Brittany Mahomes says pelvic floor issues led to a fractured back. Should I worry? An expert weighs in

When Brittany Mahomes recently shared her experience with a fractured back, many of her followers were shocked to learn the pelvic floor is connected to your back.

Mahomes, a former soccer player who has two children with NFLer Patrick Mahomes, wrote on Instagram last week, "Just your daily reminder: Once you have kids please take care of your pelvic floor. Seriously. From: A girl with a fractured back."

Many women go through life not knowing that the pelvic floor is connected to the rest of the body — and how vital this part of their body is to care for, whether they plan to have children or not.

More than 4.8 million Canadians experience some form of pelvic floor dysfunction throughout their lifetime, including incontinence, pelvic organ prolapse or chronic pelvic pain, according to the Physiotherapy Association of Canada.

But what exactly is the pelvic floor and why is it so important? Here's what you need to know.

What is the pelvic floor and how is it connected to your back?

The pelvic floor, a network of muscles, ligaments and tissues, plays a pivotal role in supporting essential organs and maintaining bodily functions; it holds in place gynecologic organs, the bladder and the rectum.

"The pelvic floor muscles hammock the organs inside the pelvis," Marie Eve Nackers, a pelvic floor physiotherapist at Maternal Health Niagara, told Yahoo Canada. Yet, despite its significance and how easily it's affected by everyday activities like weight lifting or standing for a long time, it's often overlooked when we talk about health.

The pelvic floor muscles provide stability and support to the spine. When these muscles are weak or injured, it can lead to pelvic instability and altered posture, placing increased stress on the muscles, ligaments and joints of the lower back.

Compensatory muscle tightness and impaired core stability just exacerbates the problems, putting undue stress on the lower back leading to pain, injury and at worst, fracture.

"Most of us have heard that if you have back pain you need to strengthen your core muscles... They work together to stabilise the spine and pelvis through movements," Nackers explained.

Physiotherapists who've worked in the field of pelvic health for decades have been suspecting a close relationship between pelvic floor muscles and back pain. In 2018, a group of Canadian physiotherapists did a study on 182 women, finding that 95 per cent of them had lower back pain as a result of pelvic floor muscle dysfunction.

"There's social, emotional and physical reasons why these two problems are so closely connected," Nackers said. "Every time your brain perceives a threat, like when your team is about to score and win the match, your pelvic floor will contract."

Many people think that strengthening their core or doing kegels would help protect their back, Nackers claimed, but it's not necessarily true.

"Most of us live with constant stress, with our pelvic floor muscles involuntarily contracting throughout our day," she explained. "If you [do] strengthening exercises like planks, curl ups or even kegels, you'll just keep tensing these muscles and make no difference in your back or pelvic concerns."

How do I know if I have pelvic floor issues? Here are the symptoms

Early signs of pelvic floor injury or weakening begins with urinary symptoms, like frequent peeing, burning or a feeling of fullness even after peeing. However, symptoms can extend beyond that to include:

• Urinary incontinence: Weak or dysfunctional pelvic floor muscles can lead to involuntary leakage or urine, particularly during activities like coughing, sneezing or exercising.

• Pelvic organ prolapse: In severe cases of pelvic floor weakness, one or more pelvic organs may descend or protrude into the vaginal canal, causing discomfort and disrupting normal bodily functions.

• Pelvic pain: Dysfunction within the pelvic floor muscles can contribute to chronic pelvic pain, which may manifest in discomfort, pressure or stabbing sensations in the pelvic region.

• Sexual dysfunction: Pelvic floor issues can impact sexual function and satisfaction, leading to pain or discomfort during intercourse and diminished sexual pleasure.

• Lower back pain: It can also affect the alignment and stability of the pelvis, leading to compensatory movements that strain muscles and structures of the lower back.

It’s important to note that these issues don't just affect women, but men too. "If you have a pelvis, you have a chance to develop pelvic floor muscle dysfunction," Nackers said.

How do you fix pelvic floor issues or injury?

Pelvic floor injuries, Nackers said, are treated like any other muscle injury — with a bit of a caveat.

"To properly assess these specific muscles, pelvic health physiotherapists are trained to do internal vagina or rectal assessment and treatments," she explained. "That's what's usually recommended, but may not be accessible for everyone." When that's the case, external treatment is possible with a few additional sessions.

Physiotherapy can look like performing movements on a mat, sitting and standing, squatting and carrying or lifting things while assessing how much pressure gets put on the pelvic floor. After the assessment, an at-home exercise program will be prescribed, which sometimes involves kegels, an exercise that sees the tightening and relaxing of the pelvic floor muscles.

"Just like a massage therapist releases muscles, we can release and quiet these muscles with very gentle touch during an internal exam," Nackers said. "Most pelvic floor injuries are treated by establishing a trusting therapeutic relationship that's free of judgment and shame — and a lot of education."

A central nervous system assessment is performed after a physical one, meaning the physiotherapist assesses how "feisty" their automatic nervous system can be. "Unfortunately, most of us have been through a lot in our life, making us live in a state of fright, flight and freeze," she said.

"This needs to be addressed with breathing exercises or mindful movement before even thinking of strengthening and doing kegels."

Who should get a pelvic floor assessment?

This kind of physiotherapy is for everyone who has a pelvis, Nackers said, but therapy should start when symptoms of pelvic health dysfunction are noticed. "This means you have to screen for bladder issues, bowel issues, sexual health issues, and lumbar, pelvic and hip pain," she advised.

"The most important thing we can do to take care of these muscles is talk about it, like Brittany [Mahomes] is doing."