic health is that we will do a full assessment head to toe. Look at all of those muscle groups that interact with the pelvic floor if indicated. And if you give permission, we will do an internal assessment to actually assess the pelvic floor on the inside. And then we can properly say if it's a muscle imbalance or things like that. Once we know what it is on the physical therapy side, now we can create a plan to help tight muscles get range of motion, to help weak muscles get stronger, to help not coordinated muscles learn how to work together in its simplest form. That's what we can do here. You can also do other things medically through your physician. Sometimes you have to go to a pelvic pain physician to get injections, or you get pills, anti inflammatories, muscle relaxers. There are creams that you can apply, suppositories. There's a wide variety of things I like to say. I use this podcast so we can normalize the discussion, discussion of pelvic health issues. So that people can stop suffering in silence. Nobody wants to walk around saying, oh, I feel like I've got a lightning rod right at my rectum. Nobody wants to experience that. But there are professionals out there, and we want to help you get out of that pain. So if you have been chatting with moms, sisters, cousins, friends who, whoever, and they've said something like this, maybe you can share this with them or maybe you've experienced it yourself. I would love to be able to help you find help. Be it with me in person in the Atlanta, Georgia area, virtually. I do virtual visits or helping you find someone that's closest to you. So I hope this was helpful and I will be back in two episodes with another episode. Thank you for listening to this episode of the Morone Pelvic Health podcast. Please do me a favor and leave a review so that more people can find this content and make sure you like and subscribe yourself so you never miss another episode.