Predictors of Pelvic Floor Muscle Dysfunction Among Women With Lumbopelvic Pain

Phys Ther. 2019 Dec 16;99(12):1703-1711. doi: 10.1093/ptj/pzz124.


Background: There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful.

Objective: The objective was to establish a combination of factors (self-report and physical) predictive of PFMD in women with lumbopelvic pain.

Design: This was a cross-sectional study.

Methods: Participants completed a battery of self-report and physical assessments (masked assessors). Three clinical findings characterized PFMD: weakness of the pelvic floor, lack of coordination of the pelvic floor, and pelvic floor muscle tenderness on palpation (bilateral obturator internus). Univariate and multivariate logistic regression analyses were used to determine the extent to which different predictors were associated with PFMD.

Results: One hundred eight women with self-reported lumbopelvic pain (within the past week) were included in the study (mean age = 40.4 years; SD = 12.6 years). None of the examined factors predicted pelvic floor muscle weakness. Two factors independently predicted pelvic floor muscle tenderness on palpation: very strong and/or uncontrollable urinary urges (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.13-7.59) and Central Sensitization Inventory scores of 40 or greater (OR = 3.13; 95% CI = 1.08-9.10).

Limitations: The sample consisted of young women, some of whom were not actively seeking care. Additionally, the technique for assessing pelvic floor muscle tenderness on palpation requires further validation.

Conclusions: Women who have lumbopelvic pain, uncontrollable urinary urgency, and central sensitization were, on average, 2 times more likely to test positive for pelvic floor muscle tenderness on palpation. Further studies are needed to validate and extend these findings.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Catastrophization / complications
  • Confidence Intervals
  • Cross-Sectional Studies
  • Female
  • Humans
  • Low Back Pain / physiopathology*
  • Middle Aged
  • Muscle Weakness / diagnosis*
  • Muscle, Skeletal / physiopathology*
  • Odds Ratio
  • Pain Measurement / methods
  • Palpation*
  • Pelvic Floor / physiopathology
  • Pelvic Pain / physiopathology*
  • Self Report*
  • Urinary Bladder, Overactive